909 AMBERJACK DR RERF22-0024 ,' �6�y REROOF SHINGLE PERMIT PERMIT NUMBER
A RERF22-0024
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 2/9/2022
--:. ate ATLANTIC BEACH. FL 32233 EXPIRES: 8/8/2022
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.
INOTICE: 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:
909 AMBERJACK LN REROOF SHINGLE GARAGE - SHINGLE ROOF $4800.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171177 0000 ROYAL PALMS UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN ROOFING OF 2117 University Blvd. S JACKSONVILLE FL 32216
JACKSONVILLE
OWNER: ADDRESS: CITY: STATE: ZIP:
CORSON TRACY DEE 909 AMBERJACK LN ATLANTIC BEACH FL 32233-6301
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.
7 ,.,:,
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $75.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$79.00
Issued Date:2/9/2022 1 of 2
Building Permit Application Updated 10/9/18
i City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233
HIGHLIGHTED IN GRAY
4 't 9r IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 909 Amberjack Lane,Atlantic Beach, Florida 32233 Permit Number: Ei-RP z
Legal Description 30-60 17-2S-29E ROYAL PALMS UNIT 1 LOT 23 BLK 4 RE# 171177-0000
Valuation of Work(Replacement Cost)$4,800.00 Heated/Cooled SF 0 Non-Heated/Cooled 728
• Class of Work: INew ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial SResidential
• If an existing structure, is a fire sprinkler system installed?: DYes •No
• Will tree(s) be removed in association with proposed proiect? EYes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed:
Install 10 square architectural shingles to(detached garage. 4/12 pitch.
Florida Product Approval#FL10124 FL10626 for multiple products use product approval form
Property Owner Information
Name Christopher Corson Address 909 Amberjack Lane
City Atlantic Beach State FL Zip 32233 Phone 904-588-6563
E-Mail chriscarson41@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 Builders Mutual Insurance#WCP1052393 04 OR Exempt❑ Expiration Date 5/3/2022
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
RECORDINGYOUR NOTICE OF COMMENCEMENT. - f,i �
...........
• (Signature of Owner or Agent) � (Signatur of Contractor) `aesY
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•gned and sworn to(or affirmed)before me this `� day of Signed and sworn to(or affirmed)before me this `b'�ay of a ; z
a 3brua% aoaa ,by l i 16 A reloruo rte /dap ,by ►rl lit;Aisle
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(Signature f Notary)
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NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 171177-0000
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):
30-60 17-2S-29E ROYAL PALMS UNIT 1 LOT 23 BLK 4
909 Amberjack Lane Atlantic Beach, Florida 32233
2. General Description of improvements:
Complete Tear-Off and Re-Roof of Detached Garage
3. Owner Information:
a)Name and Address: Christopher Corson 909 Amberjack Lane Atlantic Beach Florida 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 FIRST 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
Ytherreine a�ree true to the best of my knowledge and belief.
CN,ri 5 to OA(r- Co rS a/.)
Signature of Owner or Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed'Name&Title/Office
The foregoing instrument was acknowledged before me by means of@ physical presence oronline notarization,
this g day of Ft brua,rc ,20 aoj ,by a k r-15 4-0p
1‘)01" Co`C`,SoA..)
(Name of P son making statement)
a►w�y� EAtILEA SPAULDING
f `: Notary Public•State of Florida I 6(AkAB IC, ATE OF FLORID
` Commission N FIH 059009 //-`• / `/
( '. a�,d' My Comm.Expires Nov t,2024 Print Name: £M; ea U(�!L't
3.
Bonded through National Notary Assn. I
Personally Known OL.
(Affix Notary Seal Abovel
Doc#2022040202,OR BK 20142 Page 823,
Number Pages:1 Revised 3/16/2020
Recorded 02/09/2022 01:10 PM,
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00