Permit Roof 2219 W Oceanforest 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J _� � ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001954 Date 4/19/11
Property Address 2219 W OCEANFOREST DR
Application type description ROOF PERMIT
Property Zoning RES SF DISTRICT
Application valuation . . . 10995
Application desc
reroof
Owner Contractor
SIMS, ROBERT L & RACHAEL A MANN'S ROOFING AND WATERPROOFI
2219 OCEANFOREST DR W NG LLC
ATLANTIC BEACH FL 32233 2114 UNIVERSITY BLVD W
(410) 300 -3617 JACKSONVILLE FL 32217
(904) 419 -1010
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 105.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 10995
Expiration Date . 10/16/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 105.00 105.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 109.00 109.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE ill CUPLii,ATEj
Permit No. Tax Folio No.
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' 42-13 0$- 2S -29E 09 -2S -29E
Address of property being improved: 2219 W OCEANFOREST DR Atlantic Beach FL 32233
General description of improvements: Re- roofing
Owner SIMS RACHAEL A
Address 2219 W OCEANFOREST DR Atlantic Beach FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder Of other than owner) n/a
Name n/a
Address
Contractor Mann's Roofing and Waterproofing, LLC
\-)S/ Address 5023 Bowden Road, Jacksonville, Florida 32216
Phone No. 90 a �te•t010 Fax No 904 - 419 -1006
Surety (if any) Na
Address Amount of bond $
Phone No. Fax No. N c�
cn i-
a o'
Name and address of any person making a Loan for the construction of the improvements. , O
Name n/a
n all_
Address
'D o rt
Phone No. Fax No.
Name of person within the State of Florida. other than himself, designated by owner upon whom notices or other n nr IrJ 2
documents may be served: (/) '' c� 77.;
Name nta
0
f1
Address v' `w
u E u ".
Phone No. - O
Fax No. o z
C. "-�c)
In addition to nimself, 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 Owners option)
Name n/a
Address
Phone No, Fax No
Exprratior date of Notice of Commencement (the expiration date is one (1) year from the date of repording unless a
different date is. specified):
Ti�t8 SP 4CiFOR RECORDER'S USE ONLY ' NER
S«o m� gay � � A M /We h Z-3, 2 0
i l
DATE
C.ou Duval. St • Ftr a . his personally in the
} appeared
x .. - i i<j
himself/ herieM and affirms tha au statamerls and declarations herein
� c; I an true and aauraae )
D LORES PERKINS
Notary Public, State of Maryland � �.
My Commission Expires Aug. 15, 2011
""�''''�'"-° at Large. State of t!i fIir$11;r ou or mph,
my Commission expires.
Personally Known _ i •, �+
Produced identification. ( i . _.... - _. or
I
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 2219 Oceanforest Drive West, Atlantic Beach, Florida 32233 Permit Number:
Legal Description 42 -13 08- 2s -29E Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 10, 995 , Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window /door
Use of existing /proposed structure(s) circle one): Commercial Residential
If an existing structure, is a fire sprin er system installed? (Circle one): Yes No N /A
Florida Product Approval # F L _
For multiple products use product approval form
Describe in detail the type of work to be performed: Re roofing
Property Owner Information:
Name: Rachel Sims Address:2219 Oceanforest Drive West
City Atlantic Beach State FL Zip 32233 Phone: 904 -302 -1158
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: Mann's Roofing and Waterproofing, LLC Qualifying Agent: Amanda Mann
Address: 5023 Bowden Road City Jacksonville State Florida Zip 32216
Office Phone 904 - 419 -1010 Job Site/ Contact Number Travis Mann 904 - 652- 8487_Fax # 904 - 419 -1006
State Certification /Registration # CCC1328126
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of six L6) months at any time after
work is commenced. 1 understand that separate permits must be secured for ElectricalWork, Plumbing, Signs, Wells, Pools, Furnaces, Bo Heaters,
Tanks and Air Conditioners, etc.
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.
1 hereby certify that I have read and examined this . application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner o Q , mss- Signature of Contract �,,"��" Y
Print Name S NA 3 Print Name
Swo u to and subscciJed before me Sworn o and subs' 'bed be ore me
th' a ° Day of,..�,.. , 20 t I this 1 Da of i; 1�� , 20
1 5. tr l , e@ '14
No : ?Walk + otary ' u • w. G
DELORES PERKINS ",fGoy 24'4271 tevised 01.26.10
Rotary Public, Maryland 1
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