Permit Roof 386 2nd St 2010 ) ' <. CITY OF ATLANTIC BEACH
i, 800 SEMINOLE ROAD
:; ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 10- 00001418 Date 12/01/10
Property Address 386 2ND ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 6980
Application desc
REROOF
Owner Contractor
ROSS, XAVIER & JILL COASTAL BUILDING SYSTEMS ROOF
902 THOMPSON DRIVE P.O. DRAWER 1509
BAYSHORE NY 11706 1603 S 8TH ST
FERNANDINA BEACH FL 32035
(904) 261 -2233
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee . . . 85.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 6980
Expiration Date . 5/30/11
Special Notes and Comments
MUST PROVIDE ORIGINAL NOTIRIZED
APPLICATION
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 85.00 85.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 89.00 89.00 .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
„,. / 7
Job Address: , 41 4' 0 /1/41) ,: . rei i e„. , ) ' et( 1 ibi(t>1. Permit Number:
# # 0.
oux t )
Legal Description # -,-..„ - 1::: t' 72) `1"" j, 4 i ill a 6 0( Parcel # , / 4 if, - h
" or , rea o q. t. q. t
Valuation of Work $ (07 A 0 Proposed Work heated/cooled ii non-heated/cooled c? 1
IP
Class of Work (circle one): New Addition Alteration Repair ov . Demolition pool/spa window/door
.
Use of existing/proposed structure(s) (circle one): Commercial . _ - ial
If an existing structure, is a re sprinkler system instpWd? ircle one): Yes i o
Florida Product Approval # FL- laai- /1 ,.litalts) F0533 . Ry Fl
or multiple products product use approval form
Describe in detail the type of work to be performed: E Kbef
Property Owner Info ation:
Name: / av , i). 08
r
Address: 3,, ,.., A- 5 - --
U,. c; ; IR
City i-H L he - ,N-6 StateR Zip 330-33 Phone
E-Mail or Fax # (Optional)
Contractor Info malon;
Company Nam
e b45 7:6 dii)s St4 tols hr Lk) Anal' in Agent: . 1 t ilk) ;11EA )
A
Address: -- 1'4) - '4 R. rlu3t-e-... ISO '-.4 1 . --- , -, -...
t L i, A, S . e I, Zip a
c
Office Phone btf) 4.o i. ;),). 3-5 Job Site/ Contact Numbe lig '- i Fax # 'b. .... -
State Certification/Registration # Of 051M 0
Architect Name & Phone #
Engineer's Name & Phone if
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 certifj that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet the standards of &Haws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six (61 months, or if construction or work is suspended OY abandoned for a daeriod of six (5) months at any time after
work is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Headers,
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 BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certifr that 1 have read and examined this afiplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will he complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions ofany other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner ..C) ''(-^°°---' Signature of Contractor V_....' -
Print Name )lick v :co- P-....s.f. Print Name
X
Swl t . and subscribed before me Sworn to and subscribed before me
this Day of NO \lt rnetg.
/ 5
, '
, 20 10 ' this Day of 20
( z4:1 i u i (
6 Z/ii ( ez)4./..g-
Nota Public Notary Puple
VIRGINIA CONWELL
:T-, VIRGINIA CONWittise 01.26.10
;*:: MY COMMISSION # DD953292
...-
EXPIRES March 22, 2014 - . . i MY COMMISSION # DD953292
--- WA
EXPIRES March 22, 2014
7) 398-0153 Florldallots ServIce.Com
— (407) 398-0153 PloridallotaryService.com
11/29/2010 14:35 9042777600 COASTAL BUILDING PAGE 02
UOC ti LU1U4b9b94, VI( b$. 15454 Page 4U6, Number Pages: 1, Recorded 11/19/2010
at 01:51 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
•
1/0979) Permit Number Tax Folio Number
0000
NOTICE OF COMMENCEMENT
STATE OF FLORIIDA
COUNTY OF DUVAL
THE UNDERSIGNED hereby gives notice ibat improvement will be mad to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information is
provided lo this Notice of Commencement. I
1. Description of property: 1l��.5. — ! Ayat�,f- ( i /7Jo at
2. General description of improvement: r' iIlr
R
3. Owner information: /I
1. Name and Address; �,. � nD • L G ON A 301,133
2. Interest in property:
3. Name and address of fee simple titleholder (other than owner):
4. Contactor's name and ad. • Lis, sir • u •� . ► . J,5
a. Phone number: 'I1 a ]ITINF L 1 /' I L 1 A D � 17635
b. Fax number: ii,..►
3. Surety Information:
a. Name and address:
b. Phone Number:
c. Fax Number:
d. Amount of Bond:
6. :Lender's name and address:
a. Name and address:
b. Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other
documents maybe served as provided by 713.12(I)(e). Florida Statutes.
a. Name and address;
b. Phone number:
c. Fax number
8. In addition to himaeltlhcrself, owner designates of
to receive a copy of the Lienor's Notice an provided in
Section 713.12(1)(b). Florida Statutes.
9. Expiration dote of Notice of Commencement (the expiration date is one (I) year from the
date of Recording unless a di date is specified)
Signature of Owner; ( //
Sworn to and sub b re m this of /401 , 2U tad IV
Notary: (O
;411IPP
Known personally /1D shown: _0
My commission expires: 2-- ("-/-r1
0
CARLOSCAIIIOM
Notary Public, Stets of Florida
Commission* 013752054
My comm. expires Feb. 14. 2012