1755 Beach Ave 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 NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ROOF-2959
Job Type: ROOF PERMIT
Description: re-roof with wood shake (FL13714)
Estimated Value: $30,000.00
Issue Date: 1/19/2017
Expiration Date: 7/18/2017
PROPERTY ADDRESS: -
Address: 1755 BEACH AVE
RE Number: 169672-0000
PROPERTY OWNER:
Name: Swanson, Jeffrey D
Address: 1755 Beach AVE
GENERAL CONTRACTOR INFORMATION:
Name: GRASTON ROOFING CO INC
Daniel R.Graston, CCCOSS221
Address: 2680 FOX HUNT TR CIA DANIEL R. GRASTON
Phone: -
FEES:
STATE DCA SURCHARGE $3.00
STATE DBPR SURCHARGE $3.00
PLAN CHECK FEES $100.00
BUILDING PERMIT FEE $200.00
Total Payments: $306.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLOMA
BUILDING CODES.
1. City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida 32233-5445
Phone(904)247-5825 - Fax(904)247-5845 (` D�
E-mail: building-dept�wab.us Date routed: 0 1
-- City web-site: htlpl/www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I1SS �3t.tLc.V\ A\)t "Sewices
t review re uired Ye No
r
Applicant: C-11 G s4D IN 6Z- S,nil Zoning
inistrelor
Project: CY.(ALLf S,AQ,V~� + .� ICIYr rks
ities
ety
es
Revie
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verged B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: E Approved. ❑Denied.
(Circle one.) Comments:
BU
PLANNING R ZONING Reviewed by: Date: I—R-0
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 0511Uee
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OFFICE COPY
800 Seminole Road,Atlantic Beach,FL 32233
�/
Office((904)247-5826 Fax(904)247-5845
Job Address: I7.P S" ge-, , Ale— Permit Number-
Legal Description /S= /U 09 -a -;% &/40—Vic/'c ✓ arcel# Lad -3-Z
loor Area ort. q.rt
Valuation of Work$.30,odJ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Additiort Alteration epair lition pool/spa window/door
Use of existing/proposed structure( (circle one): Commercial Residco a
If an existing structure,is a fire sp k er system installed?(Circle one): o
Florida Product Approval#
For multiple products use product approval lorm `/�1 n /
Describe in eWl the type of work to be performed: K 4'/
(_ i
FrODertv Owner Information: Jl�, ,r ,I
Name: 2 teD S wovx Address: / /S.f-Ak 11 /L
City State R Zio J.�73 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: �.a..� QatkFi1,2 CoI .Z..,. Qualing Agerlp &.,L/ 6R.5
Address: d t•. A �r City �L � State �L ZiD�.7.9J'4 _
Office Phone - 0.1 Job Site/Contact Number d$7- 0978 " Fax# 904-�B�-/RJr
State Certification/Registration At C f f nJ7A 1.1 (
Architect Name&Phone# _rinsollation
Engineer's Name&Phone# ca nNIFee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain opermit to do the work and installations as indicated. Icertifythatn has rommea ' r o the
issuance ofa permit and that all work will be pe armed to meet the standards of a!/laws regulating ronstru i n in y cVm nu/!
and void tf work is not rommenced within six(6�months,or ifmnstruction or work is suspended or abandon ,for a Aerial ofsix%6)months at.,ny tim ager
ark is rommencad. I understand that separate permits must he secumdfor Electrical Work,Plumbing, Wells P urnac Bolers H ers,
Tanks and Air Conditioners,etc
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 V&k NOTICE OF
COMMENCEMENT.
l hereby rertify that l haw mad and exammed this a p!i ation and know the same to be hue and correct. A(l pmWsions oflaws and ordinances governing this
type o work will be complied with whether sppec Fdp herein or not. The granting of permit does not presume ro grve authority ro violate or tantel the
provulons olanY other federo(st re,or lata luw regulating ronsimction or the performance ofronsm chon.
Signature of Owner Signature of Contractor ,p�
Print Name Print Name ....[.&OUI&I„.......IQ._WS'7e+A.I........
IOA
Sworn to and subscribed before me Sworn to and subscribed before me
this Day of- _ //h JBA20 this Zx-Dayof kloJ .20 If*
Notary Public {:::Vit a!,^�,.,.s, t emntiWnmuWvoruMrcLvuoe
NOtmyVu51T �is
MY GCMMISSI TFF2r 0MV P";Z
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OFFICE COPY
NOTICE OF COMMENCEMENT
Permit No. /7-9opio— 75-� Tax Folio No.
State of Florida,County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legal description of property and address if available):
1755 Beach Ave Atlantic Beach FL 322 15-10 09-2S-29E N ATLANTIC BEACH UNIT NO 1 LOT 32
2. General Description of improvements:
Renovation of existing structure and replacing windows and doors
3. Owner Information:
a)Name and Address: Jeffery D.Swanson- 1755 Beach Ave,Atlantic Beach, FL 32233
b)interest in property:General
c)Name and address of simple titleholder(if other than owner):
1 4. Contractor Information:
! a)Name and Address: Bosco Building Contractors, Inc. 2158 Mayport Rd, Jacksonville, FL 32233
b)Phone Number.(904T24T-032F-
5. Surety Information: Doc a 2016207364.OR SK 177foo Page 2446,
a)Name and Address: Numlav Pages:1
RacortlEd 09/0&2016 at 09:02 AM.
b)Phone Number. Ronnie Fussell CLERK CIRCUIT COURT DUVAL
c)Amount of Bond: SCOUNTY
RECORDING$10.00
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13(])(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 Smtutes.
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 COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 71.13 FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SffE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING O
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that 1 have read the foregoing notice of commencement and that the facts stated
therein are true to the best of my knowledge and belief.
Signature of M Authorized Officer/DirectonParmer/Manager Signatoy Printed Name&Title/Office
The foregoing instrument was acknowledged before me this Co day of Za2� 20L
byf \P--(F.ey D.SnVsU �n w-
as owrC- for
( mem Person) (Iype ofAudiority,i.e. mer/Attorney) fN!W;Fo1FiRj Instrument was Execu r)
Denlb A.Ennis �-,a-e_n —irv�r..3i
NOTARY PUBLIC NO'FARV PUBLIC,STATE OF FLORIDA
STATE OF FLORIDA D2;1
''�
. C&MIN FF966426 Print Name: D2;1iS2, Ac �nnl.S
a EVIn s 3/1/2020 \.,,pLl
Personally Known
❑Identificatiorffype:
(Affix Notary Sea[Above)
Revised 3/15/12
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