539 Pelican Key re-roof permit CITY OF ATLANTIC BEACH
r s) 800 SEMINOLE ROAD
6 ;5 ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
rt
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
IOBINFORMATION:
Job ID: 16-ROOF-2706
Job Type: ROOF PERMIT
Description: re-roof
Estimated Value: $5,000.00
Issue Date: 12/5/2016
Expiration Date: 6/32017
PROPERTY ADDRESS:
Address: 539 PELICAN KEY
RE Number: 172027-5584
PROPERTY OWNER:
Name: KAROL, CAROL ANN
Address: 539 PELICAN KEY
GENERAL CONTRACTOR INFORMATION:
Name: ALTON ROOFING SERVICES
, RC29027510
Address: 532 Locust ST
Phone: -
FEES:
BUILDING PERMIT FEE $75.00
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $79.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDMG CODES.
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
n Office(904)247-5826 Fax (904)247-5845
Job Address: . 3 lr rermitNQmber 110JOOF-a1106
Legal Description 43-I� Parcel# /7 D a7^ SS89
r.
Valuation of Work S 5000,00 Proposed WorkPitea 01 eated/cool o heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proppoosed atrucmre(s)(circle ane):. Commercial Restden
If an existing struMure,is a firesprinkler system in Bed?(Circle one . es No N/A
Florida Product Approval# F/ 16& 74, / r / Q
For multiple products use product approval term ® /
Describe in detail the type of work to be performed: 40 Fd o 10
- ref7i n(ye
,� i iiA2f L Q // WGJ sh"017Qle-5
Property Owner Information:
Name: r Address: S3C/ / P�/C OA17 /CPU
City n . State " Zip ?2?33 P -:C>- Sao 9
E-Mail or Fax#(Optional)
Contractor Informix n: /�Company ? A- Qualifying Agent: JIPnnLj
Address' L O C U ' �_ City .M if- State�„_Zip 7 .�4L
OfficePhone VO4 Job Site/Contact Number 4-135•Saa4 Fax#
State Certification/Registration# el,-) ?Q e?7.5/0
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 permu to do the work and installations as indicated I certify that no work or installation has commemed prior to the
issuance o/a permit and that all work will be performed to meet the standards ofdl laws regulating construction in this jurisdiction This permit becomes null
aMvoid(fwork is not commenced within sip(6)morahs,ar ifcomtraction or work is sus/reviled or abandomdfor a rtod ofsix/6J months at any time after
work u commenced. 1 understand that separate permits must be secured for ElectricN Work,!Numbing,Sigms, Wd/s,Pools, furnaces,Boom,Rmlers,
Tanks and Air Comdrdoners,de
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 f have read amt examined this licatian and know the same to be tate amt correct. All provisions oflaws and ordtnames governing this
type o work will be complied with whether s meed herein or not. The grousing-
mmtng of a permit does not presume to give authority to violate or camel the
provaion,ofany other federal,state,or 1-1law regulating construction or the performume ofcomtruction.
Signature of OwneerrJ_ ,// J Signature of Contactor /H
Print Name L-c±srDl ft��'r.e-( o Print __ Q/lrhr � _....................._..._......_........
----------- _.._......_...._.._.....__.____...__.._....._._
Sworn to and subscribed before me Swomn to subscribed before me
this2_Dayof ovtrmM.r .20/6 this k Dayof MV .2016
np)IK,I c tom_
Notary Public T-latary Public V
Revised 01.26.10
,�+'' TRACEY KLEIN "
�� `, Comminsiona GG]l0U 's^'"••� KIMBERLY NAC'
�� 1 My Comrriisaion Espitn - MV COMMISSION k:
s's,„+^` SaPtembar 16. TORO ”` a E%PRESFemstri'�^ 2Y^
'+REPARE IN DUPLICATE)
Permit No._ __ Tax Follo No.
State of Iii County 01 DUVAL
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.
Lego tles ption of pr perry being improv
s`P�Un fake s' 71) Ln 94
Address of property being Improved: LiLy u f
3da3
Gan.mi ch scnpdon of Improvements: RE-ROOF
Owner A 01 400,01
Ada 5`?9 Pel'r r_ x lll�lxe%iC ti PL aa33
Owners interest in site of Me improvement nlI/ r
Fee Simple Titleholder(if other than owner) AL/�
Name �]
Address
Contractor NORTH FLORIDA ROOFING CONTRACTORS
Address 2730 ISABELLA BLVD ME 50 JAGRSDNVILLB BEACH.F4 32250
Phone NoFox No. 866-941.6461
Surely Df any)
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for Me construction of the improvements.
Name
Addree
Phone No. Fax No.
Name of person within the State of Flonda,other than himself.designated by owner upon whom notices or other
documents may be served:
Name At 16
Adtlre
Phone No. Fax No.
In addition b himseB..wirer designates the following person to receive a copy of the Usher's Notice as provided In
Section 713.06(2)(b).Florida Statutes.(Fill in at Owner's option).
Name
Addr s
Phone No. Fox No.
Expiration date of Notice of Commencement(the expiration data is one(1)year from the date of recording unless a
different date is specified):
THIS7RECOROER'S „l�q,Ol�"�IER31 neo: DATE / -1,GB brs mesib darer In ItsCourcy0Ducal.Slab or Frks h Per nIII., redreln bymWass hemi are aAlme sial.1 dabma d larlbnebareyl a a O#2016274149.OR BK 1770areand xcur s m SNumber Pages:1 H p
Recorded 17/0112016 at 01:03 PzO Ronnie Fussell CLERK CIRCUIT N = z D
COUNTY nlolary Publlceiaro .staso awdyw u', r y
RECORDING$10.00 My.m[elbn exp i 0
Personallym $ 3
Penally Km ar °g >7
PmMud ldentIrallm m