760 Plaza RERF22-0154 NOC & Roof Permit tf REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF22-0154
�� 800 SEMINOLE ROAD ISSUED: 6/28/2022
ATLANTIC BEACH, FL 32233 EXPIRES: 12/25/2022
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: PERMIT TYPE: DESCRIPTION: I VALUE OF WORK:.
760 PLAZA REROOF SHINGLE SHINGLE ROOF $10250.00
TYPE OF REAL ESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: + GROUP:
171287 0000 ROYAL PALMS UNIT 02
COMPANY: 1 ADDRESS: I CITY: STATE: ZIP:
RT
5380 TIMBERLINE DR JACKSONVILLE FL 32277
CONSTRUCTION &
OWNER: ADDRESS: CITY: STATE: 9 ZIP:.
HAVEN TRADING LLC 8785 PERIMETER PARK BLVD STE 300 JACKSONVILLE FL 32233
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $105.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$109.00
Issued Date:6/28/2022 1 of 2
; 1:•-,7 Building Perri at Application Updated 10/9/18
.,„ . City of Atlantic Beach Budding Department **ALL INFORMATION
s800 Seminole Road, Atlantic Beach,.FL 32233 HIGHLIGHTED IN GRAY
"`f',on}r IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: >_A `,."+. . , l j_,, i.e. I.:1.-eisi 6P 7,4...2 -: , Permit Number: PERF 2 Z— 1 ( S.4
Legal Description X-gii I7-2-,ZE Rogul Iblywkst aria-2. Lot iii Imu. RE# Ill 2'7-00oo
Valuation of Work(Replacement Cost)$ 1017,4510.- Heated/Cooled SF Non-Heated/Cooled
• Class of-Work: DNew ❑Addition DAlteration IlRepair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s):. ❑Commercial• DResidential
• If an existing structure,is a fire sprinkler system installed?: DYes ONo
• Will tree(s)be removed in association with proposed proiect? ❑Yes(must submit separate Tree Removal Permit) ONo
Describe in detail the type of work to be performed: reirtfaVe exf.pfi'er Metall red*. i glasd101$i&v1 ba&rte1 Meed
i irkt avd.oVi'1• Patelalee W c+h 61":"Ake0 neinq t ZZ St 014N2:12 Fite,.
.3
Florida Product Approval#:FL'10124%1 FI_ i8611NoR3 for multiple products use product approval form
Property Owner Information
Name }}4tirisy Tvii1 iw LLe . Address ' tra t+rk#'IC 13(041 i -
City "TcaskSaiwille J - State' IFS. Zip. $724 4' ; Phone
E-Mail ?ireepret p'2254g". tar►o►il.r in
Owner or Agent Agent;Power of Attorney or Agency Letter Required) .
Contractor Information
Name of Company 11.0aciiikaiiolf Grt 4'Irimi1Ir a Rtse4e0451riee ualifying Agent. L
Address 53$O'9FirvA#per 4'ine Dr Cityd wllre State Ft. Zip 22277
Office Phone 04611- Tx-i 31%5 lob Site Contact Number
State Certification/Registration# COOZ3$ f - E Mail" LAN 1.;"-ei ..it @ a n44-
Architect Name&Phone# ..
Engineer's Name&.Phone# • . .
Workers Compensation Insurer ' OR Exempt fi( 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
RECORDING-YOUR ICE.OF COMMENCEMENT I
l . ,=.r i►
(Signa re o wneror Agent) (signature of Contractor)
l
Signed and sworn to(or affirmed)before me this 23 day of: Signed d sworn to(or affirmed)before me this do day of
OLiA e, , 201,1, ,by':W\\kl cLhn N:Slnctr f Jr 14 ,Itis ler 1-0312, ,by .J *I4 L ircic
-420;;;40_,4,14; - //.;474,:e.06lila-614
(Signature of Notary) (Signature of Notary)
fPersonally Known OR �. Notary public semis sf Ftorid® [ 1 Personally Known OR �,m�¢ KENNETH LEE WILLIS
[ J Produced Identification .. .Buse B Bulut [ I Produced Identification . '� Commission#H1102650.2
my Commie('HH 158021 Type of Identification: w�-- or, Expires August 2,2024
Type.ofldentification: . ,. ,.�. „Orr?' Bonded ThmTroy Fein lneurance8003557019
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 171287-0000
State of Florida County of Duval
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: 30-94 17-2S-29E
Royal Palms Unit 2
Lot 14 Blk 8
Address of property being improved: 760 Plaza
Atlantic Beach,FL 32233
General description of improvements: remove and replace roofing
Owner Haven Trading LLC
Address 8785 Perimeter Park Blvd Ste 300,Jacksonville,FL 32216
Contractor Lockhart Construction and Roofing Services LLC
Address 5380 Timberline Drive.Jacksonville.FL 32277
Phone No. (904)994-3865 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
Address
Phone No. Fax No.
Name of person within the State of Florida,other than himself or herself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself or herself,owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06(2)(b),Florida 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):
OWNER o EGA AUTHORIZED REPRESENTATIVE
Doc#2022169233,OR BK 20337 Page 1041,
Number Pages:1 10(7_ I22 .
Recorded 06/28/2022 08:12 AM, Signed: ' Date: .
JODY PHILLIPS CLERK CIRCUIT COURT DUVALCOUNTY Before me this 2..) day of VW, 202.2 �b
in the County of Ouv a,i ,State of Florida,has personally appeared R4146
RECORDING $10.00 +ll i earn Sin .\r —M c..on X herein by
'J
himself/herself and affirms that all statements and declarations herein are
true and accurate.
9 al
Notary Public at Large,State of F(. ,County of Du UN s N
My commission expires: 4-1 2-0 I'LUS5
Personally known ✓ or .. �,
Produced identification