Permit Roof 352 2nd St 2012 SSS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J .
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001354 Date 9/18/12
Property Address . . . . . . 352 2ND ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4213
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Application desc
Re Roofing
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Owner Contractor
-
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WYTZKA JANE C TIER 1 CONSTRUCTION (ROOF)
352 2ND ST 13245 ATLANTIC BLVD STE 4-212
ATLANTIC BEACH FL 322335230 JACKSONVILLE FL 32225
(904) 610-7979
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4213
Expiration Date . . 3/17/13
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE 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
Job Address: 11A 5e4 0 AJ r,-r" ftAATtc gcl" • Permit Number:
Legal Description
1;& - '2 5 2 5 C �41-i A-n rl G &e 44-t Parcel# X10 5 �4��• 4 ao r�
t
Valuation of Work$ L1%23'6,1_!1-_Proposed Work heated/cooled ��/ non-heated/cooled
Class of Work(circle one): New Addition Alteration Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial Residential
If an existing structure,is a fire sprinlder system installed? (Circle one): Yes No /A
Florida Product Approval# 1^L, I C(01 Ll (Z Ll
For multiple products use product approval orm
Describe in detail the type of work to be performed: na�tv��
Property Owner Information:
Name: "P .u! 'r2rAF Address: 3T2 tic ^6 5T
City A-TL-*✓►� 3c�h State Zip t Phone C64. �f S ^ /'710
E-Mail or Fax#(Optional)
Contractor Information: ,
CompanyName: ID k 2 I Cy^Spay(X-1 ort Qualifying Agent: B 2C yy7-
Address: 132 45` A-tCwr1ny 13 i v Q City a�C IcSc►a v r li�.... State 1�G. Zip 3.� 5`"
Office Phone qp4 -A.ylo-60T0 Job Site/Contact Number F ax# t OV 2'16.0011
State Certification/Registration# cc-c- t'62-11 C S'r1
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 hereby made to obtain a permit to do the work and installations as indicated. 1 certify 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 abandoned for aperiod of si%)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnaces, Boilers, Heaters,
Tanks and Air Conditioners,eta
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
BE OM RECORDING YOUR NOTICE OF
COM
I hereb certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type ofywork well be complied with whether spate r g laleng construction or performance of constructioermit does not nresume to give authority to violate or cancel the
provisions of any other federal,state, or local l
Signature of Owner Signature of Contract r
Print Name -J ... ....... 1. t_v.. ..T._? ...........)*4.................
......_...................._.. Print Name .... .... r...�r..:4 1...............................:.............
Sworn to and subscribed bef re me Swo an s scri m
this ADay 20 L this
to PlkKWA
BRENT PARRISH -no of FbrW
No Pu c, Not ry u is d+e 28,solo
Comm.Expires May 14,2016 cow"Nion#EE"M
Commission No.EE 196158
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of =/d.,.. County of
To whom it may concern:
The undersigned hereby informs you es
that
Statutvthe following informations statedin this NOTICEOF
real
pI
aaccordance with Section 713 of the Florida
COMMENCEMENT.
Legal description of property being improved: 2��' `t I` f-�'i'L�r�'t lC- gee,-C- b 1
_
Address of property being improved:
_ J1
General description of improvements:
Owner
Address
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor
Address 2 t!`i 7 L , r► Tl G ��Q) 3 A�C_y s U dt o ivy k F -
_. Phone No. Fax No. fC7c, �4y to ct r
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.
Cvninatlnn riatp of Nntice of Commencement(the expiration date is one (1)year from the date of recording unless a