322 4TH ST - ROOF tr-
h le
o' /- - 5, CITY OF ATLANTIC BEACH
. -.4;,.... . 800 SEMINOLE ROAD
`ir _ ` "" ' 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-1164
Job Type: ROOF PERMIT
Description: RE- ROOF SHINGLES ONE SIDE OF DUPLEX
Estimated Value: $6,970.00
Issue Date: 5/19/2016
Expiration Date: 11/15/2016
PROPERTY ADDRESS:
Address: 322 4TH ST
RE Number: 169815-0150
PROPERTY OWNER:
Name: WILLIAMS, BRADLEY G & LESLIE P, *
Address: 1505 ALGONQUIN AVE
GENERAL CONTRACTOR INFORMATION:
Name: PREFERRED ROOFING LLC
Address: 2332 DUNN AVE QA ROLAND KEVIN GREEN
Phone: - -
FEES:
BUILDING PERMIT FEE $84.85
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $88.85
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233 // _n
Office(904)247-5826 Fax(904)247-5845 1 l0-ROOT" i \G'�/1
3Z91.-1
Job Address: Permit Number:
Legal Description CEsc Y1' 1�C.Q M. K78S let's–ck.041 Miontic' pg.0 Parcel T 60
(RIO
Floor Area o q. t. Sq.l•1
Valuation of Work$ (, `V�I Proposed Work heated/coolecaebe) non-heated/cooled $.27a0
Class of Work(circle one): Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial •- denti
If an existing structure,is a fir sprinkler system installed?(Circle one): 'es (CIO N/A
Florida Product Approval# tJQ)rl�. IS4U�• ,
For multiple products use product approvalform
Describe in detail the type of work to be performed: ?1'V "�y,�
"C."
Propert Owner Information: /j�/� J
Name: �4 i 1 VII a V &Address: 4th'
City i I. A a :.' O. AS Stat:4 Zip ' _ Phone'r U#. 1'7 r
E-Mail or Fax#(Optional)__
Contractor Information: y��
Compo r e d- Qualifying Agent: lIV1,Li 1►� V�
CAddrompe: a�Ilt/l City !� ms's State Zi
Office one i I-CI Job Site/Contaumber Fax# 1j 5 `'-(a(�0
State Certification/Registration# 13ct4gg84
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 Work,Plumbing,Signs, Welts,Pools.Furnaces,Boilers,Heakrs,
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 hate read and examined this application 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 nen presume to give outhorny to violate or cancel the
provisions of any other federal,state,or local law regulating consr`nction or the performance of construction.
Signature of Owne, G� Signature of Contracto \,
Print Name (.4--)////46,11–S 9,6\04\6
Print Name ,, C7' e
Swo o and subscr bed ttefore me Swor to and subscr'bed be ore me
this#4• Day of (I [l t .20 I Le this Day of I-ih . _ _ ,20
W/
N ary P tic Not lie
Revised 01.26.10
Notary Public State of Florida
gyp, Meagan Wolfla
My Commission FF
14a 0d' Expires 02J18/2020982745
Notary Public State d Florida
f'> N. Meagan Wollia
My Commission FP 902148
' w Expires 02/18/2020
Jv )
Doc # 2016110167, OR BK 17563 Page 1478, Number Pages: 1, Recorded
05/16/2016 at 04:20 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
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To whom It may concern'
The undersigned hereby Informs you that Improvements wig to made to certain real property,end si
accordance with Section 713 of the Florida Statutes.the following information is stated in this NOTICE OF
COMMENCEMENT. y'�(�2 [�[�
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Name at persan•;:stir tf-r Slaw of ...„ --- — .—
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documents:r= t`a served•
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addition It nrtself.o-.•.T•.er:ea_nates ow ruro•.•:,ne person to receive a xrpy of the ije ors Notice as oro•:i:te.et
Section 7121.05 12)tut.Ftore ttatuter•.:Fiat in at 0,nor 5 Ot;inn
Name
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Phone No. _Fex
Expiration date of Woke cf Commencement 4tne expiration date i,ens l t?year tram the ere of rap:otng rffht5.3.a
different date is spaufieer
THIS SPACE FOR RECORDER'S USE ONLY ( Q,,,,pIER
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tojeto, Notary Pubic Stals of Florida
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AI My Commission ion FF 992745
EKDifssAmle/2020
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