1898 SEA OATS DR ROOF GARAGE PERMIT ,` f-S r��`J f.
�� ► '` S, CITY OF ATLANTIC BEACH
, .. J 800 SEMINOLE ROAD
' ATLANTIC BEACH, FL 32233
si
J� INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-1188
Job Type: ROOF PERMIT
Description: RE-ROOF GARAGE - SHINGLES
Estimated Value: $3,300.00
Issue Date: 5/24/2016
Expiration Date: 11/20/2016
, PROPERTY ADDRESS:
Address: 1898 SEA OATS DR
RE Number: 172020-0584
PROPERTY OWNER:
Name: ZIEVIS FAMILY TRUST, *
Address: 1898 SEA OATS DR --
GENERAL CONTRACTOR INFORMATION:
Name: HAMMER TIME ROOFING
Address: 13465 SOLEDAD CT DR ANTHONY BETANCOURT
Phone: - - — —
FEES:
BUILDING PERMIT FEE $66.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $70.50
PERMIT IS APPROVED ONLY IN ACCORDANCE Will I ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
J ri""''`'''-iBUILDING PERMIT APPLICATION
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;; � CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
..:�rl;if�r Office: (904)247-5826 • Fax:(904)247-5845 1
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Job Address: tc& lS Sea b i Permit Number:
Legal Description 3(�-aoOcl-)S- C 5duo, I i1paG.m-i9 Nk�a1LjRE# 1136 0 - o 56 Li
Valuation of Work(Replacement Cost) $ 3,300 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): Commercialesntia5
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yidees No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
/ n
Describe� in detail
Jthe type of work to be performed: Oe .} t ._ Jo t as?
Ile• KBE. lle✓Yt,5VI ir,si 'S Ae,„ L „,,i,(10-1 .4- / 4-L 51,1,4(5
Florida Product Approval# Rl 1OL)+A I 1 /ti 11y)c).l -R 0 for multiple products use product approval form
Property Owner Information
Name: So1n 2 iio S Address: .9'S Sco. Cbl e,
City 41-ha Vic (Seoe k State 1/.Zip a a 33 Phone (C o(-l' qI 1-f 5'` ('9 L Li
E-Mail
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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.
Contractor Information: De//�� 14
Name of Company: j- vnvi Titre Kcok LL C QualifyinQualifyingAgen : /4t/ 6n�1 n cava'
Address: 3` L 5 sleC ck- City jack6&snOi 1 • St;3te Zip 3/2 t1
Office Phone (ck ck-011LI--q-1 L1G Job Site/Contact Number 1
t.
State Certification/Registration# t'_C C l 32qE-Mail
Architect Name & Phone #
Engineer's Name & Phone#
Worker's Compensation
Exempt / Insurer / Lease Employees / Expiration Date
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 a ended o abandoned for a
period of six(6)months at any tinge after work is commenced. I understand that separate permits must be secur: . Electri„J' ork,Plumbing, -
Signs, Wells, Pools, Furnaces,B,filers,Heaters, Tanks and Air Conditioners,etc. ,l
Signature of Prope mer•
:::e:nt
P-A1 Da _ C. `v
0 _
Notary Public: QS_ L i —..— Not,* ' .. ' • — • Ma +`
41. TONT GIND VERGER . NYC. 1 ION � 1 ,. .
I hereby cerci =f ,4''
•' vewttzotl16* . •. .. th appli ation and know the ,,,r-z,44.!.0 tr . • ,1 1g I zszons of laws and
ordinances g .:,-,sfhise : .: cow:(iv ,`de ' mph,d with whether spec i °ine }Q : f . of a permit does not
presume to g e'., " ••'ritjtaadtria . alio 0, th , •: 'isions of any other fe.-t;,c.,::...r.._–.:_.....e—re_.___• • J onstruction or the
performance
Rev.3/14/16
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 11a Oaf `C 8 1L�
State of \-10(i 0 L\ 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. q
'
Legal description of propertybeing improved: r o`0 CA- S-a I F
4jc ( )a(\no, (J,nA °1 tof 1 g)ka
Address of property being improved: \gn SM Oaks 04,•
/001an'-tc. kczc'h ) CSL 5>)33
General description of improvements: gt (44:70C. v C `� At>;[ c,rAGtSZ
Owner 3-0\-\n \C-VCS
Address 10'\% Seq OcAk_5 4JriOr1L f ctch PZ, 323-33
Owner's interest In site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address �j
Contractor 'r^mt( \ Nnc In :n LI L 11
Address 1340 Soltc�a� C.A JGtc�5onUi kk- f'� 3a0gJ
Phone No. (./CA CA1 tO - 9‘)1-19 Fax No.
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 \ OWNER ,
Signed ).I . _ �A
Before ',this - day of VL• I► in the
County• •uval,State of Florida,has person:Ily appeared
Doc#2016116399,OR BK 17572 Page 110, ( -4-7 O r n t 4.4- hereto by
himself/ and affirms that all statements and declarations herein
Number Pages: 1 are true: urate
Recorded 05/24/2016 at 09:04 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTYIQIN SPERGER
RECORDING$10.00
Notary Public at Large.State o t 3: .ounty of' ICu1LTl'Li:'.1�'ION#FF 924951
My commission expires: " �: "" .• !ober 6,2019
Personally Known a ` "'t;,`.' Bcndsd Thar NogghPubtc Underwriters
Produced Identification t.�' Sa <d s::�.�..• ,j