639 AQUATIC DR RERF24-0125 REROOF SHINGLE PERMIT PERMIT NUMBER
r J s CITY OF ATLANTIC BEACH RERF24-0125
ISSUED:SEMINOLE ROAD 7/23/2024
%�;3»r EXPIRES: 1/19/2025
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
639 AQUATIC DR REROOF SHINGLE SHINGLE ROOF $7951.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171818 5358 AQUATIC GARDENS
COMPANY: ADDRESS: CITY: STATE: ZIP:
MANLEY CONSTRUCTION 11691 HAMPTON PARK BOULEVARD JACKSONVILLE FL 32256
GROUP INC
OWNER: ADDRESS: CITY: STATE: ZIP:
KACZOWKA ANN 639 AQUATIC DR ATLANTIC BEACH FL 32233-3852
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC WORKS NOTICE OF COMMENCEMENT INFORMATIONAL
Notes:
No inspections may be scheduled until a copy a recorded Notice of Commencement has been submitted to the Building Department
2 PUBLIC WORKS ROOF IN-PROGRESS INSPECTION REQUIRED INFORMATIONAL
Notes:
a.The roof sheathing for all new construction must remain uncovered until the Roof Sheathing Inspection is approved.All roofing projects require an In-
Progress Inspection.Sheathing installation and replacement guidelines per APA.Underlayment must conform to FBC-R Table 905.1.1.Shingles must
conform to ASTM D3161 G or H,or ASTM D7158
Issued Date:7/23/2024 1 of 2
_ i
''r'
kREROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF24-0125
800 SEMINOLE ROAD ISSUED: 7/23/2024
�`''t �r AT EXPIRES: 1/19/2025
LANTIC BEACH. FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $90.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date:7/23/2024 2 of 2
7' v ■ ■
( . City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: ` t Afock4;4 Or Allan re_ 14 'L 72Z 33 Permit Number: RE R F Z4 O( Z5
Legal Description 3g-7/ /7-2c—21 F 4aighfc 6ardcxls ier# J —i RE# lilt l.f—535f
Valuation of Work(Replacement Cost)$ 7/5 1 . 75 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of w rk to be perf rmed: e1\oidC c ,td kc etPArcIt'r�ur=t I &A)%/91 /eg
k, r"-ti-N A F -r; ("1 int ND Arad eur6t S h,:Aslie.,s
Florida Product Approval# Ft. iv 12A -01 for multiple products use product approval form
Property Owner Information
Name 4 n (lc ci Durk& Address 6'3.9 Ait.t.AtvG V r-
Cityr1/ '1./, Le'., L' State FL. Zip '22 Z Phone 77 y- 474(-!3
E-Mail Pall,(^:e .1•1/0 3 ricti I , E,nm
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company
ompany fit en6+4dQdk 6_ TnC, Qualifying Agent rQ _ 8
Address (f �►;- ilv I City Je, ,.fJ c, State FL ",
ip 3 i-Sc
Office Phone gal-
- corfq Job Site C ntact Number '-s uce.IN `6'1 w 7—Hy - c
State Certification/Registration#�'CC 1324' .S E-Mail (v&0 f'ileyylc y C' .colni
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt/4 Expiration Date 4-3 201
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 of a permit and that all work will be performed to meet the standards of all the laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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 I R AN ATTORNEY BEFORE
RECORellG Y UR NOTICE OF COMMENCEMENT. _
\_____ L I LJ
ignature of Owner or Agent) (Signature contractor)
k
Signed and sworn to(or affirmed) before me this 1 ''day of Signed and sworn to (or affirmed) before me this I day of
„team ,by f\an i cC 2Ou) L j J� ,2o21 , b� 't b
C rri\a)s-/t-i
(Signature of Notary) (Signature of Notary)
:Nig:. CARRIEMANLEY PersonallyKnown OR R�
[ ]Personally Known OR ;;o• •; 0. 4e Tricia Llller
�. • : MY COMMISSION#HH 172719 0�; Commission#HH 379668
f‘i'1'roduced Identification *: :+: ] Produced Identification =
.4 •o; EXPIRES:December 2,2025 v Commission Expires 03.28-2027
<4'.2!'.!•`,?,'.." Bonded Tin Notary ry Pubic UndErwTiters 7j�- ° Bonded Through•Cynanotary
4�m.4 - . �.,...�— 4 l OFn Florida-Notary Public
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE) G
Permit No. Tax Folio No. 17 I6 1& - 525-
k
State of 1y—lp f N(A a County of DLL va 1
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:
?— 71 17-)-S - A yu Lc,t- so-E.
Address of property being improved: A ice:4+L tJ r A to n4 ie_ Lt_<C
F r_ /'�
General description of improvements: C', — Ocx3
Owner 4- nV\ ri r:"LO u/kcA.
Address ` ?Cj 41
uc4•'L 0C-. L114;e_ P�'rr� F, 5z,2-57
Owner's interest in site of th Improvement (214.- - SG/F
Fee Simple Titleholder(if other than owner)
Name
Address /� /� _
Contractor ! rC;/1 �e` (_G/1S'7/f Ul �l 'C �l 7;p:,�� J 41(`
Address ItCII / /iLv keN Pear tlild .lCe4-ksan,' /le FL .zzc(
Phone No. 9061 - 099 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 o,
different date is specified): r` L
N
•^
THIS SPACE FOR RECORDER'S USE ONLY OWNER � csr
Signed DATE i if B ( )L1.( at t
Before me this 1 day of in the
County of Duval, to of Florida,has pers ally appeared w —
At111 CaL2OL,O 1A herein by to
Doc#2024157830,OR BK 21132 Page 13, himself/herself and affirms that all statements and declarations herein W
are true and accurate
(-) 0 K
Number Pages: 1 v
Recorded 07/23/2024 08:05 AM,
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL n^ A
COUNTY r u v \W.A1-'\
RECORDING $10.00 No ublic at Large,State of f IDr 16 C.4, County of j)U V P L o:
My commission expires: i2.2.2 S ' �
Personally Known or i<
Produced Identification 'FL O r•:C1 'J r 1 VCO"> 1 co rl�— �it•`•:
