306 2ND ST - ROOF PERMIT s, CITY OF ATLANTIC BEACH
°`'` 9 800 SEMINOLE ROAD
\ `
J ATLANTIC BEACH, FL 32233
_____,,2\ INSPECTION PHONE LINE 247-5814
\0,319%'
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2118
Job Type: ROOF PERMIT
Description: reroof FL 10124.1
Estimated Value: $6.500.00
Issue Date: 9/8/2015
Expiration Date: 3/6/2016
PROPERTY ADDRESS:
Address: 306 2ND ST
RE Number: 169757-0010
PROPERTY OWNER:
Name: MORTON ET AL, WILLIAM K
Address: 961 LEW BLVD
GENERAL CONTRACTOR INFORMATION:
Name: D & S ROOFING OF N. FL. INC.
Address: PO BOX 1986 QA RANDALL SCOTT DRAWDY
Phone: - -
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $82.50
Total Payments: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
State of /14" County of pfoY19 L Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: /4/04/4,77 C /33/90 /t/ ea '' dr- L U l 3
&i: 3 o// ificax c' 7 --/o 97 /0-AS
Address of property being improved: /50-g Gez 0 57/7 i c
General description of improvements: /26" ,240'17:
Owner: WC(/44i fvlonrotv Address: 2 l//EJo Sr s% iT 'cr- /LC- 520511
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: OS
,14.0 K# �i+.�r/ Arf SKC C .
Address: el 4 .2 -r3
3)a5v
Telephone No.: f)Y/ .2 ll'4' 7663' Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: 42—
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: —a--
Address:
Telephone 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 Statues. (Fill in at Owner's option)
Name: _0_
Address:
Telephone 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
snecifiedl-
Doc#2015206179,OR BK 17294 Page 2437,
Number Pages:1 OWNER
Recorded 09/08/2015 at 02:27 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY Signed: Date: / 'Of 24,6-
RECORDING$10.00 Before me this ca day of aeAbtio�- in the County of Duval,State
Of Florida,has personally appeared GoI/CC/i Zvi ,idRr0/V
Personally Known:
Produced Identification: FL 1G, 0, • or
r ^oof�o� Notary Public State of Florida Notary Public: i O
Nancy E Bailey My commission expires:
J My Commission EE 156116
or pow Expires 02/08/2016
•
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: i4 /3f SEC'."0 Sj
Permit Number:
_f /304 #Legal Description /9-,C/1 A/ f 1°75 1,3 el
Valuation of Work$ vp Floor Area of Sq.Ft. t
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 'esidenti.%
If an existing structure,is a flit;sprinkler system installed? (Circle one): - • N/A
Florida Product Approval # 'l . /Oi/, ii.
For multiple products use product approval form
Describe in detail the type of work to be performed: RC /earlT
Property Owner Information:
Name: & i 1 dl27 */ v/C1a
Address: Z S%��
City 5% 40 State .Zip 32-at' Phone 9Oy BOG- / g
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS: 'a44'e cf.S MY 1!<lee.I C/"-I
Company Name: 0 0 S I /l CGH ` cQ'i(rte Qualifying Agent: f HZ-'/19 �((Q�
Address: 3�`! V• ' / 2 City V—
Office Phone 90 K 4 VG 766$' Job Site/Contact Number a State Zip ���(�
State Certification/Registration# GGC' 1 S . gv?v 3 (G GAO p Fax#
Architect Name&Phone# J4 '
Engineer's Name &Phone# /WA
Fee Simple Title Holder Name and Address ,4
Bonding Company Name and Address i
Mortgage Lender Name and Address A/
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced prior to the
issuance work islnot commenced withinlsix performed 6) onths,t ortifconstruction or of is suspended B or abandone id for ahlejurisdiction.iod of s 6)This months attany time after
work is commenced. I understand that separate permits must be secured for Electrical !York, Plumbing, Signs, Wells,Pools, Furnaces,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 certify that I have read and examined this a placation and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give thority to violate or cancel the
9rovisions of any other federal,state, r local law regulating construction or the performance of construction.
signature of Owner g /
Signature of Contractor _ ,/
'rant Name 10/1C"4,
le` M o emit, Print Name c
lefore me
C B .re Ile
its_�Day of �°��_e r ,20 f, t ils _'D. . of_ r'.'�r5_..a Public State of Florida20
lotary Pub'c• Notary Public states !odds
— . � ��
Nancy E Bailey Notary Pu:is !Y�.•
•1-. I My Commission EE 158118
MOP
Revised 01.26.10
or^ Expires 02/08/2016