1991 Mipaula Ct - ReRoof ss CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J v� 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: 16— ROOF -12
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $10,900.00
Issue Date: 1/5/2016
Expiration Date: 7/3/2016
PROPERTY ADDRESS:
Address: 1991 MIPAULA CT
RE Number: 169506 -1032
PROPERTY OWNER:
Name: GRIFFITHS, HARRY JOHN
Address: 1991 MIPAULA CT
GENERAL CONTRACTOR INFORMATION:
Name: WHITE'S ROOFING COMPANY, INC
Address: 14262 PLEASANT POINT LN QA TIMOTHY HOUSTON
WHITE
Phone: - -
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $104.50
Total Payments: $108.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
r� NOTICE OFCOMMENCEMENT
State of t iy Q i County of D L ■j a Tax Fo1i 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 COMMENCEMENT.
Legal Description of property being improved:
`' -'-J.10. No k.fe UN, f Or /
'
Address of property being improved: '1 U • t .
General description of improvements: k , .
V
Owner: _� CA N L S S . . Address: \19 Poor () a.k1 \ O.— C-1— 1 f 1 ►3rh - Fi 33x33
Owner's interest in site of the improvement:
Fee Simple Titleholder (if other than owner):
Name:
Contractor: ` m
m 0 n m m z 0
Address: ,J —f 1, o z CD a m
z • N -0 8
Telephone No.: � ( t-( a 1r) :-, Li L. • Fax No: • ro o o
T o — Ell
Surety (if any)
o m o
Address: Amount of Bond $ o o cu
Telephone No: 55 3-
Fax No: c 0 z■
Name and address of any person making a loan for the construction of the improvements o
n a,
o - u
Name: 0 u Lu
Address: 0
0
c
Phone No: y
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
7I3.06(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:
Date: //5 / 6
_ _ _ a _ Before is �; day of�r 0/ . in the County of Duval, State
,av p'o, DEBBIE J. BITTER= _
o_ a
rsonalOf Florida, has perslly appeared"'' ■
„, .. Notary Public - State of Florida ly KnoHan: Q+Ne Sae,...) (� j
~ ' ,n s Produci�ic'Tde`ntification: or
* . = My Comm. Expires Dec 12, 2017 —
I tf * iii . Qc I Not Public: a, j. 0. R.O.
F . ` �: Comm # FF 058465
II ""%‘`,T.‘" " Bonded Through National Notary Assn. ( My commission expires: -
fl r -11
i Pi
1
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"1 ■ QCt 0 1 G e(2)0.(s-k- Permit Number:
Legal Description 3� - Q9 p g - d 5 -- act E X Vet, (Ja z ' e p ON if DNS
F oor Area of Sq.Ft. Sq.Ft
Valuation of Work $ IOgc.c Di ' Proposed Work heated /cooled
non- heated /cooled
Class of Work (circle one): Cew Addition 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): Yes No N /A
Florida Product Approval # FL P190.3 0,sdtR w.ti+t FL6o2
For multiple products use product approval form
Describe in detail the type of work to be performed:
i A IL.'
' . .. ..e t / '
Property Owner Information:
Name:
I t it Al -T s k i State F Zip Address: 11 q) in . I pat) i& CA-. A I gC.1, F L
E -Mail or Fax # (Optional) p - Phone o Sq - (p 19 ' (b' 1 L
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Naine: L() ht - r r 100C� LI Co Qualifyi Agent: gnt: •T tit cry (,t,
Address: JU? P)e�ISR -1- I- ���
Office Phone p ) City J 141-)C State f / Zip 3,32,,t.5 r� �aa S 1 40 Job Site/ Contact Number Fax #
State Certification/Registration # CL-0O58 0/ 7
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 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 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 Electrical 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.
I hereby certify that I have read and examined this a plication and know the sane to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
1
. 7 \p*
Signature of Owner .1.� Signature of Contracto `-
Tint Name (� / ,
�.Dt..4....c J at 4 .. �rl, 4- Print Name I i /h rrti .. W L . 4
.........
3efore me • Before me - -
his 5 Day of t„ , ��, , : BIE J. R T��ji this 5 Day ofd 4 • _ DEBBIE J. RITTER
, �,��,AY F HB - , ,•C • • , • :� •
t (• lb. • o `• - Notary Public - State of onsa ,2017
' �. 1.. ' 2 * ' •` „ Comm. Expires Dec 12, 2017 I L, .. i 1� ; • = My Comm. Expires Dec 12, 2017
lotary "'ubltc r Commission # 1, f+ "�� Ursl .���* # Ir r' ion # FF 058465
°,`,`,: ` Bonded Through National Notary Assn• otal'y ' � bliC o, ��� O,, , ,, Bonded Through National N
,,
• � Notary Assn.
Revised 01.26.10