790 Saiilfish Dr RERF22-0061 Roofing Permit-NOC Y''°'r%• REROOF SHINGLE PERMIT PERMIT NUMBER
0
CITY OF ATLANTIC BEACH RERF22-0061
800 SEMINOLE ROAD
ISSUED: 3/24/2022
2 ° ATLANTIC BEACH. FL 32233 EXPIRES: 9/20/2022
INSPECTIONMUST CALL • I • FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' • BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF
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: VALUEOFWORK:
790 SAILFISH DR REROOF SHINGLE SHINGLE ROOF $6760.00
TYPE • BUILDING
• SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171201 0000 ROYAL PALMS UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
B. SMITH ROOFING, INC. 13525 SAWPIT RD JACKSONVILLE FL 32226
• ADDRESS:
790 SAILFISH PROPERTIES P 0 BOX 28130 JACKSONVILLE FL 32226
LLC
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.
DESCRIPTIONACCOUNT QUANTITY PAID AMOUNT
BU I LEING PERMIT 055-0000-3221000 1 0 $85.00
STATE DBPR SURCHARGE 455 0000 208 07M 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$89.00
Issued Date:3/24/2022 1 of 2
Building Permit Application Updured 1019118
IRCity of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us 15 REQUIRED.
Job Address: -AO S(> �Pysin 0(,Na fr-nl Permit Number:
Legal Description '1i0-6 D 11 '2 S- 9 rF RnYAL PfzLS Qc,A( Lok REs`S
Valuation of Work(Replacement Cost)$_ Heated/Cooled SF 011 S Non-Heated/Cooled 1lL1
• Classof Work: ❑New []Addition OAneration []Repair ❑Move ❑Demo ❑Pool E]Window/Door
• Use of existing/proposed structure(s): ❑Commercial JJAResidential
• If an existing structure,is afire sprinkler system installed?: []Yes ENo
association rotect? []Yes(must submit separate Tree ReP No
Describe in detail the type of work to be performed: S Yl l n Q
�/ C.9-13J 1-155LU.<5 jlriun,k,6 R-417355. 1
Florida Product Approval# Vn Sc. 1 ( 74 0 1 for multiple products use product approval form
Property Owner Information
Name LLC' Address Q-O $Ok ei30
City �p.k+Dove\le, State FL Zip 31i?.h Phone Qa4-310-011
E-Mail M/A
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Qa sa,64h I1aAuclw l..&. Qualifying Agent (anon Sm+i�.
Address 13[0.5 Sgvp�R-b City "N' . State Zip 3JJ.J.0
Office Phone 9011 60 lob Site Contact Number 9D�+'4gS�331$
State Certification/Registration# [ XV11 E-Mail 6<._al,dna{tins rn. aN•nd
Architect Name&Phone#
Engineers Name&Phone#
Workers Compensation Insurer 1 pHs its- N"* -11 4A41 OR Exempt O Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated.)certify that no work or Instal lation 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 ofthis
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
RECORDING YOUR NOTICE OF COMMENCEMENT.
l�r1.�� Cine ✓f—
(Signature ofOwner orAgent) (signature of Contractor) ��22
Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirme before me thiso day of
MA'.1, D)>- .by kcWy Ver (Yfad, . aoaJ. .by tis
isignature'15TIvIdtalyr
. / Nobry Pobliogtrte oERbrrlld.
' tt ;,yy"w HANNAH A. PIERCE Vl Penonalry Known OR a Commieabn#HH 183P6I
1/1 Personally Known OR Note Public- "3, a My Commleelon E�xppfres
I Produced x ry St.te of Fbride [ ]Producetl Identification po uat OB,2026
TYPe ofdificationceelan 9'1ne ' NtY.•-- e1oaN-E,1•e325] Type of ldentifcation:
u uet 09, 2021
NOTICE OF COMMENCEMENT
State of Tax Folio No.
County of
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: 30 0 17-2S-29E ROYAL PALMS UNIT 1 LOT 16 BLK 5
Address of property being improved: 790 9aNwh D Eaal Adandc Beast.Florida 37233
General description of Improvements: Re-Roof 17 Squares Shingles
Owner: 790 SelNsh Properties LLC Address: P 0 Boa 28130 Jacksonville,Florida 32726
Owner's interest in site of the improvement: Simple
Fee Simple Titleholder(if other than owner):
Name:
Contractor: B.Smith Rooeng,Inc.
Address: 13526 Sawpil Road Jacksonville,Florida 32226
Telephone No.: (9D9)3794805 Fax No: (904)378-8606
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 notion 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 Uenor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill In at Owner's option)
Name:
Address: o^
U3mm
Telephone No: Fax No: W rq
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different
specified):
1 Q� $ Ew
THIS SPACE FOR RECORDER'S USE ONLY OWNER
QZE >•a
Doc M 2022075687,OR SK 20196 Page 123, Signed:
Nuri Pages:1 Beforemethls o&5 day of Fr1As In the County of Duval, to....�
Recorded 03242072 08:11 AM, Of Florida,has personallyappearetl 4se=
JODY PHILLIPS CLERK CIRCUIT COURT DUVALDuval. sty ar
Notary Public at Large,State o lodda,County of
COUNTY My commission eapires: ',¢ '%"65F`
RECORDING $10.00
PersonallyKnown: V
Produced Identification: