1969 W SEVILLA BLVD ROOF PERMIT 'rf yLIJI
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 INFORMA71ON:
Job ID: 16-ROOF-1821
Job Type: ROOF PERMIT
Description: remove and replace existing roof
Estimated Value: $10,850.00
Issue Date: 8/10/2016
Expiration Date: 2/6/2017
PROPERTY ADDRESS:
Address: 1969 W SEVILLA BLVD
RE Number: 169462-0370
PROPERTY OWNER:
Name: KOSUI ET AL, JANETTE
Address: 1969 W SEVILLA BLVD
GENERAL CONTRACTOR INFORMATION:
Name: BURGER ROOFING CO.
Address: 134-1 E ERNEST ST QA GARY G. BURGER
Phone: -
FEES:
BUILDING PERMIT FEE $104.25
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $108.25
PERMIT IS APPROVED ONLY W ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax,(904)247-5845
Job Address: 1959 W Sevilla Blvd.Atlantic Beach FL 32233 Permit Number: ( Id' C00 F- i I a l
Legal Description 45'70&2&29E SEVILLA GARDENS UNIT 02 LOT 23 parcel 111 169462-0370
Floor tea of eq.Ft Sq.Ft
Valuation of Work S 10.850.00 Proposed Work heated/cooled no a-heated/cooled
Clean of Work(eirele one): New Addition terafion Repair Move Demolition pool/spa window/door
Use ofexifioglproDDoaedptrurture(s)(etrck ane)., Commercial idrnti w�
If an existing three hre,n a firesprinkler system Installed?(Circle one): o C
Florida Product A proval#FI 1 OR74-R9
For multiple proSacts use propro uet�approval form
Describe in detail the type of work to be performed:REMOVE AND REPLACE EXISTING ROOF
Provers,Owner Information:
Name:JANETTE KOSUT Address:1969 W SEVILLA BLVD
City An.ANne BEACH Stme--ZIP 122W—Phone aodasseea:
B-Msil or New#(Optional)
Contractor Information:
Company Name: BURGER ROOFING CO Qualifying Agent GARY BURGER
Address: 134 ERNEST ST City JACKSONVILLE Slate FL Zip 32204
Offiec Phone 904-355-2756 Job Site/Contact Number 904-237-9664 Fax# 904-358-0733
Slate Cerlification(Regisnffiion# CCCO32514
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Tide Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
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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 Y6M NOTICE OF
COMMENCEMENT.
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OW F 2016184321,OR BK 17667 Page 2347,
Number Pages:1
Recorded MiO/2016 at 11:44 AM,
Forms Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00 PERMIT NO.:
NOTICE OF COMMENCEMENT
To whom it may concern
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance
with Section 713.13 of the Florida Statutes,the following information is stated in
this NOTICE OF COMMENCEMENT.
Description nfproperty(169462-0370) 1969 W SEVILLA BLVD Atlantic Beach FL 32233
45-7 08-2S-29E SEVILLA GARDENS UNIT 02 LOT 23
General description of improvements REMOVE AND REPLACE ROOF.
ownerJANETTE KOSUT
Address 1969 W SEVILLA BLVD Atlantic Beach FL 32233
Owner's interest in site of the improvement FEE SBvIPLE
Fee Simple Title holder(if other than Owner)
Name
Address Address
\1 corrector BURGER ROOFING CO.
Y\ ddress 1341 ERNEST ST,JACKSONVILLE, FL 32204
Surety(if my)
Address Amount of Bond
Name of person within the State of Florida designated by owner upon whom notices or other
documents may be served
Name
Address
In addition to himself,owner designates the following person to receive a copy of the Liemses
Notice as provided in Section 713.06(2)(b),Florida Statutes(Fill in at Owner's option)
Name Address •- //�
Notary Sea;EXPRES:
unty
vown Sigoa u e
T1� f osw
Pratt Owner Name
MONIFF Sworn to d subscribe efore me thisNIB$IIXSIWUp75eJd714,2m7 ,2016
VuarilaaGaylsn ed
Notary Public