63 9th St RERF18-0055 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
RICKERSON JOHN L HC 2 BOX 2285 AGUADILLA PR 00603-9630
COMPANY:ADDRESS:CITY:STATE:ZIP:
ROMANO BROTHERS
ROOFING, INC 155 LEVY RD ATLANTIC BEACH FL 32233
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170812 5000 ATLANTIC BEACH SEC H
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
63 W 9TH ST REROOF SHINGLE SINGLE ROOF $7000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $90.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL: $94.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 2/23/2018
PERMIT NUMBER
RERF18-0055
ISSUED: 2/23/2018
EXPIRES: 8/29/2018
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
r4;,
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
5;800 Seminole Road,Atlantic Beach FL 32233Office:(904)247-5826 • Fax:(904)247-5845 RC__ .CROSS
Job Address: , U) 9 j-4 'J- A fl Lac,A // 39037
Legal Description 18-34 38-2S-29E .090 ATLANTIC BEACH SEC H
Permit Number:
RE#1 m b 1 rti>Valuation of Work(Replacement Cost)$ 7,000.00
Heated/Cooled SF Non-Heated/Cooled
0 Class of Work(Circle one): New Addition teratio RepairUseofexisting/proposedp o Pool Window/Doorstructure(s)(Circle one): Commercial siden ' -XIlanexistingstructure,is a fire sprinkler system installed?(Circle one): Yes No N/ASubmitaTreeRemovalPermitApplicationifanytreesaretoberemovedorAffidavitofNoTree RemovalDescribeindetailthetypeofworktobeperformed:
30YR ARCH WITH PALISADE SUB LAYER
L
A.nFloridaProductApproval#1 l71_ ) 4. ,1
for multiple products use product approval formPropertyOwnerInformation
John L RickersonName:
City_,J Address: I 4, 1 . _' ,
E-Mail kerson. ohn@ ahoo.com
tater/Zip - ),3 Phone • 4' /o-ch
i 3
Owner or Agent (If Agent,Power ofAttorney or Agency Letter Required
771t11i i-1.I.s Vr^17.1: YOUR FAILURE TO RECORD A NOTICEOTICE OF COMiviENCEM_ l IT MAYRESULTidYOURICEFORIIviPRCTEVENTSTOYOURPROPERTY. IF YOU , \
ITENDT"
OBTAIN FINANCING. CONSULT UR TLENDER OR AN ATT, „ .rRECORDINGYOURNOTI`E OF Cv11.n E1 1
Contractor In-for-Matt n:
Name of Comapht r -t,Qualifying Agaft:C. '• c t '
Address: I .,
City i_. State Zip ja-2OfficePhone [ lti G, Job Site/Contact NumberStateCertific. -on/Registration# CC_f.t:,-C = E-MailArchitectName&Phone#
Engineer's Name&Phone#
Worker's Compensation t_; IL L
1, tempt nsure( ease mp oyees . "ration ri ate
TrisApplication
is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
l
nor to the issuance ofa permit and that all work will be performed to meet the standards ofall/aws regulating construction in thisjurisdiction.)permit becomes null and void ifwork is not commenced within six(6)months, or ifconstruction or work rs sus,e,•
s commencedperiodofsix(6)months at any time after work is commenced. I: derstand that separate permits must be secured for " ectrical War 'lurnbing, 4b
Signs, Wells, ools,Furnaces,Bode..,Heaters,T, aks and Ai onditioners,etc
ab°nd redfor a
Signature of Property Owner / A CI
Before a Signature of Contractor fie, yt
this Day Z.
Before me this Day of may, 1"F z o
zi 0 0 0NotaryPublic: ,_ ii,•_. jIs. 0 3 1"v
NotaryPublic0A-in bVC-iL31herebycer7 'that I have read and eear/hur d this application and lawny the same to be true and correct. all provisions of knt s torr -.tr .::ordinances governing this type of work will be complied with whether specified herein or not. The granting ofa permit does i:(.presume to give authority to violate or cancel the provisions of any other'.federal, regulatingderal, state, or local law rhoJCIfor7narrceofCOrrS!r!CtjOn.
COirSti'l!Ctis77 or r..';.' (1,1
SARAH WEBER
1 Notary Public
4 State of North Dakota
iMy Commission Expires Aug. 25, 2021
NOTICE OF COMMENCEMENT
PREPARE IN DUPLIcA TEI
Permit No. Tax-F-.;-0 ,?,.-.1-1b_52.t! j 1,Q -5D; (-)State of Florida County of;i .J \/ ii
To whom it may concern:
The undersigned hereby informs you that improvements will be made to certain real property,and inaccordancewithSection713oftheFloridaStatutes,the following information is stated in this NOTICE OCOMMENCEMENT.
Legal description of property being improved: 18-34 38-2S-29E.090 ATLANTIC BEACH SEC
Address of property being improved: 6s j'j 9.4 s91.-. )14-4 P44 . -/ 3X ;
General description of improvements: ..t_,v0 L
S'io )11.1 St ‘th") L4*-1411w4.. d 5-9Y $
Owner John L Rickerson -mailing address: ;' ! ' -
PropertyAAddress C.3 1,t)
c)",
s.3- /1.I .c/1 - ' -3;17-33
Owner's interest in site of the improvement
Fee Simple Titleholder(ifother than owner)
eme
Addres
Contra r. it O1t ,1O''3 CI 1; • '` - 1-4- !1!?1--,A.Address
Phone No - 4 Wa e Fax No.
Surety(if any)
Address
Amount of bond S
Phone No. Fax No.
Name and address of any person making a loan for the constriction of the improvements.NameN/A
Address
Phone No. Fax No.
Name of person:within the State of Florida.other than himself,designated by owner upon whom notices or otherdocumentsmaybeserved:
Name N/A
Address
Phone No. Fax No.
In addition to himself.owner designates the following person to receive a copy of the Lienors Notice as provided inSection713.00(2)(b).Florida Statutes.(Fill in at Owners option).
Name. N/A
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless adifferentdateisspecified):
THIS SPACE FOR RECORDER'S USE ONLY. OWNER
9FFDATEathis .aof in•I5afor
Co -. D,uval. of ri!rrida.has personally appeared I,
QW.. e .rte'+ here14—pr i r)thimself.'herself and affirms that all statements and declarations hereinaretrueandaccurate
Doc#2018043466,OR BK 18292 Page 1450,
Number Pages:1
Recorded 02123/2018 01:23 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
Notary miss(at Larc=,seta of T,v ty,of l•aMouyIJCOUNTYlaycommissionexpires:
RECORDING $10.00 Personally Cno..n
Produced identification VPIETTIPSIII SARAH WEBER
No ary Public
State of North Dakota
My Commission Expires_Aug. 25, 2021 •