226 POINSETTIA ST - ROOF tp
111
CITY OF ATLANTIC BEACH
• 800 SEMINOLE ROAD
j r� 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-1784
Job Type: ROOF PERMIT
Description: re-roof shingle to shingle
Estimated Value: $2,600.00
Issue Date: 8/5/2016
Expiration Date: 2/1/2017
PROPERTY ADDRESS:
Address: 226 POINSETTIA ST
RE Number: 170573-0010
PROPERTY OWNER:
Name: KERR, MICAHEL &VALERIA, *
Address: 1119 E PEREGRINE CIR
GENERAL CONTRACTOR INFORMATION:
Name: HAMMER TIME ROOFING
Address: 13465 SOLEDAD CT DR ANTHONY BETANCOURT
Phone: - -
FEES:
BUILDING PERMIT FEE $63.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $67.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH AL1. CITY OF ATLANTIC BE.AC11 ORDINANCES AND T IIE; FLORIDA
BUILDING CODES.
AO'1''"V. BUILDING PERMIT APPLICATION
',.--'\
CITY OF ATLANTIC BEACH
K:)J V. 800 Seminole Road,Atlantic Beach FL 32233
-,..4.9;11_:)9r• Office:(904)247-5826 • Fax:(904)247-5845 _
I 6v Roo r _ 1`783
Job Address: a PO,n 4,c4 c Si-. Permit Number:
CoS�'-C7
Legal Description 10-I to lb- aS - 3 g L Ikta�( Sr( 3 S1/3 KE# I t o T.7 c>000
Valuation of Work(Replacement Cost)$ ,,S D Heated/Cooled SF Non-Heated/Cooled
■ Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed struc e(s)(Circle one): Commercial esidentia
• If an existing structure,is a fire sprinkler system installed?(Circle one): e o 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: n I / /� i )
emovc A30�p.1k Shu n.s1ea) 12r ` /kxi 1I c`ec t< / rt( - irc c
Florida Product Approval# Fl /007 1 - -�7 Sh,"y' for multiple productsJuse product approval form
FC /5-O/6. i-kb
Property Owner Information
Name: Anneb (`�'s Address: 'a as P.t)5'+•4 p. a3-.
City /-1'�Ict,.t�,( t r{ecac k State_Zip 3' 3 Phone
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: } m -r r' / !xe 4Cl'(_.(_e Qualifying Agent: /1r t0vl.� �` n(OLt f7
Address: l3xI(9`i %rCadi -\- City -yttck5ov2vt)1c State Zip F( 3aa
Office Phone Job Site/Contact Number
State Certification/Registration# C( l32`3 q.$3 E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation p.
Exempt / Insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work and installations a standards of all laws regulating traction in this jurisdiction.
This permit becomes null and void if work is not commenced within six(6 months, or if construction or work '. s spended or a, n•.ned for a 6 s
period}six( months at any time after work is commenced. 1 understand that separate permits must be secur:d fo Electr, , / /Plumbing, 2 8>4
igns, Wells,Pools,Furnaces,Boilers4\AAAO
eaters, Tan a;Id Air Con itioners,etc. " w g
oQa�
Signature of Property Owner: ,' A 1 Signature of Contractor: �" ttd
Before me .
this��Day of J U I< Zp-m I'6 Before me th' `— D f ' _ �.
/ I i i '?ice
Notary Public: ,a u,u, PE GARCIA otary Public: CZ''� ... `
a .� 1' Notary Public State of Florida
I herebycerti that I have react i" 'T:f7 th . '' % 'Q*fir FF 75 a same to be true and correct. All provisions of laws and
ordinanes governing this type r i't4',, •.' bMY A'• • •.t Ill '►heti'mom
eci�ted herein or not. The granting of a permit does not
presume to give authority to vw r , . - ederal, state, or local law regulating construction or the
peifonnance of construction.
Rev.3/14/16
1
•
•
NO'ff'IICIE ®IF COMMENCEMENT
State of- 70(;d C County of
Q Tax Folio No. p
To Whom It May Concern: Q
The undersigned hereby informs you that improvements will be made to certain realro ertY,and in accordance with Section 713 of
the Florida Statutes,the following infonnation is stated in this NOTICE OF CO
P P
L'egal Description ofproperty being improved: MENCEMENT.
1.i S S-C 3 s r s
•
Address of property being improved: 0
General description of improvements: a - — : C
Owner: A A A , be T
Gin
Owner's interest in site of the improvement: Address: t)a a if)
57L, 4c6eac 6
•
Fee Simple Titleholder(if other than owner):• 3 -5)
IPkX Name:
•Contractor: ,,� m p
• Address: i3 y6 SJ f eda C( ,--
Telephone No.: / ��..
Fax No: mooxzo
Surety(if any) `" o 8
Address: x,--1_n`D a-, N
N c) o)
Telephone No: •
Amount ofBond$ czi -c-",`?, �,
Fax No: o p g- —
Name and address of anyperson making a loan for the construction of the improvements
O m�
o xo 0
x� xi
Name:
o w
Address: n w -
—•
V
D
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Phone No:
Fax No:
lame of person within the State of Florida,other than himself,'designated by
:rued: Name: o caner upon whom notices or other documents may o gi
Address: D
r
. Telephone No:
Fax No:
addition to himself, owner designates.the following
3.06(2)(b),Florida Statues. (Fill in at Owner's option) person to receive a copy of the Lienor's Notice as provided in Section
Name: •
.
Address:
Telephone No:
Fax No:
iration date of Notice of Commencement(the expiration date is one
ified): (1) year from the date of recording unless a different date is � �
SPACE FOR RECORDER'S USE O
OWNER
Z .•
Signed: 1.1n
Before me this �►, - Date: _
Of Before
Florida,has personally a day A1,._._. b '
p Y ppeaed 'L,a.t m•a ,. �. ..).,, e
Personally Known: J!'.5���:• GUADALUPE GARCIA I
a
Produced Identificatio,• I. mins �,�, I '4Att Notay Puiiic-Stan of Florida I
Notary Public: -0,..1._..„.... i: t ommiaaion e FF 14136,75S
My commission expires: L Expka Doe 25ms I
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