1671 BEACH AVE ROOF PERMIT % #U.\ .
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
r
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-1 390
Job Type: ROOF PERMIT
Description: RE- ROOF
Estimated Value: $19,000.00
Issue Date: 6/16/2016
Expiration Date: 12/13/2016
PROPERTY ADDRESS:
Address: 1671 BEACH AVE
RE Number: 169658-0000
PROPERTY OWNER:
Name: GAY TRUST, SHIRLEY W
Address: 1671 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: B. SMITH ROOFING, INC.
Address: 13525 SAWPIT RD QA SMITH, BRIAN EUGENE
Phone:
FEES:
BUILDING PERMIT FEE $145.00
STATE DCA SURCHARGE $2.18
STATE DBPR SURCHARGE $2.18
Total Payments: $149.36
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL cTTV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Permit No. NOTICE OF COMMENCEMENT
Tax Folio No.
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
I. Description of property (legal description of property and address if available):
1671 Beach Ave, Atlantic Beach, FL - 15-10 09-2S-29E .240 - N ATLANTIC BEACH UNIT 1 PT LOT 15
2. General Description of improvements:
Re-roof J <�Att�tc
, -5 j�,
3. Owner Information:
a)Name and Address: Adam & Jenice Dunayer- 3309 Caruth Blvd, Dallas, TX 75225
b) Interest in property:_.General
c)Name and address of simple titleholder (if other than owner):
Contractor Information:
a)Name and Address: 3;�
b) Phone Number: !jaL4_ 5,
5. Surety Information:
a)Name and Address: Doc#2016136634,OR BK 17600 Page 138,
b) Phone Number: Number Pages:1
Recorded 06/16/2016 at 10:47 AM,
c) Amount of BonF. Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
6. Lender Information: RECORDING$10.00
a)Name and Address:
b) Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a) 7, Florida Statutes:
a)Name and Address:
b) Phone Numbers of Designated Person:
8. In addition to himself/herself, Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713-13 (1) (b), Florida Statutes.
a)Name and Address:
b) Phone Number of person or entity designated by owner:
Q Fxniration date of Notice of Commencement(the expiration date may not be before the completion of construction
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 6-R cx::)f---13 ) 0
Job Address: 1671 Beach Ave, Atlantic Beach, FL Permit Number:
Legal Description 15-10 09-2S-29E .240 -N ATLANTIC BEACH UNIT NO I PT Parcel# Lot 15
Floor Area of Sa.Ft. Sq'Ft
Valuation of Work S 1%0 m-00 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial
If an existing structure,is a fire sprinkler system installed? (Circle one). 1140
Florida Product Approval # A-� 10 04.1 � FL. �,�2 33
For multiple products use product app-roval torm
Describe in detail the type of work to be performed: Re-roof 4) SjLble& Jh.c.4-5 ;1 itsquptcs
Property Owner Information:
Name: Adam &Jenice Dunayer Address: 3309 Caruth Blvd
City Dallas State TXZip 75225 Phone
E-Mail or Fax 4 (Optional)
Contractor Information:
CompanyName: -Qualifyi Agent: 6(tpo 511�4
Address: 13,52-5 50,�p,-4 9U city y4l)e State Zip_3;,7a4
Office Phone 104-3-ro-6604 Job Site/Contact Number 90L4-LJ"�- 6"3-l'& Fax# clotI_3-0106
State Certification/Registration# Q),491Z
Architect Name & Phone#
Engineer's Name & Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commencedprior 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 abandonedfor eriod of six(6)months at any time after
work is commenced I understand that separate permits must be securedfor Electricar 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.
lhereb certify that I have read and examined thisia plication and know the same to be true and correct. All provisions of laws and ordinances governing this
"r c e hereinornot. The granting of a permit does not presume to give authgritylto violate or cancel the
typ e o7work will be complied sr e I A
provisions of any otherfedera 9 construction or the pe�formance of construction.
Sianature of Owner
C.) Signature of Contra&-Rr
Print Name Print Name /-3,-;A-,7 , 7
.......................................:.5�
....................Nalro D y-ey........................ ...7.. ..............................................................................
Sworn to and subser' ed before me Sworn to and subscribed before me
this_t� Day of A;r. 1 204- this iq Day of 120.14
A
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Notary Pdblitt' kokafy Pliiiie
LISA L.REAGORRevised .26.10
DU
PEGGY LOUISE STOWERS V`� commission#FF 144354
tote of Texos
Nototy Public.S
Expireq Nrwember8,M8
My Commission Expires A 385
B-ded T�;.NY i6.awim WA85-701 9
FebruofY 19, 2017 E.�