1565 richard lm RERF21-0228 '`''‘''`
REROOF SHINGLE PERMIT PERMIT NUMBER
,�� ,� RERF21-0228
-:�: s-, CITY OF ATLANTIC BEACH
,� r 800 SEMINOLE ROAD ISSUED: 9/22/2021
1..rr:!" ATLANTIC BEACH, FL 32233 EXPIRES: 3/21/2022
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:
Shingle: FL5444-R16,
1565 RICHARDSON LN REROOF SHINGLE $7500.00
FL15216-R3
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172097 9555 FRANCIS COVE REPLAT
COMPANY: ADDRESS: CITY: s STATE: ZIP:
Metal Wall Systems, Inc. 924 NW 60th St Gainesville FL 32605
OWNER: ADDRESS: CITY: STATE: ZIP:
Noble Oak Construction 1565 Richardson Lane Atlantic Beach Fl 32233
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 OFCONDITION,,S, ,,.
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
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: $94.00
Issued Date:9/22/2021 1 of 2
Q'';',.„ Building Permit Application Updated 10/9/18
:� City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233
FHIGHLIGHTED IN GRAY
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 1 .OS ( t;..Ar\G%t`-ck.11 -1 l.Q,(Q__ Permit Number:
Legal Description 52.. 11 G-7—23 2'1 e- a )41/1 RE# 1717 —'--1)75-5—
, caio
Valuation of Work(Replacement Cost)$ 75 C�) '---�-Heated/Cooled SF Non-Heated/Cooled
• , Class of Work: ❑New DAddition ❑Alteration 9 epair DMove ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial1esidential
• If an existing structure,is a fire sprinkler system installed.: ❑Yes o
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) .=4''o
Describe in detail the type of work to be performed: �— —(j,ije'�pa stmiltsz
Florida Product Approval#FL 5`1/.4 'Rho ;CL /5-2-1(o —123 for multiple products use product approval form
Property Owner Information / `l-e—
Name il,t1a... \ / (1644-, a3kt, Q4)k4`'"`'Address 7233 nu) .S Se *-3
City State
�' 4L. Zip 32(Ot Phone 3S2. Z3l 3(a OA
E-Mail @,elft.0o.�G.C�r1S DVRAfl %CSO(II
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company kO (A St J .) Qualifying Agent
Address q 2t( (ILL) (Q C1' S'c City [jut.kjuoyvi,k, State \1.r Zip 3-2.( o
Office Phone 2 S2- (0-)-Z - 0\ L -.1 Job Site Contact Number 3.52 672 r i 3
State Certification/Registration# E-Mail o� AA. _ !,, S , - di• Ah.
Architect Name& Phone#
Engineer's Name& Phone#
Workers Compensation Insurer OR Exempt a Expiration Date
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 •R AN A ORNEY BEFORE
RECORD! G YOUR N,/OTIC 0 COMMENCEMENT. /.....- -/ /
(Signature of O or Agent) (Signature of Contractor)
/Signed an sworn to(or affir7d)before me this )\ day of Signed and sworn to(or a it d)before me this 3\ day of
P''% LESLEY NB i S ` ;�,o� LEY iv.LVINS -��'
moo` °Bi'' ���- o` +�'' Notary PE. F •riria ,
�:a_*_Notary Public-Jt N-4.4)
t ripe_ + ,,, �z
"�4 Commission#H 160 ItncAure of Notary) _'•I- •E Commi sion# 110. ur( of Notary)
.. ' ." My Co sten Expires
,?l' '•; My Commission Expires %��,.�"��
,,, p "___ August 03,2025
" ` August 03,2025 ,MM,
[ ] PQcsona ly Known R [7.5.- nally Known OR
[Produced Identificatio [ duced Identification
Type of Identification: 01.6'.1,-. 2L-- Type of Identification:
NOTICE OF COMMENCEMENT
State of F404.�9/5Tax Folio No.
County of D
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: 0.-9 9/ 1 7 2 S — 9 ` . . 1 y / fie49e,78 —
CC V f-klyz ig-r-redor
Address of property being improved: 1S(0S 4(0/.0. char\ rge0.Ck7233
General description of improvements: 'Q./. c xk Q/:
Owner: rcO.& O*JL (101‘. L.L.t Address: 223 3 aca.,..t.)004.2 -
Owner's interest in site of the improvement: Doc#2021248725,OR BK 19924 Page 1409,
Number Pages: 1
Fee Simple Titleholder(if other than owner): Recorded 09/22/2021 01.46 PM,
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL
Name: COUNTY
RECORDING $10.00
Contractor: 1 L /. , S T /
Address: (1)-.4U/4 /(/ C9 .Sr- l� 116 05
Telephone No.: 3 5Z 6-72_0 /3 Fax No:
Surety(if any) _
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
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: _
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:
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
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER �/ n-
Signed: �„6444/44,.....
444/ t4 A V`- Date: � ��
� 41,,,,,„ LESLEY NEVINS
,��1� Notary Public-State of Florida Before me is c \ day of ,.� .r in the Co �,.. of; . State
`*�'=ter= Commission#HH 160644 Of Florida as ersonall O
;y. .g: personally appearedISOM — — -� •
„00,$ My Commission Expires
August 03,2025 Notary Public at Large,State of Florida,County of-=• 1
My commission expires: AsLI 3, 1
Personally Known: or
Produced Identification: Cor,r\ r1 f J e f s