1841 N SHERR RERF22-0072 NOC REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF22-0072
800 SEMINOLE ROAD ISSUED:
ATLANTIC BEACH. FL 32233 EXPIRES:
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:
1841 N SHERRY DR REROOF SHINGLE SHINGLE ROOF $13000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0788 SELVA MARINA UNIT
10B
COMPANY: ADDRESS: CITY: STATE: ZIP:
MONAHAN ROOFING 2050 S KING CIR NEPTUNE BEACH FL 32266
OWNER: ADDRESS: CITY: STATE: ZIP:
CARROLL CHARLES R 1841 SHERRY DR N ATLANTIC BEACH FL 32233-4516
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $120.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$124.00
Issued Date: 1 of 2
Building Permit Application Updated 10/9/18
' City of Atlantic Beach Building Department **ALL INFORMATION
-�F ,�,, 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: I K( No r{h err Q r, Permit Number: F(�-_1�►- Z Z- 0c7
A Legal Description 26o-- 1 c7 •- ZS 2Q t Jeliun fY)cyr,A . (4'- t /0-.a RE#
Lc '- /
Valuation of Work(Replacement Cost)$ ►3, 600, Heated/Cooled SF Non-Heated/Cooled
den .C‘
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed:
Re ,-z Q�isIn5 Sy r- , ,ns.k•11 C, AF 1imbe.rfinA
ola r -F.rr, in.:,r-!1....J
Florida Product Approval# PL /11/ 2 y—/ ' /feet_ (s,,._,i-r+� for multiple products use product approval form
Propert 0 ner Informatics FL--1 43G
Name L ale /0.T J a ko II Address ail/ 4) JYt.1)/..74&
City A. • cc a, ' • _ State r L Zip 3 1-Z-g Phone v ! yb. 2-;((if V
E-Mail (1 i-CC L-rc,I ri 6 `,/ • •C 0✓4k n
Owner or Agent(If Agent, Power of Mtorney or Agency Letter Required) (�`‘la ti' le C" ( `a l 7011
Contractor Information
Name of Company ( ,Zana,. ( o♦-tn5 Qualifying Agent TO' mo, h.
Address ,c3 Sc ices: C,rc ( < City lvep4K— State FRS Zip 2zzc.>c,..
Office Phone CI Oct- 2--2..( -SSS Job Site Contact Number
State Certification/Registration# t2cC `t-13(1'1 E-Mail `T-L. ' Ona-an ej comc c,11-, nQ (-
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR ExemptL Expiration Date y-S-23
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/�rc YO,' •TICE •FCOM ENCEMENT.
(Signature of Owner or Agent) (Sign of Contractor
2 r
Si ned and sworn to(or affirmed)before me this75 day of Signed and sworn to(or affirm d)before me this J L day of
V7a.rr,� ,7 2-Z ,by a • kc--, r f'r- , 2022,b, hpyylh, MdrA 1
AMELIA GARTLEY �i ?Z 6/-1 10- /•1`/�•J ��►2
<?Ye .: (Signa t of Notary) 1 �1?' . ►•
,.. = MY COMMISSION#HH 176171
* �,-,;-�� t';i1',ry, •• A IAM.GABRIEL
,�...a,` EXPIRES:September 19,2025
-'•`` c FLAP', , =.Th u N.,. PUI>uc Undenvrilers , a r•. Commission#GG 345160
r ••r .�. I ,... . . • [ ]Personally Known OR i:` ;''":' '
-�.>; __' *N,� Ezplros Juno 13,2023
Produced Identification :!:r,f�
Produced Identification ,.> BnndnAT Troy FalnImmo 110Q:10rr701f1
Type of Identification: 1-^L IX, Type of Identification: ��iwI -----ys-.
Permit Number Tax Folio Number
NOTICE OF COMMENCEMENT
STATE OF FLORIDA
COUNTY OF DUVAL
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance
with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. escription of property(Street address): \ .8 qt Nor I-k her r t-kon.F_c Be_tcti _
' egal Description: 3�- (o I 0 5 - 2 S 2 __57e � N U/V
' � v A AR .. q t 4 /0 -e i_6 / i3
2. General description of improvement: Cc'4-1 p f eF e- 2e co- (2-
COwner information: /"�
a. Name and Address: 45 C_..Q�2m 1f / / SI�/ rJ leg(l.�J 4./1 44 Fc- 3 2 z �3
a. Interest in property: Obi e-'e2
b. Name and address of fee simple titleholder(other than owner):
1.a. Contactor's name and address: /Ylo Aa tn.. R.= ,-+ 5 C� i r'a.c E o r /1 < ti c
b. Phone number: S G 8-c(9 2 d Fax number:
5. Surety Information:
a. Name and address:
b. Phone Number: N (a Fax Number:
c. Amount of Bond:
i. a.Lender's name and address: p i
a. Phone Number:
'. Person within the State of Florida designated by Owner upon whom notices or other documents may be served
as provided by 713.12(1)(a)7.Florida Statutes.
a. Name and address: ti 1 O-
b. Phone numbers of designated persons:
3. a. In addition to himself or herself, Owner designates r✓ 112-- of
to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b),Florida Statutes.
b. Phone number of person or entity designated by owner:
J
. Expiration date of notice of commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified) IQ ( p- N o
N F-
CV CL
'VARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE E o
TOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, 1-
'ART I,SECTION 713.13,FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR N 2 0
MPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED Y 5
►ND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN CO N Y
CC 0
FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK o N w CC w 0o
)R RECORDING YOUR NOTICE OF COMMENCEMENT. �N" o cn
�g �,
c0 �c2 o
ignature o e ner(0, er's , ithorized Officer/Director/Partner/Manager): N a�= o
ilh
/// ., N al 1:3 Z 0
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Signatory's Title/Office)
\ D Z CIU ce
he foregoing instrument was acknowledged before me this / day of lL(-C(,�, ,20 2 7
/
y l Lifi�l-�('u4�.1. gas r _• / Cir.4,1e
for fly j
•
y psi`''""" AMEUgt;ARTI FY
f otary: Z/7 / // A *: ,*; MY COMMISSION#HH 176171
,_ :,�` EXPIRES:September 19,2026
_ ''r.ii'ei�?�.� Bonded Thou Notary Public Undenvo lets
ersonally Known or Produced Identification )( Type of identification Produced: 1'L t-
ly commission expires: 9/ I/77
rnder penalties of perjury,I declare that I have read the foregoing and that the facts stated in it are true to the
est of my knowledge and belief.