365 Sargo Rd RERF22-0143 NOC & Roof Permit REROOF SHINGLE PERMIT PERMIT NUMBER
s r _� CITY OF ATLANTIC BEACH RERF22-0143
800 SEMINOLE ROAD ISSUED: 6/21/2022
J 94
t.j
ATLANTIC BEACH. FL 32233. EXPIRES: 12/18/2022
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: I PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
365 SARGO RD REROOF SHINGLE SHINGLE ROOF $8515.00
TYPE OF REAL ESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:.
171696 0000 ROYAL PALMS UNIT
02A3.00
COMPANY: I ADDRESS: CITY: I STATE: I ZIP:
EQUITY BUILDERS OF 2650-2 ROSSELLE STREET JACKSONVILLE FL 32204
FLORIDA LLC
OWNER: I ADDRESS: ! CITY:. I STATE: I' ZIP:
EASTON SAMUEL 365 SARGO RD ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II\'
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 $95.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$99.00
Issued Date:6/21/2022 1 of 2
.:P Jib- Building Permit Application Updated 10/9/18
- A City of Atlantic Beach Building Department **ALL INFORMATION
1` 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us Q IS REQUIRED.
Job Address:l 365 Sargo Rd.Atlantic Beach,FL 32233 Permit Number: R:E-R{- ZZ—01 43
Legal Description r 31-16 17-2S-29E R/P OF PT OF ROYAL PALMS UNIT 2 A LOT 4 BLK 25 RE# 171696-0000
Valuation of Work(Replacement Cost)$ 8,515.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repaiir�Move 0 Demo ❑Pool ❑Window/Door re- fooF
• Use of existing/proposed structure(s): ❑Commercial ®Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes Et o
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) 12‘o
Describe in detail the type of work to be performed: Remove and replace existing shingle roof with peel and stick underlayment
and architectural shingles
Florida Product Approval# FL10674-R15 for multiple products use product approval form
Property Owner Information
Sam Easton h _.
Name Address. 365 Sar o Rd.
City, Atlantic Beach State FL I Zip 32233 ,phone_I 305-496-1589
E-Mail eastsam16@aol.com
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company, Equity Builders of Floirda LLC 'Qualifying Agent Joseph Indriolo
Address 2650-2-Rosselle Street City Jacksonville !State FL 'Zip, 32204 '
Office Phone 904-398-1044 ,Job Site Contact Number
State Certification/Registration#, CCC1329091 E-Mail joe@psrps.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer Builders Insurance Group OR Exempt❑ Expiration Date, 7/21/22
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. :0111E1'In addittion RDthe requirementsJthi•
;'tlialDoittaggiiiferi additional restnctlons appher glicableft$WOoperty that,mayZbe fou 1 nd of public recordsc county,and
AIME/la/LP LP additional permits,rep uiredffrom,otovernmental entities;'sueh as water_management distrlicts, agencies,o'
ederal .
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.
(Signature of Owner or Agent) (Signatur of Contractor)
Signed and sworn to(or affirmed)before me this ,7 day of Signed and sworn to(or affirmeefore me this f7 day of
%v,,w, , 3d.7'- .by - c, , L > ,. .,,,, Ib 6 , --21)22-,byf i d
,4 1 Lure of Notary) l(Sig ature of Notary)
.41I
I •"'v F' KPersonall Known OR riir'a�B,,, STANTON.WELCH HUDMON
�rsonally Known OR ��.�_ �,G JOSEPH INDRIOLO Y � •o L.
[ ]Produced Identification '.?:,`�C'_ Notary Public State of Florida [ ]Produced Identification ? ` Notary Public.State of Florida
r of Commission#GG 933448
Type of Identification: + �`, Commission N GG 984890 Type of Identification: �' yComm FY fres Mar 16,2024 P
Bonded through National Notary Assn. ¢
'''''''''Bonded through National Notary Assn.
Doc # 2022162866, OR BK 20328 Page 566, Number Pages: 1,
Recorded 06/21/2022 09:06 AM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No, 17 1lo%2-4000
State of County of 1)t,vaA
To whom It may concern:
The undersigned hereby informs you that Improvements will be made to certain real property,and In '
accordance with Section 713 of the Florida Statutes,the following Information Is stated In this NOTICE OF
COMMENCEMENT.
Legal de ription of property bei g improved: l ((D I7-as-ayf R/P o 4T (F
Rd11 �&k* , Uv a A wi '1 Blk a5
Address of property being improved: 3(oS Sot6 Qt1 t A. 1-r aA\1‘C. Eke acL)'FL P233
General destion of im ro ements: e• J + c-Anse- -,L; M. !A, (rs)
t)ee� + 5 .1C tt �'e( urs& t e. a/c 2 J ON. .rs
Owner 7Av'1 CS n
Address %5 Salty Rpt.. P4L L. (t"ick, F` 3a.213
Owner's interest in site of the Mmprovement tie*,
Fee Simple Titleholder(if other than owner)- {�
Name Fv
Address
Contractor /Lin-‘ gv;l�?/5 a� lcf14 LLC..
Address (, R65.50.I(2, )nc15eVise+11Z ) PL 3aad�-I
Phone No. '/Oi-123 41/1/(4 Fax No.
Surety(If any)
Address Amount of bond$
Phone No. Fax No!
Name and address of any person making a loan for the construction of the improvements.
Name Jq�///
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 maybe ry d;
Name
Address
Phone 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), fids Statutes.(Fill in at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date Is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER D6— t1,i'.a
Signed: DATE
Before me MI6 day of / q a,r -n .3_ In the
County of OuvalrStete of Floridahas personally appeared
• f.ri 'J e/71-r herein by
himself/hers`ed end aftimts that all stater8onts and declarations hereto
are true and accurate
* .......
ey••. JOSEPH INDRIOLO
G �� t� ;r°• � Notary Public-State of Florida
�/[/ ''-y Commission GG 984890
Notary Public atL= . ;Zia of / ' County of i'r'- q.•'. My Comm.Expires May 5.2024
Mycommission=,•r l7 S•or•
Personally Kna n I 0� through National Notary Assn.
Produced/on• a8on