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Permit Roof 28 Sherry Dr 2012 CITY OF ATLANTIC BEACH sy 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00001824 Date 12/17/12 Property Address . . . . . . 28 SHERRY DR Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 17600 ---------------------------------------------------------------------------- Application desc reroof ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HARBA LLC EXCEL ROOFING CONTRACTING 1775 SELVA MARINA DR 2368 SANDY RUN DR N ATLANTIC BEACH FL 32233 MIDDLEBURG FL 32068 (904) 463-3438 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 140 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 17600 Expiration Date . . 6/15/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 10 STATE DBPR SURCHARGE 2 . 10 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 140 . 00 140 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 20 4 . 20 . 00 . 00 Grand Total 144 . 20 144 . 20 . 00 . 00 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: a"5 '!5R L f V-Y Y)K k kJ ," Permit Number: Legal Description L cr- ) 'SS'I– 'T q Parcel# oor Area of Sq.Ft. Sq.Pt Valuation of Work$ 1 q. LOO - roposed Work heated/cooled non-heated/cooled f - IZO©r-- Class =Class of Work(circle one)`--New---A-Mition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): ommercial , Residential If an existing structure,is a fire sprinkler system nista e ne): Yes No N/A Florida Product Approval # (-=h For multiple products use product approval form Describe in detail the type of work to be performed: jee- 1�e)6f Z5 14t14,64C ff&& 5drneC-= Pro a Owner Information: Name: PAM ti4RAddress: 113' 6ft� Y D& VE City <J& Statef?_ Zip 31�33 Phone E-Mail or Fax#(Optional) Contractor Information: Company Name: G`$CE1- KWRNN �56 Qualifying Agent: J� 'Z�Sc�rC�%I�SEGI Address: 4'`1u14K City Ae, -�4c— State FL-- Zip kff Office Phone qb q-(G3l -7 bW 3 Job Site/Contact Number .SF c q Fax# State Certification/Registration# Cee_ 112,1.9© 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 ape rmit 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 ofsix 6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work, 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. l hereb certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordi antes governing this type of work will be complied with whether sped led herein or not. The granting of a permit does not presume to give th ity t violate or cancel the provisions of any other federal,state, or local law regulating construction or the performance of construction. Signature of Owner Signature of Contractor g Print Name .4L .... .Tt�?..z. '.?'.... ............................................... Print Name ..5.,.�.�T....Jl..��E►15 E✓1................................................... .. BeforTe 7 Before 20 this I Day Q s 20 i-. this _ Y PUBLIC OF FLORIDA SME Notary Public Comm#EE071938 s t n jJ: ; o loll t s l�)P4PAlS510N�D 957760 E�hea 3/812015 1 it� r,s,s,Februa 14,201 Revised 01.26.10 "> sande.i 4,u NofarY public U iderwnters Ht i,cr'c NOTICE OF COMMENCEMENT State of A ar.\ta 41 County of V)U /Y}L Tax Folio No. 1 -76-7 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 , �, _ ::5/ I 7Z Address of property being improved: r '� '` '( 4 t taw General f r description of improvements: i P P �.- �'�_«:e,�'� � 4 a ori/,,r„_xz Owner: 'A v4 1.-(. _ Address: i'11 3 Owner's interest in site of the improvement: 8 t� Nc t�''� FG 7�rti3 3 Fee Simple Titleholder(if other than owner): Name: Contractor: Z:>o'� €;.,a?, w Address: 5-'7 ]� d n q�K50�a rL 34 I A' Telephone No.: (0 31-74,4, lj Fax No: Surety(if any) Address:_ k / Amount of Bond S Telephone No: Fax No:_ Name and address of any person making a loan for the construction of the improvements Name: _ I _ Address:_ r 1A_ Phone No: 77 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: h Telephone No: ax 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:lC n & Date: / ` 17-/� Before me this jn day of_ 4�-. in the County of Duval,State Of Florida,has personally ppeared Personally Known: or Produced Identification: Notary Public:_ Doc#2012287985,OR BK 16184 Page 1035, My commission expires: Number Pages: 1 *ftil:xOes3t8=5 Recorded 1211 T2012 at 09:57 AM, .HM FIJI I FR CI_FRK CIRCt lIT COHRT fit IVAI COUNTY RECORDING$10.00