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418 SKATE RD ROOF 2016 ! ! 40 j y 1 J'J , f r \ s, CITY OF ATLANTIC BEACH �. J 800 SEMINOLE ROAD �`° r ATLANTIC BEACH, FL 32233 t)l INSPECTION PHONE LINE 247 -5814 \JF11>'" ROOF PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814 JOB INFORMATION: Job ID: 15- ROOF -559 Job Type: ROOF PERMIT Description: REROOF fl 253.3.1 Estimated Value: $8,240.00 Issue Date: 3/12/2015 Expiration Date: 10/12/2016 PROPERTY ADDRESS: Address: 418 SKATE RD RE Number: 171558 -0000 GENERAL CONTRACTOR INFORMATION: Name: SCHULTZ ROOFING COMPANY INC Address: 216 N 20TH ST QA DOUGLAS ARTHUR SCHULTZ Phone: - - FEES: BUILDING PERMIT FEE $91.20 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $95.20 I 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: `� 1. `2 5 Ka + e R o cxc� Permit Nu ber: Un, � f� Lot / Legal Description 31 1 1 , S .cj l We Pr Ao t K- � tvParcel # l 7/56'R-0000 , J ay© Floor Area of Sq.F't. Sq. t Valuation of Work $ `a Proposed Work heated/cooled non - heated /cooled Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door Re. (boo+ Use of existing/proposed structure(s) (circle one): Commercial Reside i, If an existing structure, is a firesprinkler system m tailed? (Circle one): ' es No N /A Florida Product Approval # FL a 5 "3 "3 , For multiple products use pr uct approval form Describe in detail the type of work to be performed: 1emrn/� eic � s n 5 LOLL) e i ` + 5 A, n3 L roof ci,d(L. i OS -U C e.r -- c i..,4e2 A I- 14 ash c . 5 13_S 0100 -6-Pd 3 tt Property Owner Information: �n Name: �, n ', c -- For - 5 t Address: 1 1 3 8 Se- `` ua m � net Dr - City -M-t &rvb'c_ (earls- State FLZip 32233 Phone q 0 y - a 4 1 - cf c 2. E -Mail or Fax # (Optional) Contractor Information: L Company Name: c U 1 z_ 001 �� n9 1 • Qualifying Agent: � 6� ' a 5 P - S L.J. -t- 52 Z-. Address: 1(p a.0 . City � 2 .� ckSonU Ili CL � t ate F t Zip Office Phone gOL( - ",k -a315 Job Site/ Contact Number , ci - CO( ?) Fax # a 4 1 - 3 'o & State Certification/Registration # C C. C... 0 3 (p a g ° l 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 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. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo 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 placation 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 provisions of any other federal, state, or local law regulating construction or the performance of construction. s 1 ' a , illik,_ — Signature of Owner , .. A I _ ' • ..4 w ignature of Contractor Print Name _.7...1...0. 1 Q LdLQ. l�.l . . ._.. t J...._�- _ . Print Name 5 . .. Z..._._.__...._. J Sworn tq, and subsc �•� d ' before me Sworn to and subscribed before e this - Day of ' ` 20 / (' • �1 Day of , 20 /CE ROSE/AWE t:, PERRY - 1 N • ary Public . ...v.:: my autism r FF gone ' Notary Public ROB i EXPIRES: January 5, 2020 MY I:OMMiSSIQN 0 EF 4 DLt +f , ' !ended lbw Notary Mk lMdevrGNS . 't ' '' i AiRed it , ` NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. State of County of 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: 3 i - I to V1 . s - a9 6 P T o gex a Q - Pod m s l —L a-4 1 s B(K Address of property being improved: LA t B .S k� a c/ is' 4 P ( 3 22 - 3 5 General description of improvements: et- (ZOOS Owner t l \ Son Tip r,cc �h Address 1 g ' U ok. (Y1 a.C (N_Q D T . 14=t-1. L Bch 3zz 3 3 Owner's interest in site of the improvement Fee Simple Titleholder (if other than owner) Name Address Contractor S C4" u--1 • 00 0 CO • ._ITn C Address (-(� N c�-� �-�- • ;T p d , r- r 3 22-5-6 Phone No. 90Y o2S1(Q pc 3 /S Fax No. 9 L/ 7- 3 802 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 provide 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 •\ OWNER (--( ` 1 `- I' J, j/� Signed: V i tip ay k 4 JJ3V\ � td DATE Before me this — of in th County of Duval, Stat- of Florida, has • - sonally appeared rc �, herein by himself/ herself and affirms that all statements ani declarations herein Doc # 2016084763, OR BK 17528 Page 397, are true and accurate Number Pages: 1 Recorded 04/15/2016 at 09:10 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL e / C.P4 COUNTY I v I RECORDING $10.00 Notary Public at Large, State of •_' My commission expire I '+ "''• • ROS •IEC.FtNHT T • • n�L'" or Personally Known I.:�"': _ Produced Identification s�r•��orx�"�