690 AAQUATIC DR - ROOF Js # J�t�
s f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
+� r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
4
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2720
Job Type: ROOF PERMIT
Description: RE-ROOF
Estimated Value: $3,200.00
Issue Date: 11/20/2015
Expiration Date: 5/18/2016
PROPERTY ADDRESS:
Address: 690 AQUATIC DR
RE Number: 171818-5230
PROPERTY OWNER:
Name: METZGER/MCWHIRTER, *
Address: 690 AQUATIC DR
GENERAL CONTRACTOR INFORMATION:
Name: JUSTIN LARSEN CONSTRUCTION INC
Address: PO BOX 1942 LIC # BELOW 4 GERALD GOLLOBIT
Phone: 904-327-4311
FEES:
BUILDING PERMIT FEE $66.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $70.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
I
get BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
I CJ• �R
no F-z-720
Job Address: ,'/ 1, , _ _ i .. 1-__: 2
-_-_ Permit Number:
Legal Description 38'- / /7 •?s- fir' ��/6-C Parcel#
Valuation of Work$ Prorea of Sq.Ft. q t
,/ posed Work heated/cooled non-heated/coolecl
Class of Work(circle one): New • I'i ion Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): , No N/A
Florida Product Approval# .o r / ,
For multiple products use pro uct approva orm 6i Artie,
Describe in detail the type o work to be performed: ge - gocf Aff 5
Ad fie /03611) -Kt- 1„ ,K,,,, . ez /
o
Property Owner Information:
Name: Address:
City State_Zip Phone
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
..--.Company Name: . _, w -_ /A I ;sin Twc-• Qualifying Agent: 3 -V jr$e, .
Address: 7d i P I d ��n' us "'�
�t S1ru-k• City mme„Inu.r State pi_ Zip 3,.. (263-..
Office Phone 9D'- 3a.- 93/J Job Site/Contact Number 9 p6-2,28.6/ 0 Fax#
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certifr that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void f work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a_period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for ElectricalWork,Plumbing,Signs, Wells,Pools, Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
7 hereby cert fy that I have read and examined this a placation and know the same to be true and correct. All provisions laws and ordinances governing this
type ofwork will be complied with whether specified herein or not. The granti of ng of a permit does not presume to give authority to violate or cancel the
9rovisions of any other federal,state, or local law regulating construction or the performance of construction.
signature of Owner - W •— S
o /
ignature of Contractor --$-�� ,_,1„
'rint Name ��,; ,�„ '�,,,,� l '\-
�� 4 Print Name ��Ili ft, ,r
3efore e Before me �/
'arse Day /NOW1- this 5 Day of /`1P �' luf
II�ir,►.�". Lam__ ,"A\''."*",..rNO SAGITfA L MOWN ,•*►'w 4 SC�TI�CEA RSEN
`� ,a: ;,; MY COMMISSIONIFF�410 ' '-' `1 MY COMMISSION#FF022491
Iota 1 Public ' ` �b E EXPIRES.September 3,2017 Notary Public
i"4.'7:•7bc• gonaea Tl ru Plot�ry Pubic UndKwi�n .., a�,,,� EXPIRES May 30,2017
—•++_ taryService.com I40 eOd 0 1 Flp[o
N':.1)11[CIE OF COMMENCEMENT
State of 7/�'!'i( t_ County of ��
��r,��1 ___Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF C_OMMENC MENT.
Legal Description of property being improved: 3? 7/ //;�5- 29A 4,.... .. C.,,. /4-c
Address of property being improved: ,• 1 � j � X3 3
General description of improvements: f&- .
Owner: Ais a (?JL L,.//pI/ Address: ofn Le SI e /4/ , ,:L it „3 ,233
Owner's interest in site of the improvement: 4fZ:,
Fee Simple Titleholder(if other than owner):
Name:
C tractor: f_ f_,.e.gl�� j, �r
., + f i.L
Address: 4► (' �, {j'free / �� , •,'
Telephone No.: 70Y :337_ •_•3l1 Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
•
Phone No: Fax No:
Name of person within the State of Florida other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
. Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1) year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
•
Signed: d -ti. Date: i t ` J _. J
{�slit:,:'%y'•,, SAGITTA L ANDERSON Before me this 5 day of t2!' in the County of Duval,State
; MY COMMISSION#FF 898410 Of Florida,has personally,appeared
;� �it EXPIRES:September 3,2017 Personally Known: V 4/'iii 0 p�oA _itivp, or
,::: d' Bondod ENS: PubCc Undererten Produced Identifi•.Non
�- .. .pry Public: P ��i' ��3Q,�._....�
Doc#2015259064,OR BK 17365 Page 684, :ommission ex pi Number Pages:1
Recorded 11/12/2015 at 08:37 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00
Page 1 of 1
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:OQ tNE pAp .y,
J
�
1/4J ,, Print Date:
#'" 11/12/2015 8:37:24 AM
Transaction#: 2911338
Receipt#: 2830812
Cashier Ronnie Fussell
Date: 11/12/2015 Clerk Circuit Court
8:37:23 AM (ARIVAS) Duval County
501 West Adams St RM 1051
Jacksonville, FL 32202
(904) 255-2000
Customer Information Transaction Information Payment Summary
DateReceived: 11/12/2015
Source Code: BEACH
J. E. LANSEN CONSTRUCTION INC Q Code: BEACH
() Over the Total Fees $10.00
Return Code:Counter Total Payments $10.00
Trans Type: Recording
Agent Ref
Num:
1 Payments
CHECK 1227 $10.00
1 Recorded Items
BK/PG: 17365/684 CFN:2015259064
f (N/C) NOTICE COMMENCEMENT Date:11/12/2015 8:37:13 AM
From: CAMPBELL MARIA COLLEEN To: J E
LANSEN CONSTRUCTION INC
INDEXING 2 $0.00
RECORDING 1 $10.00
10 Search Items 1
10 Miscellaneous Items
file:///C:/Program%20Files/RecordingModule/default.htm 11/12/2015