1102 ROSE ST RERF21-0232 ,: ,f Building Pi nit Application Updated 10/9/18
.-7.-
;'-' City of Atlantic --ach Building Department **ALL INFORMATION
S. E00 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
r* Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 1102 Rose Street Atlantic Beach, FL 32233 Permit Number: RERF Z k 0 2. '2)a
18-34 38-2S-29E.210 ATLANTIC BEACH SEC H S 40FT LOT 6,STREET LYING S
Legal Description THEREFORE CLOSED BY U/R BCH ORD#65-84-10 BLK 192 RE# 171007-0150
Valuation of Work(Replacement Cost)$ 11,200 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 l Residential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes lt1No
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) i?iNo
Describe in detail the type of work to be performed: Full Roof Re lacement Architectural Shingle 1 Story 19 Squares 5/12 pitch
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Florida Product Approval # tL-10? ') VL...1j for multiple products use product approval form
Property Owner Information
Name Linda Jo Anne Starling Address 1102 Rose Street
City Atlantic Beach State FL Zip 32233 Phone 904-241-7492
E-mail (starling1344@gmail.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company American Roofing of Jacksonville, LLC Qualifying Agent Dan Kinkel
Address 2117 University Boulevard South City Jacksonville State FL Zip 32216
Office Phone (904)385-4375 Job Site Contact Number 904-385-4374
State Certification/Registration# RC29027546 E-mail admin@americanroofingjax.com
Architect Name& Phone# N/A
Engineer's Name&Phone# N/A
Workers Compensation Insurer Builder's Mutual Insurance#WCP1052393 OR Exempt 0 Expiration Date 05/03/2022
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 OR AN ATTORNEY BEFORE
RECO DI . YOUR NOTICE OF COMMENCEMENT.
nature Owner•• _!.nt) .,eff
((natur of Contractor)
Signed and sworn to(or off :•) b'fore me this / day of Sign^edand sworn tto(or affirmed) be ore me this p,4 aay of
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- . •t.t (Signature of Notary)
,.risk i7". ALBERT MORENO
?°�h1� Notary Public State of Florida
o`; Commission GG 304875 i►nrr^,• EMILEA SPAULDING
[ 1 Personally Know . '.;..W
, WE:. � (pj Personally Known OR f `�': Notary Public-State of Florida
oxcs,-. My Comm.Expires Jun 9,2023 €.
ttei Produced Identification Bonded through National NotaryAssn. [ ) Produced Identification _ Commission#HH 059001
Type of Identification: +FL • ——�---———— — — .Type of Identification: % a ,.,. My Comm.Expires Nov 1, 2024
Bonded through rlatlonai Notary Assn.
Doc # 2021243834 , OR BK 19916 Page 2022 , Number Pages: 1 ,
Recorded 09/17/2021 09:09 AM, JODY PHILLIPS CLERK CIRCUIT COURT DWAL COUNTY
RECORDING $10 .00
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 171007-0150
State of Florida,County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance
with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legal description of property and address if available):
18-34 39-2S-29E.210 ATLANTIC BEACH SEC H S 40FT LOT 6,STREET LYING S THEREOF CLOSED BY U/R BCH ORD#65-84-10 8LK 192
1102 Rose Street Atlantic Beach, FL 32233
2. General Description of improvements:
Complete Tear-Off and Re-Roof
3. Owner Information:
a)Name and Address: LINDA JO ANNE STARLING 1102 Rose Street Atlantic Beach, FL 32233
b)Interest in 100%
c)Name and address of simple titleholder(if other than owner):
NA
4. Contractor Information:
a)Name and Address: American Roofing of Jacksonville
2117 University Blvd S, Jacksonville, FL 32216
b)Phone Number: (904) 385-4375
5. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN 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 FIIZST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true o best of my knowledge and belief.41/
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( v:--.0@-) �' '^^'`',� L t r&A -SIC-0-J 111/1
Signature of 0 or Owner's AuZtrerized Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The foregoing instrument was acknowledged before me by me. of®.h"sical presence or[J online notarization,
Sf • i
this I day of Ste'"^C3 ,20 7\ by t-1 ' j 51- ^'v
j(Nam Itrson making statement)
A Le
A,B ar MORENO NOT• • P : STATE OF FLORIDA
Notary Public State of Florida
ComTissionmGG 304875 Punt me: 1T t—/3�� ►
My Com .Expires Jun 9,2023
Bonder]thrucgh National Nctiry Assn,
ersonally Known
ErIdentification'Type:
(Alto-(Notary Seal Above)
Revised 3/16/2020