1277 BEACH AVE - ROOF f /,; ' S, CITY OF ATLANTIC BEACH
} 800 SEMINOLE ROAD
5, i i;:' . : '', _c ;' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
\0.21>r
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ROOF-3838
Job Type: ROOF PERMIT
Description: RE ROOF SHINGLES
Estimated Value: $7,392.00
Issue Date: 4/26/2017
Expiration Date: 10/23/2017
PROPERTY ADDRESS:
Address: 1277 BEACH AVE
RE Number: 170294-0000
PROPERTY OWNER:
Name: YAZBI, ABDO
Address: 1277 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: PEAK ROOFING & CONSTRUCTION
PEAK ROOFING MICHAEL HOLEVA, CCC1325540
Address: 2288 Lookout Landing DR
Phone: - -
FEES:
PLAN CHECK FEES $43.48
BUILDING PERMIT FEE $86.96
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $134.44
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
r;y14/rye., BUILDING PERMIT APPLICATION
is = CITY OF ATLANTIC BEACH DATE
v . V 800 Seminole Road,Atlantic Beach FL 32233 !26-/
-A:4m >e Office: (904)247-5826 • Fax:(904)247-5845
Job Address: /o2 77 i3 acs /4e- i/1j14 Soto/ ,1Z 233 Permit Number:i 7- (oo F--3 83 8
Legal Description 6q-- / Xi- �'/1 G Stat 4 hi g r/O a6 RE#_
Valuation of Work(Replacement Cost) $ 73/2 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): Commercial Residentia
• If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N/
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in d tail the ty e of work to be performed: /, / /
iC 49g) i^ llox,' 11 r {4 J - Jilt 6C / J4/ / ,/I
duct A roval # �L le,
. ' cL I U )b. ~,Z for thultiple products use product approval form
Florida Pro pp l
Property Owner Information
,
Name: �//ra L't Address: /2 7 7 /ella At if-I- 141 gg17
City R/'t?C- /S-(et h State/ Zip 32733 Phone gel j -.01`6 -3 if0y
E-Mail
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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.
Contractor Information: / '��C/ 44(e.Name of Company: Atte_ pp �I T ONSij1/� i prl, Quali ing Agent:/,r
Address: X6.53 (//` wit & •..bIZ (E City Ju k F-(_ State Zip 3Z ?I 1
Office Phone ql"{r Z31" Li it a Job Site/Contact Number a31-if f/ t
State Certification/Registration #e /3 Z rill 0 E-Mail
Architect Name &Phone #
Engineer's Name &Phone#
Worker's Compensation
Exempt / Insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. I certi that no work or installation has commenced
prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction.
This permit becomes null and void if work is not commenced within six(6) months, or if construction or work is suspended or abandone for a
period of six(6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electric I Work,PI twig,
Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. c
Signature of Propert Own- : �h�� _iic,i G Signature of Contractor: Ali •
Befor e e 1i
this Day of i► /f , ,� 02 T 7 Before me this 2- ,o ,D, • , in ZO7
1 /
r J.HOLEVA V to,4r.
Notary Public: .. ',:kUc Notary Public: !
i r �ttr . • ORM
•b,•,• Comm*FF194464
I hereby certify that I have read and examiTer h?�gtion and know the sa tt -Irue,,ffzzjj�!tc0 ;f#Fieg, jovt:'ons of laws and
ordinances governing this type ofwork will be complied with whether specifi=�' i=ar 11 ,,,,.` '';,•"J•t 1• yf .ermit does not
presume to give authorityto violte or cancel the provisions of any other fedet 14-•,- .:,,Wi9r Wear��c ••ary, •,. r.'.,c.r struction or the
erformancof construcon. ;t;F,,.• Banded
Rev. 5/2/16
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. /7o29y--dD0 t7
State of l,-i/A County of 1)vt/4 l
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. h
Legal description of property being improved: 6'/ ALL',1� G K' C /q
�
r/ i
Address of property being improved: /2 77 /JAG« 74/ le e
PL 32 L 3 3
General description of improvements: ,-C e4./
7.
Owner 4&)0 Ydt t' I
Address /277 /Sore-, 4€ 11./W: ,Me-, fl .32 0 33
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor 41 k di‘c. /i ✓ q
Addre b q Ult 1N Ja5€ 2 4tX fat- 3e z/
Phone No. Z 3 7 -'f'` Z Fax No.
Surety(if any)
Address Amount of bond $
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06 (2)(b), Florida Statutes. (Fill in at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER / �]
Signed: DATE 3- / ` f
Before m is` dad of in the
County AD,uv ,Stat- . Florid.,Itas personally appeared
�l h • / Z s herein by
himself/herself and -L ms the ORMEtu eLelfkdeclarations herein
Page 814, are true and acc ��'''```"j�. . NOTARY PUBLIC
Doc##2017093951,OR BK 17956 ��'' •TATE OF FLORIDA
Number Pages:1 -�� . `
Recorded 04/24/2017 at 12:21 PM, v/�,t�/� omm#FF194464
Ronnie Fussell CLERK CIRCUIT COURT DUVA VAI Pi/
• res 1/29/2019
COUNTY
RECORDING$10.00
Not! Public;t Largr, e of or. County of /,7
My commission expires: 1 �L
• Personally Known or
Produced Identification