559 Ocean Blvd 2014 ROOF lux
C, „� r•
s� CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
U :" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
AIT
Application Number . . . . . 14-00000933 Date 6/10/14
Property Address . . . . . . 559 OCEAN BLVD
Application type description ROOF PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 8900
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Application desc
REROOF
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Owner Contractor
------------------------
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GOLDEN, IRVIN P K & D ROOFING & CONSTRUCTION
559 OCEAN BLVD 2758 DAWN RD SUITE 1NE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207
(904) 553-1381
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 8900
Expiration Date . . 12/07/14
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95 . 00 95 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 99 . 00 99 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
��Ji:lJr.
10-
CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
Date
Job Address:
Owner of Property: rr
Address: Telephone:
ki740 ,�
Roof Contractor: • State License Number: C�c � -
J C
Contractor's Address:
Telephon Fax: Email: -tew/•�
Scope of Work: Roofing Material
FL Product Approval# Valuation of Work: 16
Required Inspections: Sheathing/In Progress-Dry In /Final
If re-roof: Assessed Value of Structure:_<$300,000/_>$300,000;Roof-to-wall improvements required?
(Applies to single family structures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD 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"
SIGNATURE OF OWNER: CoxDate:
AS TO OWNER:
Sworn to and subscribed before me this t!i —day of 20 ,14.
State of Florida,County of Duval A,"(\_74
ry's Signature:
AUJO/ N 0 Personally known
-
NMt1wwy pow eft el/bf1f pq�Produced identification
MYCMl11.DOM Od1. MY Type of identification producedC=MWft 400 FF
SI �IDw Date: ' 1
AS TO CONTRACTOR: `\
Sworn to and subscribed before me this day of `�" `3_r 20
State of Florida,County of Duval
Notary's Signatures ` '\
personally known
TERRI BURT LI Produced identification
�,"Y°"s''•, Type of identification produced
iP� ��; Notary Public-State of Florida YP
•e My Comm.Expires May 5,2016
Commission#EE 192338 800 Seminole Road Atlantic Beach,Florida 32233-5445
°F Bonded Through National Notary Assn. Telephone: (904)247-5800 Fax:(904)247-5845
F:\roof permit applicaton 2010
-.JTICE OF COMMENCEMx.-r.T
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of FLORHb1 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 iroperty being giproved:
1
A f pr ert bein improve
General description of improvements: REROOF USING 5 0 YEAR SHINGLES
1
Owner
Address
Owner's interest in site of the improve t
Fee Simple Titleholder(if other than o4wner)
Name.
Address
Contractor K&D ROOFING& CONSTRUCTION CO.JNC
Address 2758 DAWN RD.SUITE 3 JACKSONVILLE,FLORIDA 32207
Phone No. 904-541-1700 Fax No. 904-369-3249
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.designated by owner upon whom notices or other
documents may be served:
Name _
Address
Phone 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 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):
THIS SPACE FOR RECORDER'S USE ONLY O NER e
Before: thi14f��,of�
oin theCountyofDura,has pe onally appeared
herein by
Doc#2014128731,OR BK 16808 Page 107, himself,herself and affirms t end-declarations herein
9 I are true and accurate ���u0r i' MLLIW F S M
Number Pages: 1 �.
Recorded 06110/2014 at 04:05 PM, *{ Natauy Pmbk-Stag of l%ft
Ronnie Fussell CLERK CIRCUIT COURT DUVAL My Cma low*$Oct 1,2017
COUNTY C �0
RECORDING$10.00 Notary Public at Large.sta o!
My conimissioii expires:
Personalty Known
Produced ldentiticaHcn 'r
CGMM 9617-3f00
DURABLE POWER OF ATTORNEY
STATE OF FLORIDA )
COUNTY OF DUVAL )
BY THIS DURABLE POWER OF ATTORNEY, I, HELEN T. GOLDEN, a resident of Duval
County, Florida, appoint as my attorney-in-fact to manage my affairs, my son, ROBERT E.
COSBY, whose current address is 56 San Juan Drive, Ponte Vedra Beach, Florida, 32082. If my
son cannot or declines to perform his duties as my attorney-in-fact, then I appoint my son, JAY
T. GOLDEN, whose current address is 11496 Road #122, D'Iberville, Mississippi, 39540, as my
successor attorney-in-fact to manage my affairs.
This Durable Power of Attorney shall not be affected by any subsequent physical or
mental incapacity that I may suffer except as provided in Section 709, Florida Statutes, and shall
be exercisable from the date hereof. All acts done by my attorney-in-fact pursuant to this
power shall bind me, my heirs, devisees and personal representatives. This power of attorney
is non-delegable and is exercisable as of the date of execution. I hereby revoke any and all prior
Durable Powers of Attorney signed by me.
This Durable Power of Attorney applies to any interest in property owned by me,
including, without limitation, my interest in all real property, including homestead real
property; all personal common, joint tenancy with right of survivorship, or a tenancy by the
entirety; all property over which I hold a general, limited, or special power of appointment;
choses in action; and all other contractual or statutory rights or elections, including, but not
limited to, any rights or elections in any probate or similar proceeding to which I am or may
become entitled.
I authorize my attorney-in-fact to do anything regarding my estate, property and affairs
that I could do myself, if competent, except that this power of attorney shall not be effective to
make or amend my will or any codicil thereto or to direct withdrawals of principal from or to
modify, terminate, or amend any living trust which I may have established during my lifetime.
My attorney-in-fact is not liable for any act or decision it makes in good faith under the terms of
this Durable Power of Attorney.
A third party who acts in reliance upon the authority granted my attorney-in-fact under
this instrument and in accordance with the instructions of my attorney-in-fact, shall be held
harmless from any loss suffered or liability incurred as a result of actions taken prior to receipt
of written notice of revocation, suspension, notice of a petition to determine incapacity, partial
or complete termination, or my death. Under these conditions, such third party is not liable to
me, my estate or beneficiaries, or joint owners of property.
1.
A third party who has not received written notice as previously described may, but need
not, require my attorney-in-fact to execute an affidavit confirming the status of the agency
relationship. Such affidavit may, but is not required to take the following form:
STATE OF FLORIDA )
COUNTY OF DUVAL )
Before me, the undersigned authority, personally appeared ( ) ("Affiant"), who swore or
affirmed that:
1. Affiant is the attorney-in-fact named in the Durable Power of Attorney executed by
("Principal")on
2. This Power of Attorney is currently exercisable by Affiant. The Principal is domiciled in
3. To the best of Affiant's knowledge after diligent search and inquiry:
a. The Principal is not deceased, has not been adjudicated incapacitated,and has not revoked, partially
or completely terminated,or suspended the Durable Power of Attorney;and
b. A petition to determine the incapacity of or to appoint a guardian'or guardian advocate for the
Principal is not pending.
C. Affiant is acting within the scope of authority granted in the Power of Attorney.
4. Affiant agrees not to exercise any powers granted by the Durable Power of Attorney if Affiant attains
knowledge that it has been revoked, partially or completely terminated, suspended, or is no longer valid because
of the death or adjudication of incapacity of the Principal.
Affiant
Sworn to(or affirmed)and subscribed before me this day of 20_,by
Notary Public
Without limiting the broad powers conferred by the preceding provisions, I authorize
my attorney-in-fact to:
1. Collect, receive and receipt for any and all sums of money or payments due or to
become due to me.
2.
2. Sue in my name and behalf for the recovery of ani; and all sums of money or
payments due or to become due to me and to collect on any judgments recovered by me and
execute satisfactions of the same.
3. Initiate, defend, continue, or settle suits in my behalf or to enforce the exercise of
these powers granted to my attorney-in-fact.
4. Hire or discharge (with or without cause) employees including, but not limited to,
physicians, nurses, attorneys, and domestics.
5. Deposit to or withdraw from, or draw checks or drafts apon, any and all savings or
checking accounts, money market funds or any other type of account in my name; open or
terminate any such accounts in my name in any bank or financial institution or with any
insurance or brokerage firm; and endorse my name to any and all negotiable instruments.
6. Conduct banking transactions as provided in section 709.2208(1), Florida Statutes.
These banking transactions include but are not limited to the following actions:
(a) Establish, continue, modify, or terminate an account or other banking arrangement
with a financial institution.
(b) Contract for services available from a financial institution, including renting a safe-
deposit box or space in a vault.
(c) Withdraw, by check, order, electronic funds transfer, or otherwise, money or
property of the principal deposited with or left in the custody of a financial institution.
(d) Receive statements of account, vouchers, notices, and similar documents from a
financial institution and act with respect to them.
(e) Purchase cashier's checks, official checks, counter checks, bank drafts, money
orders, and similar instruments.
(f) Endorse and negotiate checks, cashier's checks, official checks, drafts, and other
negotiable paper of the principal or payable to the principal or the principal's order, transfer
money, receive the cash or other proceeds of those transactions, and accept a draft drawn by a
person upon the principal and pay it when due.
(g) Apply for, receive, and use debit cards, electronic transaction authorizations, and
traveler's checks from a financial institution.
3.
(h) Use, charge, or draw upon any line of credit, credit card, or other credit established
by the principal with a financial institution.
(i) Consent to an extension of the time of payment with respect to commercial paper
or a financial transaction with a financial institution.
(j) Open new bank accounts, close accounts, merge accounts in Wells Fargo Bank, N.A.;
Wells Fargo Advisors, LLC; Wells Fargo Advisors Financial Network, LLC; SunTrust Bank, and any
other bank or financial institution in which I have an interest.
7. Pay any and all bills, accounts, claims, and demand- ..nw or hereafter payable by
me.
8. Receive and endorse for deposit in any account any payments that I receive from
any branch or department of the United States or other government including without
limitation, Social Security payments, Veteran's Administration payments or grants, Medicare or
Medicaid payments, and tax refunds.
9. Represent me before any office of the Internal Revenue Service or any state
agency; prepare and sign any tax return on my behalf; receive confidential information
regarding tax matters for all periods, whether before or after the execution of this instrument;
and to make any tax elections on my behalf.
10. Borrow money and to otherwise incur or guarantee indebtedness for which I will
be liable, and to secure any such indebtedness by mortgage or other security interests
encumbering my assets.
11. Act for me in any business or enterprise in which I am now or have been
engaged or interested or with respect to any trust in which I have a beneficial interest.
12. Manage all insurance policies, including but not limited to life, disability, long-
term care and health, belonging to me or in which I have any interest, including but not limited
to the opening, closing, transferring, and filing or processing claims of said policies on my
behalf.
13. Manage all assets and properties belonging to me or in which I have any interest,
and to expend whatever funds my attorney-in-fact deems proper for the preservation,
maintenance, or improvement of those assets or properties.
14. Compromise, arbitrate, or otherwise adjust claims in favor of or against me or
any assets or entity in which I have an interest, and to agree to anN rescission or modification of
any contract or agreement.
4.
15. Participate in any type of liquidation or reorganizati- of any enterprise.
16. Join with other persons with whom I own property in any type of joint tenancy in
any transaction regarding that property.
17. Conduct investment transactions as provided in -section 709.2208(2), Florida
Statutes. These investment transactions include, but are not limited to the following actions:
(a) Buy, sell, and exchange investment instruments.
(b) Establish, continue, modify, or terminate an account with respect to investment
instruments.
(c) Pledge investment instruments as security to borrow, pay, renew, or extend the
time of payment of a debt of the principal.
(d) Receive certificates and other evidences of ownership with respect to investment
instruments.
(e) Exercise voting rights with respect to investment instruments in person or by proxy,
enter into voting trusts, and consent to limitations on the right to vote.
(f) Sell commodity futures contracts and call and put options on stocks and stock
indexes.
18. Vote and exercise all rights and options, or empower another to vote and
exercise those rights and options, concerning any corporate stock, securities, or other assets; to
enter into or approve agreements for merger, reorganization or equivalent transactions with
respect to any company or enterprise; to delegate those rights to an agent; and to enter into
voting trusts and other agreements or subscriptions.
19. Exercise all rights and options, or empower another to exercise those rights and
options, concerning sole proprietorships, general or limited partnerships, joint ventures,
business trusts, land trusts, limited liability companies, and other domestic and foreign forms of
organizations.
home20 Sell, rent, lease for any term, or exchange any real estate, including my
, or interest in it for such considerations and upon such terms and conditions as my
attorney-in-fact may see fit, and sign, acknowledge and deliver all instruments conveying or
encumbering property titled in my name alone as well as any property owned by me and any
S.
other person jointly as a life tenant/remainderman, or as tenants by the entireties, joint
tenants with rights of survivorship, or tenants in common. This power shall apply specifically to
any interest which I have in the house and real property located at SS9 Ocean Boulevard,
Atlantic Beach, Florida 32233, and legally described as:
A PART OF LOTS 3 AND 4, BLOCK 19, ATLANTIC BEACH, AS RECORDED IN PLAT BOOK 5, PAGE 69 OF THE
CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA, MORE PARTICULARLY DESCRIBED AS FOLLOWS: FOR A
POINT-OF-BEGINNING COMMENCE AT THE NORTHWEST CORNER OF SAID LOT 4;THENCE RUN SOUTHERLY ALONG
THE EASTERLY LINE OF OCEAN BOULEVARD, A DISTANCE OF 100 FEET TO THE SOUTHWESTERLY CORNER OF SAID
LOT 3;THENCE RUN EASTERLY ALONG THE SOUTHERLY LINE OF SAID LOT 3, A DISTANCE OF 102.76 FEET,THENCE
RUN NORTHERLY ALONG A LINE PARALLEL TO THE WEST LINE OF BEACH AVENUE,A DISTANCE OF 100.03 FEET TO
THE NORTHERLY LINE OF SAID LOT 4; THENCE RUN WESTERLY ALONG THE NORTHERLY LINE OF SAID LOT 4, A
DISTANCE OF 10533 FEET TO THE POINT OF BEGINNING.
The house and real property located at 559 Ocean Boulevard, Atlantic Beach, Florida 32233, is
also described by the Duval County Taxing Authorities as follows:
16-2S-29E ATLANTIC BEACH PT LOTS 3,4 RECD O/R BK 2783-1021 BLK 19
This power shall also apply specifically to any interest I have in the 5.87 acres of real property
located at 25 Meadow Brook Lane, in Royston, Georgia, and legally described as:
In the 370`h District, G.M_, Franklin County, Georgia, containing 5.87 acres, more or less, being designated
as Tract 25 on the below mentioned plat of survey,and being bound now or formerly as follows: On the North by
Meadow Brook Drive; on the East by Tract 26 of said plat; on the South by branch (181 feet, more or less, along
centerline of branch is property line);and on the West by Tract 24 of said plat.
Said tract of land being more particularly described according to a plat of survey prepared by Clelland A.
Tyson, Surveyor, dated February 5, 1981, which plat, recorded in Plat Book 12 at Page 345, Public Records of
Franklin County,Georgia, is by reference incorporated herein as a part of this description.
This 5.87 acres of real property located at 25 Meadow Brook Lane, in Royston, Georgia, is also
described by the Franklin County Board of Tax Assessors as follows:
0191-008-BO1//MEADOW BROOK 025
Property ID Number 047 090
21. Exercise dli poyVers eVp..n though rpX [ttorngy-in-fact may also be acting
individually or on behalf of any Other perspn or entity int9.fes4ed in the same matters.
22. Transact all business, make, exeg;pte and acknowledge all contracts, orders,
deeds, bills of sale, assurances, promissory notes, mortgages and other instruments of any
nature which may be requisite or proper to effectuate any matter or things pertaining to or
belonging to me.
6.
23. Make gifts for estate planning purposes, including gifts to my attorney-in-fact;
change the beneficiaries of any life insurance policies or other qualified or nonqualified benefit
plans; create revocable or irrevocable trusts for the benefit of myself or of other persons; and
consent to the creation or extension of trusts established by other persons for my benefit.
24. Buy U.S. Treasury Bonds redeemable at par in payment of estate taxes, and to
purchase, sell, or redeem U.S. Savings Bonds.
25. Employ and compensate any investment management service, financial
institution, or similar organization to advise my attorney-in-fact and to handle all investments
and to render all accountings of funds held on my behalf under custodial, agency, or other
agreements.
26. Enter into any safe deposit box for which I am a lessee and add or remove items.
d'
27. Claim, disclaim or waive any interest in property that I have or would otherwise
receive, including but not limited to homestead and elective share.
28. Demand, obtain, review, and release to others medical records or other
documents protected by the patient-physician privilege, attorney-client privilege or any similar
privilege.
29. File or process claims for any medical bills with all insurance companies through
which I have coverage, including but not limited to Medicare and Medicaid, and to receive from
United Healthcare,The Hartford Insurance Company, or any other insurer information obtained
in the adjudication of any claim in regard to services furnished to me under Title 18 of the Social
Security Act.
30. Nominate on my behalf a person (including my attorney-in-fact) or entity to be
appointed by a court of appropriate jurisdiction as guardian of my person or property, or both,
or as custodian for my property during the pendency of any proceedings to determine my
competency.
31. Invest in assets, securities, or interests in securities of any nature, including
(without limit) commodities, options, futures, precious metals, currencies, and in domestic and
foreign markets or investment funds, including common trust funds; to trade on credit or
margin accounts (whether secured or unsecured); and to pledge assets for that purpose.
32. Insure any of my property, real or personal, in such-amounts and on such terms
as my attorney-in-fact may deem proper.
7.
STATE OF FLORIDA )
COUNTY OF DUVAL )
This instrument was acknowledged before me this day of ,2013, by
HELEN T. GOLDEN, (✓) who is personally known to me or ( )who has produced a driver's license as
identification.
Notary Public
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° n Notary Public State of Florida
Sharon P Smith f�
T` Pr My Commission EE098526 r
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