1750 Ocean Grove Dr RERF24-0026 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
* GOWEN WILLIAM G &
MARYLU M 1750 OCEAN GROVE DR ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
BRC Hynes Construction,
LLC 10950-60 San Jose Blvd Suite 289 JACKSONVILLE FL 32223
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169617 0000 OCEAN GROVE UNIT 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1750 OCEAN GROVE DR REROOF SHINGLE SHINGLE ROOF $9810.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $100.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $104.00
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: 2/14/2024
PERMIT NUMBER
RERF24-0026
ISSUED: 2/14/2024
EXPIRES: 8/12/2024
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 2/14/2024
PERMIT NUMBER
RERF24-0026
ISSUED: 2/14/2024
EXPIRES: 8/12/2024
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
r„., BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
City of Atlantic Beach Building Department 0026PERMIT# t\ERF Z4
800 Seminole Road,Atlantic Beach, FL 32233
ALL information required to process
F:3>'° Phone: (904) 247-5826 Email: Building-DeptPcoab.us
Job Address 1750 Ocean Grove Drive RE# 169616-0050
Legal Description 20-20 09-2S-29E OCEAN GROVE UNIT NO 2 51/2 LOT 22
Valuation of Work(Replacement Cost) 59810 Heated/Cooled SF 1888 Non-Heated/Cooled SF 2468
Class of Work: El New El Addition ['Alteration Z Repair ['Move ['Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial X Residential •If 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) X No
Describe in detail the type of work to be performed:
Tear off existing roof and replace with 30 year architectural shingles. 20 squares-5:12 slope
5v/.macer Ft /a1.7y
Florida Product Approval# syprp/ErlC FL ISA lit. / For multiple products use Product Approval Information Sheet)
Property Owner Information Name William and Marylu Gowen Phone 904-534-9520
Address 1750 Ocean Grove Drive City Atlantic Beach State FL Zip 32233
Email Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information Name of Company BRC Hynes Construction LLC Phone 904-591-4959
Address 10950-60 San Jose Blvd.#289 City Jacksonville State FL Zip 32223
Qualifying Agent S. Brian Hynes State Certification/Registration# CCC1330022
Email brchynes@gmail.com Job Site Contact Number 904-591-4959
Worker's Compensation Insurer American Zurich OR Exempt Expiration Date
Architect's Name Email Phone
Engineer's Name Email Phone
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 city/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 YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
J>
ATTORNEY BEFORE RECORDING YOUR NOTICE OF C MMENCE NT.
Signature of Owner or Agent)
2/
Sign re ontractor)
Signed and sworn to(or affirmed)before me this 7 day of Signed and sworn to(or ffirmed)before me this 19 day of
TA NMARV , J.O.2 41 by id L thPsi &oW& Ye b /2ti 4 17 .20 Y by / r_iun. iiy ,,,s
Signature of Notary i . i/' "r Signature of Notary 2ri—.
Personally Known OR A P d ed Identification Kl.Personally Known R [ I Produced Identification
Type of Identification: ft .P.4 1L._— /C. Type of Identification:
Notary Public State of Florida
S. Brien Hynes JERRY C.ROWE
I mY4 202924 on
MY COMMISSION 8 HH2O325
4 EXp.12I1712025 i St„,ce EXPIRES:August 26,2024
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No.
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: 1750 Ocean Grove Drive
20-20 09-2S-29E OCEAN GROVE UNIT NO 2 S 1/2 LOT 22
Address of property being improved: 1750 Ocean Grove Drive,Atlantic Beach,FL 32233
General description of improvements: Tear off and replace existing shingle roof.
Owner: William and Marylu Gowen Address: 1750 Ocean Grove Drive,Atlantic Beach,FL 32233
Owner's interest in site of the improvement: Fee Simple
Fee Simple Titleholder(if other than owner):
Name:
Contractor: BRC Hynes construction LLC
Address: 10950-60 San Jose Blvd.#289,Jacksonville, FL 32223
Telephone No.: (904)591-4959 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 from the date of ur es y$ub
r ,ciotiq jfjaa
specified): 4 s.
Arran
H nes .
1My
NH 20424 n
THIS SPACE FOR RECORDER'S USE ONLY OWNER 1 Exp.12/1712025
Doc#2024031172,OR BK 20951 Page 2128, AI C L
Number Pages: 1
Signed: Date: f 'T
Recorded 02/14/2024 11:23 AM, Before me this H day ofSAm/iq/l Y in the County of Duval,State
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL Of Florida,has personally appeared kat/41P1 ( aLiE1
COUNTY Notary Public at Large,State of Flor'da, unty of Duval. €
w
RECORDING $10.00 My commission expires: /2/ 7 Joar
Personally Known: or
Produced Identification: FL 1)RI . hi C.