369 10th St 03-00026146 re-roof permit �SCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 03-00026146 Date 5/29/03
Property Address . . . . . . 369 10TH ST
Tenant nbr, name . . . . . . REROOF, GAF 30YR,TIMBERLIN
Application description . . . ROOF
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5175
Owner Contractor
------------------------ ------------------------
PILCHER, W. G. THRIFT ROOFING
369 10TH STREET 1601 BILL HURLBERT ROAD
ATLANTIC BEACH FL 32233 YULEE FL 32097
(904) 225-8008
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 5175
Fee summary Charged Paid Credited Due
--- -------------- ---------- ---------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 90 . 00 90 . 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
BUILDING OFFICIAL
i y-1�1 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
TELEPHONE:(904)247-5800
J FAX:(904)247-5805
r SUNCOM:852-5800
http://ci.atlantic-beach.fl.us
3
PLAN REVIEW COMMENTS
Permit Application
Applicant: `Thr F-t Koo Vii'n C,
Address: 3Ld 1011 Q5--
Project: rP r-nnirSAF Ur 7rmh�r Jnr
a,/Your application is approved
o Your permit application has been reviewed and the following items need
attention:
Please re-submit your application when these items have been completed.
Reviewed by 'ti
Signed Date
Contractor Notified Date
CITY OF ATLANTIC BEACH PERMIT . CALCULATION SHEET
3�
•Address ��T Gti
Heated Square Footage @ $ er sq ft .._ $ '
Garage/Shed @ $ -Per .sq ft = $
Carport/Porch @ er sq ft ._ $
Deck @ $ per sq ft = $
.Patio @ $ per sq ft = $
( TOTAL VALUATION: $
C/` a
Total Valuation 1st $ lC00
Remaining Value $5-. "aper thousand
or :portion thereof
TOTAL BUILDING FEE $
+ 1/2 Filing Fee
(. )
Fireplaces @ ' $15 .00 $.
.BUILDING PERMIT FEE $ �Lr'
WATER IMPACT FEE $
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL .IMPROVEMENT. $
. SEWER TAP $
( ) -RADON (HRS) . 0050: $
SECTION H PAVING ( ) $
HYDRAULIC SHARES $
CROSS CONNECTION $
( ) SURCHARGE . 0050 $
OTHER $
GRAND .TOTAL DUE
ADDITIONAL PERMITS OR FEES : .Mechanical ,.Plumbing
Electric/New Electric/Temp ;SwimmingPool
Septic Tank Well Sign Finish Floor Elevation
Survey Other
CALCULATIONS and/or NOTES :
RECEIVED
CITY OF ATLANTIC BEACH
BUILDING &ZONING
CITY OF ATLANTIC BEACH
i MAY 2 7 2003
ROOFING PERMIT APPLICATION
BY:
22
JOB LOCATION: 2�p 1 S �]^ef�� A-T)
OWNER OF PROPERTY: UI�A LT�l2 � ' C he
CONTRACTOR.-
CONTRACTOR'S
ONTRACTOR:CONTRACTOR'S ADDRESS:J.��/ � G U
Z1P:
STATE LICENSE NUMBER: (�CC' D�j Sj Z� TELEPHONE. �3 -7
DESCRIBE WORK TO BE PERFORMED:
VALUATION OF PROPOSED CONSTRUCTION J
MAT R S TO BE USED:
SIGNATURE OF nwNER. -;' ✓�
t;
�,v h O
J� BED BEFORE ME THIS _DAY OF
-7oNOTARY PU@l.
'p.RY PU OFFlCWLDTARy
0 �<� PHILnCone .oca Supplied Q COMMIS91 O CCContractor License Information Su lied �OFFILO MY�Mpp SEPT
Occupational License Information Supplied
MIN. Poulm as NOTICE OF COMM kNCEMENT
nHONE# O3
ermi Nc.
Book 11112 Page 1762
State .if Fiorda D
County of D i) A-t,
�t
The undersigned hereby gives notice that improvements will a made to certain real property, and in
accordance with section 713.13 of the Florida Statutes,ja� l
lowing information is provided in this
NGT 10E OF COMMENCEMENT.
Legal description f prope Include Street Address4fbi) 3�-Y
General description of Improv ents e c C96
Owner
Address a/,0:24
Owner's interest in site of the Improvement
Fee Simple Title holder(if other uian owner)
Name_
Address
Contactor 17R 7' X7 `
r
.Address /�'f/
Surety
Address Amount of and
Any persor making a ican for the construction of the Imprcv irents'.
Mame
Address _
Ferson Mthin the State of Ficnda designated by owner upon whom notices of other documents may be
served as provided by Section 713.13(1)(a) 7, Florida Statut .
Name S
Address
In addition to himself, owner designates
Of
to receive a copy of the Lienors Notice as provided in Sectio 713.13(1)(b), Florida Statutes. -
Expiration date of Notice cf Commencement (the expiration late is one(1)year from the date of
recording unlesj a different date is ifr
of Uwncr ud Name of Owner
I Notary Rubber Stamp Seal r have rellcd UP4 die foilowing idenfificatto of the Afant
S wo Su cubed 3c me 6 /b1y of' NO 3
203i�7446
9: 1,L 1112 a'
Fi�QS/Z7/ 003�2:10:36 Ph PrinudNamc
JIN FIRIT CtNlRT 1�av v� GFiC1AL NOTARY SEgI
CLERK ��y 2 el� PHIWP13GUAR
DUYALVU��' ; 5.00 Q COMMISSION NUMBER
RECORDFWD i 1.04 9�F �� MY COMM.'S$ipN EXFIRE3
OF Fly SEPT 14,2004 r