1187 MAIN ST RERF22-0130 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
ACRES KENNETH D 1187 MAIN ST ATLANTIC BEACH FL 32233-2623
COMPANY:ADDRESS:CITY:STATE:ZIP:
MEDITERRANEAN
CONSTRUCTION 2751 MCCORMICK WOODS DRIVE JACKSONVILLE FL 32225
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171015 0050 ATLANTIC BEACH SEC H
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1187 MAIN ST REROOF SHINGLE SHINGLE ROOF OVER $6000.00
FEES
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
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 6/2/2022
PERMIT NUMBER
RERF22-0130
ISSUED: 6/2/2022
EXPIRES: 11/29/2022
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 6/2/2022
PERMIT NUMBER
RERF22-0130
ISSUED: 6/2/2022
EXPIRES: 11/29/2022
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
NOTICE OF COMMENCEMENT
State of Tax Folio No. k l 0 t c DO S'p
County of U VCiL-
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: SE' C % A'r I. 0.n-4 ;c 19-.B LI. (q ci
Address of property being improved: I\sl
General description of improvements: RooF pvAcz.,r . , L25.
Owner: Ire,',n AAddress: ( 111/4-4-ca ; S t r
Fee Simple Titleholder(if other than owner):
Name:
1 1
Contractor: r rr.,,v..e p v,co „r, Co.res,ircza,, _
Address: 2 0 C L..tc, rlr., ..,fit]cel pS� j�u ��Si v`2 I�l_ 32D 9 2-
Telephone
Telephone No.: Fax No:
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 notices 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 Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year (:•.-s. . • ori1ine.unLess a different date is
specified): 1 4!%` c':':',, TONI(;INni ESPPAr _
MY COMMISSION#GG 353178
THIS SPACE FOR RECORDER'S USE ONLY OWNERp EXPIRES:October 6,2023
°F"°' Bonded Thru Notary Public Unde '
;I
Signe 1 4071j e.
Doc#2022147062 OR BK 20304 Pae 2334,
9 Before me this day of u a v 'n t - County,L�o\\f D val,State
Number Pages: 1 Of Florida,has personally appeared ll ( A Cie .
Recorded 06/01/2022 12:55 PM.
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of Florid Co y of Duv I.
COUNTY My commission expires:
RECORDING $10.00 Personally Known: CIL. ' . t or
Produced Identification: �-� .
srS4ri. Building Permit Application Updated 10/9/18
r; City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
�r IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 1 t$tl Mnay. StY.
Permit Number:�CKr2zVoi 3
Lo-t5 I,26Lk-Ir{q
Legal Description I % -3Lk -• 9--5�1 _2`i C-G .2 _q.a_ C N ki I 1, ' (,,± (3.4._RE# 11 101S- 0050
Valuation of Work(Replacement Cost)$ 6 OOO'° 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 6]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: Ro' S c3UQv C z- St 1 -
i Ik frk v c S trt-; ,.,o,t.e S .
Florida Product Approval# FL. \ 3 35S— (2,6 for multiple products use product approval form
Property Owner Information
Name 'Ke_r‘r1 Rcv--e__<._- Address 11c t Iko.'rr Str.
City At o-v,..-k-.c. :.c... State ►=l Zip 39,.9:39) Phone '\0--i •--)k53 •3\Qk-k
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company t ftp G,,, Qualifying Agent -to.V;r•c $ &c n-i -g
Address i�0n
1 c� e "YY - oL
) cd P City Ace State FL Zip '19_V-10._.
Office Phone<=:t0 t..1.,3 00C-*j Job Site Contact Numb r 90-t• <4'735 vUIrl
State Certification/Registration# E-MailS-to.v o' r-•e e-oofle Bi-Ao,..( c.or..•t
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt D Expiration Date
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
R C DING YOUR NE OF COMMENCEMENT.
�
.�•e-vGC � D
- _..._)v-e I;-s---_
(Signature of Owner or Agent) I (Signature of Contractor)
(or .-- me is 1 da of Si ned and sworn to(or ffirm-d)before me this i day of
-_e„.,2o2 __
if
- /ITTe' t -I,,i�� , ?027_. .y . • 4 can O�
a�;AYy;, TONI GINDLESPE'
f':'
�u `; MY COMMISSION#GG v:41.i =nat i ,` `=Rima � 41)
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:-; ;_;
'n'm%
''�.-'`„1,9EXPIRES:October 6,20
-FOFF�° Bonde "hr N ' 'y'Public Underwriters
''i' n a--
[ ]Personally Known OR s;aJN;,,
[ ]Produced Identification [ ]Produced Identification ''' �'; TONT ISSIO SPERGER
�• ; MY COMMISSION#GG 353178
Type of Identification:_ . L_ Type of Identification: -.^,_ �' • • _ _
,;F�oP,. .- ., • 3
°F,F`•' Bonded Thru Notary Public Underwriters