825 CAVALLA RD - RE-ROOF �, S, CITY OF ATLANTIC BEACH
"N 800 SEMINOLE ROAD
1)1" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2887
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $5,395.00
Issue Date: 12/14/2015
Expiration Date: 6/11/2016
PROPERTY ADDRESS:
Address: 825 CAVALLA RD
RE Number: 171681-0000
PROPERTY OWNER:
Name: FASON, BARBARA D
Address: 825 CAVALLA RD
GENERAL CONTRACTOR INFORMATION:
Name: QUALITY DISCOUNT ROOFING LLC
Address: 1794 ROGERO RD QA RICHARD BRIGGS
Phone: 904-396-5000
FEES:
BUILDING PERMIT FEE $76.98
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $80.98
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: C" ('La. , I VA 112C1,Athv -iC. CC C1 32C63Permit Number:
Legal Description3i-Its NP eC?)--F.ctil I Rills MParcel# P I tie 1-0000
00 Floor Area of q.l•t. Sq.Ft
Valuation of Work S 5 Proposed Work heated/cooled la non-heated/cooled 1.3/3
Class of Work(circle one): New Addition Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial
If an existing structure,is a Amsjirtn.ider system installe ?(Circle one): es No N/A
Florida Product Approval#1cC4, Phi 00 Qct ci..-15a11D
For multiple products use product approval form
Describe in detail the type of work to be performed: Qert100L ( \c .je ekst,cdn - ;vac ci tGk. 12ena;I
decd (ter Ott cZt pYtcc. w■4'(1 cx4A) 1 fry sh,r5ve all yv.ctre s --1C '.L/
Property Owner Information:
Name:43Grtarxt. R-.A r1 Address:R95 (1G,v2iia eeto),f/533
City PNLtflrrtC i CSC ti StateFLZip�Phone
E-Mail or Fax#(Optional) n(c
Contractor Information:
Company Name:S_. a. A- 1 k `-ara is L • Qualifying Agent: *i
Address: 3) r,.Jgl City • •Vu I ' State gt Zip
Office Phones•4-3'I(o- i a' Job Site/Contact Number 19 lv- 5Z'rLYJ Fax# BI)- 0-� 9
State Certification/Registration# ( l? PFi
Architect Name&Phone
Engineer's Name&Phone# /Tl
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 certify 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 if ff work is not commenced within six(6f months,or if construction or work is suspended or abandoned for o_pe o p f�(6 montrhs at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, 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.
Ihe by certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
t of work will be hether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any of rfederal,slat or local law regulat nsrructton or the performance of construction.
Signature of I . �-.sL ` � Signature of Contractor ,,/�
Print Name irk ca SC)n Print Name /c>_ x�-f 2.6,6 l'�v
Sworn t d subsc ' •d before me Sworn to and subs 'bed before me
th' Day of ( 415_ this Day of • 20
Notary Public Or Notary • • tc
Revised 01.26.10
•
;;;'p• SHEREE J.CARUSO „e SHEREE J.CARUSO
Notary Public State of Florida ;2°; „` Notary Public State of Florida
•: � ;•= Commission# FF 227615 g• •E Commission # FF 227615
My Comm.Expires May 5,2019 %N;����o My Comm.Expires May 5,2019
,,' "`'' Bonded through National Not Assn. O o F��°,,`
„���,,, oug Notary Bonded through National Notary Assn.
Doc # 2015283088, OR BK 17397 Page 95, Number Pages: 1, Recorded 12/19/2015
at 10:38 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
(PREPARE IN DLIPLiCATE)
Permit No. Tax Folio No. i,.1j...‘ae.1
State of Florida County of T.">:,i•,.VOOI
To whom it may concern:
The undersigned hereby Informs you that improvements will be made to certain real property,and in
accordance with Section 793 of the Florida Statutes,the following Information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:
RJPc4 Pr DP- t
A .
Address of property being improved: R'.';'t V."(.>• 'ttA'ACtr‘4
;75....!o2 3•3
General description of improvements: Re-Roof
Owner 1.--cx„t-3cr),
Address 5- ("1.1,Ja I(a .
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner).
Name
Address
Contractor Quality Discount Roofing LLC,
Address 3481 St.Augustine Rd.Jacksonville,FL.32207
Phone No.904-396-5000 Fax No.886-329.-6692
Surety(if any) J/fk
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name Al
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
Phone 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 Statutes.(Fill in at Owners option).
Name
Address
Phone 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):
....... 0 0:: o *re :
'47 CS1
THIS SPACE FOR RECORDER'S USE ONLY °wNtEcr'
DATE 1 4-1 (3. ta,
asfofe rose. day of -Tee/rUVI-;*:Zi'i' In the zog
County cfAzy.el,Stata of FloriOt has personalty appeared u es >4
hAti:aq. herein by
Milne%herself and affams that all statements and declarations herein
are tnia and seculate ;.`s
•
oefltiN
e / ?e' .$ .P7
1 e
4mg40,
ho pry Public at Large,stetvbf^
My wrarnlealon expires:too 1 4
' N:stoo,,j.
or . ,ikte
Personally4ncr4n.,
rreiktret.1 ktrentrr4los o
1