770 PLAZA RERF22-0201 REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
RERF22-0201
8
ISSUED: 9/27/2022
00 SEMINOLE ROAD
Jit1vr ATLANTIC BEACH. FL 32233 EXPIRES: 3/26/2023
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:
770 PLAZA REROOF SHINGLE SHINGLE ROOF $11000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171286 0000 ROYAL PALMS UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
MONAHAN ROOFING 2050 S KING CIR NEPTUNE BEACH FL 32266
OWNER: ADDRESS: CITY: STATE: ZIP:
RAMIREZ JOSE F 770 PLAZA ATLANTIC BEACH FL 32233-3932
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 $110.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2 00
TOTAL:$114.00
Issued Date:9/27/2022 1 of 1
- Building Permit Application Updated 10/9/18
l City of Atlantic Beach Building Department **ALL INFORMATION
`\ # y 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
‘<:'-.J.)1119;-• IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 1 -7( f/R 2. •, Permit Number:ERE Z.Z.— 02 O (
Legal Description ,1 / '1 `2d - 21 E /207 ec /,,,, ti.-.'i- 2, [c<f.JhA,t Z RE#0
1Z ' — 000
Valuation of Work(Replacement Cost)$ / OOU 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 I Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes C31Qo
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) 'No
Describe in detailthetype f work to t ..o performed:
COMpj-ei-C reit)" f-/ (A%,-, GA r- -r,,,,./.-e-(0, ` ,jA/^)1--(-1-
Florida Product Approval# FC�, /0I 2`7—R.21 P4/0 62G oeie for multiple products use product approval form
Property Owner Information Irrinbe^/i^-(-66r e/fh'•"4-`-,
xa
( Name , 5 >j//l �2 Address 76 PIA 2,9 t'/
v �j�'
City / 7'.L�'/✓ G LA '7 State /=--"h Zip 3 X214 Phone ?a / 97 /
E-Mail c J/' /ll4/7/pkz /2'jSt in/ i) • iC'/,
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Mom&<ha.. Roo f,^) Qualifying Agent —r3,., fllo".../.e.t-.
Address 2OSu IC_c.•,3J C,rcrt `S.„,th City hip-1k.. gc), State 4. Zip 2zz9C
Office Phone 22 I - ou Sc.\ Job Site Contact Number
State Certification/Registration# gC c c.cti 3k C E-Mail "TL in ono,ha,.., ® r,4 .[;., i- .
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt Expiration Date 14 t 5. J
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 YOU„R,NOTICE OF COMMENCEMENT. 4/
(V.,,,.-----
✓�y4 � (Signature of Owner or Agent) (Signature of Con actor)
,
ligned and sworn to(or affirmed)before me this �.2 day of t,
igned and swfor t�oA9r aaffirr e )before me this day of
�' ,o.i• .- - — - - o - F. av,,.v tt-z 1,i1 t” ii 1_y 7 '4U v ' ,by I 0 / Y1
4ti�,pY Pbn.;, .1 E CODNER-KONGOUEE ��� �� /
--I °= .ignature of Not;;
,., • :Commission#GG 279187 —+
-• • 8 2023 ,,d tYts'• LE�ANN�t��'ONUE
. .:a, Expires February. , .�
`;;,..• • -- Commission#GG 943250
;Fot pq4, Bonded Thor Troy Fain Insurance 800-385-7019- :.: ,
-- . . y nown OR Vrsonally Known OR •:i,o FoP' Expires April28,2024
Bonded Thru Troy Fain Insurance 800.385.7019
fskoroduced Identification �� duced Identification.— cr,
Type of Identification: V&�� O V _�� Type of Identification:
NOTICE OF COMMENCEMENT
State of Fic--• Tax Folio No.
County of f),-(4'4-1
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 itted in this NOTICE QF COMMENCEMENT., y
Legal Description of property being improved: re- f 7�",1P ;di•1 lf 67 h ��,/ %1 14rif ;
Address of property being improved: 7 74 "k /? /9)---L pa,
General description of improvements: Ree,"F
Owner: c.'r-f f f1/91/? ' Address: / 10 j)L•fj/.A 7), 47/. j' /
Owner's interest in site of the improvement: /4/P 2_
Fee Simple Titleholder(if other than owner):
Name:
Contractor: (no f-Ir% Con -racl-ctJ INC
Address: 2 0 s Kr,� l t.l r ( � 304-,
r,4(.1 4...n g eR Get /T G✓tiet�
Telephone No.: WO'1 - .5Gg Fax No:
Surety(if any) I (�
Address: Amount of Bond$ _
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: '\j )
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: tV I ct-
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)yea .u .• • • • •• • • f•rent date is
specified): :'w;;P';'•.• JUNE CODNER-KONGQUEE
' ,,,.1•.'„'",,Commission#GG •
THIS SPACE FOR RECORDER'S USE ONLY OWNER ;;;.,� P ExpiresFebruery8,2023
/\(
� �° Bonded Thru Troy Fain Insurance 800.385-7 010
' / Signed: fy I �: '�(' Date: 4s2Z a-
Doc#2022247446,OR BK 20448 Page 754, Before m•this day. p 2 Zin3he County of Du al,State
Number Pages: 1 Of Florida,has personally appeared 7710 k re-
Recorded
LRecorded 09/27/2022 03:09 PM, Notary Public at Large,State of Florida,Gunty of Duval.
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL My commission expires: — 3
COUNTY
RECORDING $10.00 Personally Known: \ or
Produced Identification: *'.\ 'e-s1-1- 1J -