1721 Sea Oats Dr re-roof permit age, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
rai,L. ATLANTIC BEACH,FL 32233
V ��
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEI(T DAY INSPECTION: 247-5814
JOBINFORMATION:
Job ID: 16-ROOF-2736
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated Value: $10,000.00
Issue Date: 12/8/2016
Expiration Date: 6/6/2017
PROPERTY ADDRESS:
Address: 1721 SEA OATS DR
RE Number: 172020-0441
PROPERTY OWNER:
Name: CROWLEY, BETTY ANN
Address: 1721 SEA OATS DR
GENERAL CONTRACTOR INFORMATION:
Name: CENTURY CONSTRUCTION INC
,CCC1328787 & COC1251066
Address: 509 PORPOISE POINT DR QAALBERTLEWIS
ROGERS
Phone:
FEES:
BUILDING PERMIT FEE $100.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
PENJUIT IS APPROWD ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND ME 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 1 (o -Rec�-Z-73G
Job Address: tM/ ,:5--CLCOtS DT, P&mg�7,wp
gr:
Legal Descripition ,�q-l?-,5 (pq-r25'- 5�-
tloor& �144L,' lltfarcel#
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Valuation of Work �Coo Proposed Work heated/cooled— li�n-heatedlcooled—
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pr sed atructureQ)(circle one): Commercial C]�
Han existing strur"re,is afire sp alijersystenii at Bed?(Circleone) �eso N/A
Florida Product pi q #- 32 7
For multiple pr=cts use product approval torm,
Describe in detail the type of work to be performed: PX--12C�OF — sk ( n5le-',
Prom%Owner Information:
Name: f Addrcssf2215ean,-,us1)r..
city V State aZip 32233--Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company IN e ft bbn Cionli i Agent:�Akgf-32
ty State �PC zip Sd�
Office Phone Job Site/Contact Number f-f Z//, Fax#
State Cerrification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Leader Name and Address
Application is hereby made to obtain.Permit to do the work and installations as indicated. I cortify that no work or itenallanan has coinmeniodprior to the
hiseance ofapermit and that all wor*will beperformed to meet the standards ofall laws regulating construction in thisjuriselletion. Thitnemsebecomes null
Zad,Lzang not commenced within six(6)months,or if construction or work k;sus ndedormbandonedfora armdqf,axP5)months at any lime after
c, ad pe Ff
f
I understand that separate permits most he secumilfor Electrica Work,Plumbing,Signs, dMiPums, urnaces,11odenHemers,
Tanks andAir ConalftioneM da
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 Y61jk NOTICE OF
COMMENCEMENT. 1\
cas nglhl;
Im=rn.'ce h
Signature of i-moner Signature of Contractor
C�,aj,
Print Name e- Print Name
. ............... ..... .. . . ........ ............... ft\rA�K ..............-.-..................
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� NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida, County of Duval
TIE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accor I dance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
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2. General Description of improvements: :xAva� MaLt"AQ C"hk,L-
z0b
3. OwnerInfournation CV \g:!j
I J�
a)Name and Addre iS
b)Interest in pro e
P
c)Name and addre a of simple titleholder(if other than o�vner):
4. Contractor Infunfunio Qw
a)NameamidAddim s7:A1,Qe,4 meaw .5t, 6�� FZ-
b)Phone Numbenja.X(,rCjq�y" 0 Y
5. Surety Information:
a)Name and Address:
b)Phone Number:_ D-#201W7905,OR8K178DD Pagelo72,
c)Amount of Bond: Number cases:i
Recorded IZWQ016 4 12 58 PM
6. Lender Information: Rmnie FussaIt CLERK CIRCUIT 6OURT DUVAL
a)Name and Address: COUNTY
b)Phone Number: RECORDING$10.00
nnno er
7. Person within the State of Florida designated by owner upon who otices or A——dmurnents rEa-y-be seived as
provided by 713.13 (1)(a) 7,Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to himself/herself,Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713.13 (1)(b),Florida STAIttiftes.
a)Name and Address:
b)Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording Unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF CONDAENCETvIENT ARE CONSIDERED RVIPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 713.13 FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMTROVEI�ENTS TO YOUR PROPERTY. A NOTICE OF CONMENCENIENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMNEENCEMENT.
Under penalty of pedury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true to the best of my knowledge and belief.
-f-
V 9T91!!turb59r0N;jf o--L--qUo`rized Officer/Director/Partner/Manager Name&Title/vffice
The foregoing instruntent was acknowledged before me this day of 20
by � ac� �z G as for
iNanoe of Mean) (Type ofAuthority,i.e.Officer/Attorney) (Narte at Forly Instrument was Executed Tor)
LNOJARY PWBLIC, STATE OF FLORIDA
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dentiffication/Type:(A�X'n�'e
(AffIK Notary Sea]Above)
Revised 3/15/12