1756 LIVE OAK LN ROOF PERMIT CITY OF ATLANTIC BEACH
ss1
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-1334
Job Type: ROOF PERMIT
Description: RE -ROOF , SHINGLES
Estimated Value: $12,600.00
Issue Date: 6/10/2016
Expiration Date: 12/7/2016
PROPERTY ADDRESS:
Address: 1756 LIVE OAK LN
RE Number: 172020-0200
PROPERTY OWNER:
Name: CAWRSE TRUST, LEONARD M
Address: 1756 LIVE OAK LN 1756 LIVE OAK LANE
GENERAL CONTRACTOR INFORMATION:
Name: PRO ROOFING & ASSOCIATE
Address: 10752 DEERWOOD PARK BLVD APT 100 QA ELMER
ANTONIO CAMPOS
Phone: - -
FEES:
BUILDING PERMIT FEE $113.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $117.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
S BUILDING PERMIT APPLICATION
:J
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
Office: (904)247-5826 • Fax: (904)247-5845
I6-Rao -, 1 334
Job Address: J Q�k Y� q h�� bt4�Permit Number:
Legal Description Je�1�A MiAIJ nq U G L A t3uG ( ( RE# / 702 0oV —4:p* !/
Valuation of Work(Replacement Cost) $ 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): Commercial Residential
■ If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No N/A
■ Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: kc<, [2DIC- W(4-i-,
Florida Product Approval# �q A0ap
for multiple products use product approval fonn
Property Owner Information
Name: yi
r Address: l L
ak L
City State C Zip;_Phone r
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:
Name of Company: Qualifying Agent: e
Address: 3 S ; City Ut` �f�State Zip 3 7�(o S
Office Phone 40 S Z— S9Job Site/Contact Number
State Certification/Registration# 2' X E-Mail
Architect Name & Phone#
Engineer's Name& Phone#
Worker's Compensation
xempt Insurer Lease Employees 7 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 jurisdi
This permit becomes null and void if work is not commenced within six(6) months, or if construction or work i nded or abando e fo
period o{six(6)months at anytime after work is commenced. I understand that separate permits must be secur f ectrical Work,Plum ing,
Signs, [fells,Isools,Furnaces,Boilers, eaters, Tank and Ai Conditioners,etc.
Signature of Property Owner: ignature of Contractor:
Befoe
this43 Day of �t......t ii Before Yne this a of o
Notary Public: ��' ••`; 11aary Public:
MY comm.Expkw
7� - oas.zote
I hereby certify that I have read and examined this alicd7}o W' otic theSame to be true and correct. All provisions of laws and
ordinances governing this type of work will be com d ivith°whether spesi ied herein or not. The granting of a permit does not
presume to give authority to violate or cancel the proi'lsjN bf any oderal, state, or local law regulating construction or the
performance of construction.
Rev. 3/14/16
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. J-7
State of County
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. yy
Legal description of property being improved: 5c L�� Qw" VIA (,(6 LZ
Address of property being improved: 2"10e
General description of improvements: �,rl�✓d
Owner
Address 1777�G�
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner) h
Name AJIA
Address
Contractor 2f,e Rgdl,-,4XLk/h f/I
Address ®'<1 A2tsr°�—
y*Qd 15W4 ® " tIC. 35b
Phone No. 4Ki • S qa •�0, Fax No. `197 5,19--5963
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 67�/p
E
Jam/�.r"v`r.` � /r� TE
Signed: in the
Before me this day of
C unty of Duva e of Florida,hasp somi arpepred t
herein by
Doc#20161 5426!,OR BK 1X569 Page 629, himself/herself and a irms t a s � s,aod,, �ns herein
Number Pages:"I �
Recorded 05,120/2016 at 09:58 AM, are true and accurate eij ,• 'Q
Ronnie Fussell CLERK CIRCUIT COURT DUVAL j4Comm.Expires
COUNTY oct6.201e
No.FF 24a, ;y
RECORDING$10.00 TARY
PUBLIC
Notary Publi ar ,state of Cod f.
My com on xp r %%
Person own ! t or
Produced Identification r