845 Sailfish Dr RERF21-0261 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
A g CITY OF ATLANTIC BEACH RERF21-0261
800 SEMINOLE ROAD ISSUED: 11/8/2021
ATLANTIC BEACH. FL 32233
EXPIRES: 5/7/2022
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:
845 SAILFISH DR REROOF SHINGLE Shingle: FL10674R15,
Underlayment: FL15216 $6940.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171245 0000 ROYAL PALMS UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
SUNRISE ROOFING 762 7TH AVE S JACKSONVILLE FL 32250
COMPANY
OWNER: ADDRESS: CITY: STATE: ZIP:
LORIN ELIETTE MARIA 1972 COLINA CT ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If\
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $85.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$89.00
Issued Date:11/8/2021 1 of 2
I
i REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF21-0261
800 SEMINOLE ROAD ISSUED: 11/8/2021�. !
ATLANTIC BEACH. FL 32233 EXPIRES: 5/7/2022
Issued Date:11/8/2021 2 of 2
Building Permit Application
Updated 10/9/18
(:: .T., City of Atlantic Beach Building Department
**ALL INFORMATION
us:i" 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
eZNmJob Address: 94s sail c Sh Plvici t}�c is i,7 . Permit Number: RC-FFi - C2�D I
Legal Description 9P-{c0 11-25.-2.`i 1' (.ic.t 2c,_10 un;t 1 t_04- 27 g\kijp RE# 11 I V4'5-'-000 3
Valuation of Work(Replacement Cost)$ Cot
01+-10.o 0 Heated/Cooled SF 1 7.--1
5 Non-Heated/Cooled 3�
• Class of Work: ❑New DAddition Alteration 1 epair ❑Move ❑Demo ❑Pool DWindow/Door
• Use of existing/proposed structure(s): ❑Commercial Mesidential
• If an existing structure, is a fire sprinkler system installed?: cPeft ❑No
• Will tree(s) be removed in association with proposed project?❑Yes(must submit separate Tree Removal Permit) Ko
Describe in detail the type of work to be performed: F4,2_—tZ -F= --'. OW L1rlS Cor�, +
Florida Product Approval# L.;0611-112k 5) }�L-1 S 2`b7 a for multiple products use product approval
Property Owner Information
Name ,'r 0-\--e. L`L '-- .— Address t cj 1 Z ��C.o\ t ck- C.k •
City +0 ckyl-KL tre,a . . State '- Zip 3 2_2_33 Phone CTON — 23-' —Ooa-- j
E-Mail f-NVI .(- ,�Y'1 ,n )1QC (./0 rrY')Cti \ : (" .0YV\
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company �j,kohi JZ� r�C r A�,„ualif ing Agent ( t e 'a .
ill
Address 10".1_,-M V Q S. Cityi ti L... I.91:32.-- -C-0
Nte -P
Office Phone ' --3 2 )i 2 Job Site Contact Number
^i---fei
( oi...--
State Certification/Registration# LC'LI � 1 Z� 1eqp,E-Mail i� �� go
Architect Name&Phone# 1\n O--
Engineer's Name&Phone# Jul v -
Workers Compensation Insurer OR ExempX Expiration Date I/ Il 27
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 IA,M U l DTIC OF COMMENCEMENT. ---I, � ,\
,f_z________
ll ((,,(S��ignatu((ree of Owner''er</or-Agent)
(Signature of Contracto
Signed and sworn to(or affirmed) before me this ! 2-day of Signed and sworn to(or affirms)before me this dicey of
�'; b NOV , 20'2,1 ,by " S ,A .
C. :._Commissicat GG 16-5631 -4\1\c , rL w (, l/r Cev� .(�[�
-:- �•-o Expires December 7,2021 (Sigr�ture of Notary) (Signature of Notary) //
''..f. `?.''. Banded MN Troy Fain Insurance 800-385-7019
tF." CHRISTIAN GILES
[ ]Personally Known OR [ ]I;ersonally Known OR fl,i. 6, '
MY COMMISSION#1-01 117153
IA Produced Identification `"' EXPIR&S:April 13,2025
[ Produced Identification .,,�1�,o;=
Type of Identification: C �`0..iL�.� Type of Identification: Bonded Th
1-\ FL b L � Ur+derwrirexa
Doc # 2021277238, OR BK 19969 Page 1570 , Number Pages : 1 ,
Recorded 10/21/2021 08 :33 AM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
i FRFPARE IN DUPLICATE;.
Permit No. Tax Folio No. 171245-0000
State of rte;"
County of Duval To whom it may concern,
The undersigned hereby Informs you that improvements will be made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the lot:owing information is stated in this NOTICE OF
COMMENCEMENT,
Legal description of property being improved: 30 60 17-25-29E ROYAL PALMS UNIT I LOT 27 BLK 6
Address of property being improved: 845 SAILFISH DR., ATLANTIC BEACH, FL 32233
General description of improvements: Re-roof
O:ner ELIETTE LORIN
Address 1972 COLINA CT-,ATLANTIC BEACH,FL 32233 — —-
Owner's interest in site of the improvement owner
Fee Simple Titleholder(if other than owner)N/A
Name
Address
Contractor Sn,nss RoofingConipany
Address 762 7th Ave.S.,Jacksonville Beach,FL 32250
Phone No. 834 495-1835 Fax No.
Surely(if any)NSA
—
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements
Name N/A
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 NIA
Address
Phone No. Fax No
In addition to himself,owner designates the following person to receive a copy of the t_tenors Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owners option).
Name N/A
Address
Phone No.,_ Fax No.
Expiration date of Notice of Commencement(the expiration date:s one(1)year from the date of recording unless a ' .;'.
different date is specified): �•��••ti �';S_
THIS SPACE FOR RECORDER'S USE ONLY a..",i,
O ftR ,,
t0 .4. ..-Sg : Di.T /o.,...._ .'.�. ... ' O
Before me this �.._ day or in the G- g R O ,r--
Cuung_o(Otivat. ta' or Flonde.has persgnaii ppeared , rr— rn
1 1-l'5, t C� `�!__ herrn!;y m ' T
hirnseif'herse2 and aitrnts Nat all statements and declarations herein x a
are true and accurate . ,i q,t .7c
' rn
i m
- • r
-' i : z
Molar,/Public at Large.State of coup of �.1 :1\ N
61y commission expires:_ _ __ _
' Personalty Kno..i, _ _ a
PiodNredIdervrncahon__ S -
e titans or-- 6t' ph,As'kc.at r t Ser- \c¢ --