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2106 S Fairway Villas Ln - ReRoof ,..,i_t\iv, s ". CITY OF ATLANTIC BEACH .,. , __ j 800 SEMINOLE ROAD �� 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 -294 Job Type: ROOF PERMIT Description: REROOF Estimated Value: $7,000.00 j Issue Date: 2/8/2016 Expiration Date: 8/6/2016 PROPERTY ADDRESS: Address: 2106 S FAIRWAY VILLAS LN RE Number: 169398 -1030 PROPERTY OWNER: Name: LEBEL, JUDITH Address: 2106 S FAIRWAY VILLAS LN GENERAL CONTRACTOR INFORMATION: Name: ALPHA AND OMEGA BUILDER OF JACKSONVILLE INC Address: 6943 ORIELY DR S Jacksonville S Phone: 904 - 755 -2086 FEES: BUILDING PERMIT FEE $85.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $89.00 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: ;40 (0 (-C� r VI t 143 L 4 Permit Number: ha trip. -taco rci� +o tq e .e ' Legal Description its t , it a rV "� , 39 '- - �2_a.Nd �Z19 • Parcel # Valuation of Work $ 1,00c • (10 Proposed Area o q. t. q. t Proposed Work heated /cooled non - heated /cooled Class of Work (circle one): New 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 # F L g71a • 1 1. . For multiple products use product approva orm Describe in detail the type of work to be performed: R p 1200 -c Property Owner Information: Name: rtM-< 41VA f ro e -e-,A (ts Address: I ($ t 1-} K« S GUM.. t r l j City c< Sc AU I State({ Zip _ 3 hone00‘fj "7 1() L. 65 1 E -Mail or Fax # (Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: Or- Uv ∎cy.k il,,. . v � � r eXIQualifying Agent: Address: IA `f 3 0 r -1 'c- 1 i CZ r (�' gc).w%Ilk- State Pic. Zip 34 .1 ® Office Phon�o ) �11 b — pyry Job Site/ Contact Number 9uy) 71 L„ po,, -t,q Fax # !o C.... 31 /-7 State Certification/Registration # GCC 13 3$ s( a-0 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 'Fork, Plumbing, Signs, Wells, Pools, urnaces, 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 same 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 7rovisions of any other federal, state, or local law regulating construction or the performance of construction. signature of Owner 1 Signature of Contractor 'rint Name /`g ) ti]1 d. Kos + a e-e Print Name 5 �..e.r ,-cs S 1 3efore Be • a e his ,..y o_ twat yI/ r , 20`' this Da a ._ . P ,,k_diek._ � �'� COMAAtIssiow # FF • 1 11 " lot • ' ' ubl ; % JONATHAN BOTT ' � ,+o PIRES : 6, 2019 Notary Public Commission # FF 146109 /) �4 , , Expires July 29, 2018 I r ' ; pF `• Bonded Tluu Troy Fan Insurance 800- 385 -7019 Revised 01.26.10 _ iw NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. State of p•r , County of bUi/4 1 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: Z'�� �� ,R-4 e r IS i} 7/ .A.4 vdet. � Address of property being improved: 79 i? 1 & &J f2 •3- 33 General description of improvements: g e_ — {2c'a 4 Owner Address ,. of Owner's interest in site of the improvement Fee Simple Titleholder (if other than owner) Name Address Contractor AA 1 ,1.4 44, 0 ■v�c� � c 4• b 4a t n L Address L M' O A' S c' i ( c , 3 2 21 0 Phone No.`I r, b —O a ` 9 Fax No. 1 3 f 1 "1 Surety (if any) Address Amount of bond $ Phone 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 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 Owner's 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): THIS SPACE FOR RECORDER'S USE ONLY c O NER q Signed: DATE 4 th / / l $ Before me this " 5 da of f>ratlAkve.( County of Duval State of Florida, personally appeared in the N/a t t a lA (%} le-Las herein by himself/ herself and affirms t are true and accurate r +�tc�WL BRANDI MCKINNON Doc # 2016028927, OR BK 17454 Page 831, ' A. Commission # FF 004720 Number Pages: 1 Recorded 02/08 /2016 at 02:31 PM, y +r Expires Apnl 3, 2017 Ronnie Fussell CLERK CIRCUIT COURT DUVAL 9orwTi.uToy Fain Insurance moJar >701e COUNTY # • /' RECORDING $10.00 No ary Public -t Large, State of Irxi , County of • v(' My commission expires: 6 410 aGi Personally Known or Produced Identification f'pL- g930-- - 30N -O