1620 MARITIME OAK DR - ROOFING S, �; City of Atlantic Beach S
:L� APPLICATION NUMBER
�-", Building Department \\9 (To be assigned by the Building Department.)
: s 800 Seminole Road \ C
�•` Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
x L 0110- E-mail: building-dept@coab.us Date routed: ( los" I vet
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1(40a 0 Kat(-k;NIL OttV--- 1 - De artment review required Yes.,_ No
�uil to
Applicant: TOP C-lU1\ 9-00-Vi�� Planning &Zoning
Tree Administrator
Project: ik k-1-) IhOk f DO O (ltAi "0 v."4-- Public Works
Public Utilities
Public Safety
r p rod v re_U(tic.-L o!\- Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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: 1pproved. ['Denied.
(Circle one.) Comments:
UILDIN
PLANNING &ZONING Reviewed by: Date: L/'6 /e-
Reviewed
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 05/14/09
BUILDING PERMIT APPLICATION Y, ECCA
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 \
Job Address: 1620 Maritime Oak Drive Atlantic Beach,FL 32233 Permit Number
Legal Description 67-132 08-2S-29E Atlantic Beach Country Club Unit 02 I.ot 132 Parcel# 16905-1955
Floor Area of Sq.Ft. Sy.Ft
Valuation of Work S 26,400 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one New)Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial id
If an existing structure,is a lire sprinkler system installed?(Circle one): YeT No N/A
Florida Product Approval#FL 1151
For multiple products use productapproval form
Describe in detail t • • . - t ormed: •
ew construction single family residence metal roof
grope I" • ation:-
Name:)NORTH FLORIDA BUILDERS OF JACKSONVILLE.INC
Address:8225 PERIMETER PARK BLVD.#204
City JACKSONVILLE State Zip 32216
Phone(9041288-7670
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: TOP GUN ROOFING.INC. Qualifying Agent: MATT P.MCLEOD
Address:5570 FLORIDA MINING BLVD.S.#501 • City JACKSONVILLE State FL Zip23 257
Office Phone (9041342-0211 Job Site/Contact Number(9041509-2595 Matt_Fax#_(9041379-7059
State Certification/Registration# CCC058178
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 h reI�,made t a�tainp a Dermic p do rhe work Rod installations r tc led. I certify hat no work or installs row has commend prior to
the issuance of�a pfrmit and that all Work will be performed to meet the stan of all laws regulating construction in this jurisdiction. This permit
becomes null d void if work is not commenced widtin sir(6r months,or if construction or work is suspended or ubandone4 ora period gfsia(¢J monde
at anylime after work u commenced. l understand that separate permits must be secured for Electrical Work,Plumbing,Signs ells,rooks,rurnaces,
Boilers,Heaters,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 YOUR NOTICE OF
COMMENCEMENT.
I hereby eesti(u that I have read and examined this a lication and know the same to be true and correct. All provisions of laws and ordin j s governing
this type of work will be complied with whether specified herein or not. The grantin of a permit does not presume to give authority to vio; or cancel the
provisions ofanv other federal.state.or local law regulating onstruction or the performance of construction.
SignatJdre o j` �,,:..__....= Signature of . tor
nn
Print Name JH S .)A l (,( (1•
I C Print Name Iv`ok.. pt► Me Lica----.__.
Swo tt��and subscribed before a l� Sworn to and subs• ' d before me i 2
_1,1 pi' of Yr✓ 1 t r;� � �( _20/7 IL��ay of 20 1 T
}otary�b �11 �k' / II `t c
Notary Public
TERESA MARIE WRIGHT Revised 01.26.10
Notary Public,State of Florida °' TERESA STONE IRWIN
My Comm.Expires Oct_7,2017 f:01411^.1Commission # Ft 896991
Commission No.FF 60714 =�,lii,of My Commission Expires
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Doc # 2016179973, OR BK 17661 Page 957, Number Pages: 2, Recorded 08/04/2016
at 03:36 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $18.50
This Instrument Prepared By:
employee of
Sheffield&Boatright Title Services,LLC
6101 Gazebo Park Place North,Suite 101,Jacksonville,Florida 32257
Pennit No.,1°7" gOOF—34, FZ
Tax Folio No. 169505-1955
File No.:2016-1168
Commitment No.:3604300
NOTICE OF COMMENCEMENT
STATE OF FLORIDA
COUNTY OF Duval
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter
713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property: Lot 132 of ATLANTIC BEACH COUNTRY CLUB UNIT 2, according to the 1'lat thereof as
recorded in Plat Book 67,Page(s) 132 through 137,of the Public Records of Duval County,Florida.
2. Address: 1620 Maritime Oaks Drive,Atlantic Beach,Florida 32233
3. General description of improvement: Construction of single family home.
3. Owner information:
a. Name and address: North Florida Builders of Jacksonville,Inc
8825 Perimeter Park Blvd#204,Jacksonville,Florida 32216
b. Interest in property: Fee Simple
c. Name and address of fee simple titleholder(if other than owner):
4. Contractor:
Name and address: North Florida Builders of Jacksonville,Inc
8825 Perimeter Park Blvd#204,Jacksonville,Florida 32216
b. Phone number:( )
c. Fax number(optional,if service by fax is acceptable):
5. Surety: Not Applicable
a. Name and address: N/A
b. Amount of bond: $ N/A
d. Fax number(optional,if service by fax is acceptable):
6. Lender:
a. Name and address: Fidelity Bank
10611 Deerwood Park Blvd,Jacksonville,Florida 32256
Attn:
b. Phone number.( )`.___
c. Fax number(optional,if service by fax is acceptable):( ) -
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided in
section 713.13(1)(a)7.,Florida Statutes:
a. Name and address:
OR BK 17661 PAGE 958
°l s-, fr+v,r*i
b. Phone number:
c. Fax number(optional,if service by fax is acceptable):
8. In addition to himself,Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1Xb),Florida Statutes:
a. Name and address: Fidelity Bank
10611 Deerwood Park Blvd,Jacksonville,Florida 32256
Attn:
b. Phone number:( ) -
c. Fax number(optional,if service by fax is acceptable):( ) -_
9. Expiration date of notice of commencement(the expiration date is I 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 713.13, 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 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 COMMENCEMENT.
Verification pursuant to Section 92.325,Florida Statutes.
Under penalties of perjury,i declare that 1 have read the foregoing and that the facts stated in it are true to the best of my knowledge
and belief.
North Florida Builders of Jacksonville,Inc
By:X
®Jason H,White
Its:President
STATE OF FLORIDA
COUNTY OF DUVAL
The foregoing instrument was acknowledged before me this 08/04/2016 by Jason H. White, President of North Florida
Builders of Jacksonville,Inc on behalf of the company who is personally known to me or has produced a valid driver's license as
identification.
f J
Signature of Notary
TERESA MARIE WRIGHT
Notary Public,State of ftorida
My Comm.Expires Oct.7,2017
Commission No.If 8071a