800 Bonita Rd roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NE)lT DAY INSPECTION: 247-5814
308 INFORMATION:
Job ID: 16-ROOF-2574
Job Type: ROOF PERMIT
Description: RE ROOF, SHINGLES AND TPO OVER FLAT ROOF
WITH 3/4" INSULATION BOARD
Estimated Value: $7,000.00
Issue Date: 11/17/2016
Expiration Date: 5/16/2017
PROPERTY ADDRESS:
Address: 800 BONITA RD
RE Number: 171100-0000
PROPERTY OWNER:
Name: BROWN, ELGIA
Address: 800 BONITA RD
GENERAL CONTRACTOR INFORMATION:
Name: ANDERSON BUILDING RESOURCES
,CCC1328282
Address: 15410EDARBAYRD QA DAVID SAUL ANDERSON
Phone:
FEES:
PLAN CHECK FEES $42.50
BUILDING PERMIT FEE $85.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $131.50
PER*[rr IS ApriurvED ONLY IN ACCORDANCE WITH ALL CM OF ATI,ANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Departmient (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida 32233�5445 IG - Roor-ZS74
Phone(904)247-5826 Fax(904)247-5945 4—1-5�
E-mail: building-dept@wab.us Date muted:
City web-site: http:/hvnw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:8100 D M ant review required Yes No
11
Ad$
Applicant: :Plan—ning &Zoning
Tree Administrator
Project: C— QPOF - zs�4 (ADGtf�� Public Works
Public Utilities
Public Safety
Fire Services
Other Agency Review or permit Required 'low=I'll Date
of permit
Florida Dept.of Environmental Protection
FI orida Dept.at Transportation
it.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
-6ther:
APP��ATION STATUS JDenied.
Reviswing Department First Review: _Approved.
(Circle one.) Comments:
PLANBUILDING
ZONING Reviewed by:_ Date
TREEADMIN. Second Review: DApproved as revised. E]DenieclY
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ElDenied.
Comments:
Reviewed by: Date
Revised 06114M
OFFICE COPY
BUILDING PERmrr APPUCATION
CITY OF ATLANTIC BEACH
800 Semisole li Atlantic Beach FL 32233
Uri Office:(904)247-5826 - Fax:(904)247-5845 16-Roov_ zs-74-
Job Address: R'0 Pennit Number:
Legal Description L 04 to DM4 I R-A I A IM 1941 00 OIDZ)6
_L2LL_
Valuation of Work(Replacement Cost)Z2006--11--tedlCooled SF Non.Heated/Cooled
• Class of Work(Circle one): New Addition Attention epair Mow Drum, Pool Window/Door
ComI —
• Use of existing/proposed structure(s)(Circle one): arcut I Ce-AS�
• If an existing structure,is a fire,sprinkler system installed?(Circle one): Yes No <U�
• Submit a Trec Removal Permit Application if any Irma are to be removed or Affidavit of No Tree Removal
Describe in debit the type of work to be performed: ":�;,�-(L '/I Z_ 15L-0ev-
-T,45.4 9 A)".) R0041 30vr /,CA rb, maio i3mr) -1-N mfdfl,'� mAl
Florida Product Approval# IiI 5k;410�; 111VORI-1 TPD for multiple Produce,use prudwo uppo,witl for.
Property Owner Inforriarlation OV(? 5411 lt�_60("�vx
Narne� &: 19;4 j9rOVol Address: 800 &0 ;1r,
E-Mail 411A .state pZ2,�Phone ql7Z-
Owner or Agent (if Agat,Powe,of Attum�or A�rca,r Requient)
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 NOTffE OF COMMENCEMENT.
Contractor Inforinagion. "t
-*I- / Quali gAgen0lall 4k.4
Name of Cornpru U'4',4
Address: /5 1 I'DV-P Ma. , -)W,V __ ity Stadd Zip
Office Phone ' ql�W-719�7 - C1 7Q-j` Job SitetContact Numbeir
State Certificationlittigistraficin# 137W 97 E-M ai I &am r.WX-7 P 7 7'
Architect Name:&Phone# Al //I
Engineer'sNarnc&Phone# 11/111
Worker's Compensation r-:,ZvK q
E.amin J I.surar J .Empiyees I Expiration onto
Afflication is hereby made to obtain a permit to do the work and installations as indicated I mrsti,that no work or installation has commenced
9 or to the issuattes aft;fermi,and tha,all work will be nerfOrmed to rem,the standard,afall lAws rghodad.
hispernotbecannestudIturdeanI ismactemne."d.0hin g conservelum to thisj.ddien
Sir 3( months,or li'masurruadme.1 wark ur gminfird or abandenedPr a
'od
months at am,time after work is nommenced. lundersta thaimparate,seradits must be securedfor NedricalWarkplum Ms.
ours,Furnaces,SoMe M H s,T mufAir Czmdhdmn�de.
Signuture of Property Owner� isnatmofContractor.
Before me
thi.14 Dwv� f- e me thig of tl) P_M 60, .2 Olt.
NotaryPubli-� nfjql?�� Notary Public: n 0 r_'I 0
Q U
I hereby cerrify that I haw read and counined this application and know the same to be true and correct. Allpronsions oflaves and
ordinances joiwrwl� ot-nol. 7h,granturF.fapernutdoesnoir
g this tipe ofivork will be complied with whether sjuec�,d —
presume to gi,e out Orin io i Wart �)? nin� /tht,pi�)s i�u)a.s oft, rontiruction 0,the
performance afeanstructiQ
......n, .016 NOERSON MY coiNISSION I FF W201e,.3/14/16
Myo)WISSIONIFFX02 EXPIRES Aural 24 20
EXPjRES:AugW124,2019
NOTICE OF COMMENCEMENT
Permit No / (PREPARE IN DUPLICATE) TICE-COPY
7axpaioNo.- QF
State Of e,_ Courayd—jxau
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.
L I d ption of Property bet intprov.d:
1-or.K f- . �
N", 05M I--/ I
4,4'�.44 I
Address of p I
ro,e�lbeing Improved Bgwt
EL 9213
General description of Improvements: -r-n a IF
owner VP0 L4/
Add 14211 ;'k
Owners Interest In site oftho improvement P-j2�5:,E&L, e
Fee Simple Tipehold (Votherth owner)
Nar
Address
Contractor A Doawja�a,
Add:7 -jrkA �-e- 72 ?18
Pho No. Fax No.
Surety(W any)
Address ount of bond
Phone No. Fax No.
Name and address of any person making a Ims,for the consmucflon ofthe improvements.
Name /J 0 01
Address
Phone No. Fax No.
Name of person within the State of Fiords,other than himself.designated by owner upon whom notices or other
documents my be served+
Nam Vflf
Address
phone W. Fax No.
In addition k,himself owner designates the blk�ing Person to receive a copy ofthe Lienor's Notice as provided In
Seaton 713 (2)(b),Florklat Statutes.(Fill in at Owners option).
Nam�TOW%
Address
Phone No. Fax No.
Expiration dals,Of Notice ofCommencement(the expiration date is one(1)year from the date of recording unless a
diffievent date is specified):
THIS SPACE FOR RECORDER'S USE ONLY
by
Doo#201626D7541.OR BK 17775 Page 1633, hi.W wff..� M.In
Number Pages:I w.sAs
Recorded 11/1412016 a 02.20 PM. A, %Ai
Ronnie Fusselt CLERK CIRCUIT COURT DUVAL EXPJRES!AUguljZ4,20j0
C � T
OUNTY OVO ""Norystrik"
RECORDING$10.00 C� P,.I s=�!
N9 - cRustorn,"""
MY=L&w
�=Mx�Knwn
P1,xW.d
Florida Building Code Online Page 2 of 2
OFFICE COPY
Praditt Approval Mil Method!1 Option D
Date S.Ramittored 02/14/2016
Date Valldirad 02/16/2016
Den Pending F�Approval 02/17/2016
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