1220 Seminole Rd 2014 Roof ► 'L`1
CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
ROOF PERMIT INSPECTION PHONE LINE 247-5814
ALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMA --
Job -
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $8,975.00
Issue Date: 10/23/2014
Expiration Date: 4/21/2015
PROPERTY ADDRESS:
Address: 1220 SEMINOLE RD
RE Number: 171936-0000
PROPERTY OWNER:
Name: ELF, ROBERT D TRUST
Address: 1220 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: BRC HIGH TECH ROOF DIVISION
Address:
Phone: - -
FEES:
PLAN CHECK FEES $47.44
BUILDING PERMIT FEE $94.88
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $146.32
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUIIIDING PERNUT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904) 247-5845
Job Address: -%.gym ►aj& M I MI a&',C, rtkdN Permit Number:
Legal Description ?-I' b> 11&--?,S- E SAA e. \k6 v%,* t?- Parcel#
Valuation of Work$g9 7S '` Proposed Work heated/cooled .2 �C� non-heated/cooled
Class of Work(circle one): New Addition Alteration ( epair Move Demolition pool/spa window/door
Use of ezisting/propposed structures}(Circle one):. Commercial Residential.-m,
If an existing stractare,is a fire sprtn&ler system installed? (Circle one): Yes N/A
Florida Product Approval#
For multiple products use p o uct approva arm
Describe in detail the type of work to be performed: ?,=& \aCX-Cnra-�-
Property Owner Information:
Name: D-�Asi -Ny�St Address: ,� S-\� •�\ t�`C'a��-
city G a*kr\e!,J i 11 e_ State VZip Phone %a1\- �NZN%1
E-Mail or Fax#(Optional)
Contractor Information: DD
Company Name: �R(.�r 6 Qualifying Agent:Sec'�rh 4P"Q
Address: 1 I 1.S o O -1\4 S40 s i '213 City State -7\.- Zip
Office Phone Job Site/Contact Number Fax# D
State Certification/Registration# LCx-,oS 10398
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 iratallattons as Indicated I certify that no work or installation has commenced prior to the
issuance a permit and that all work will be pe armed to meet the standards of a!!laws regulating construction In this jurisdiction This permit becomes null
and void work is not commenced within six(6months, or tf consmtctfon or work is suspended or abandoned for aeclod of sic(6)months at any time after
work is commenced I understand that separate permits must be secured jar Electrlca!Rork,Plumblieg,Slgtts, Wells,Pooh Flirnaces,Boilers,Hewers,
Tanks and Air Condttlatters,etG
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMNIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMI?ROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here certify that I have read?=or
lfcation and know the same to be true and correct. All provisions of laws and ordinances governing this
type o)work will be comp!' ted herein or not The granting of a permit does not presume to gyve authority to violate or cancel the
provisions of any other f �a�jw regtelatittg construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Print Name
Sworn and su before Sworn to and subscribed before me
this Day of l�( ';CC��P f� .20 this Day of .20_
Notary Public ros`"""' c� SHANNON KINARD OtalyPu 1C
MY COMMISSION#FF014697 Revised 01.26.10
EXPIRES May 24,2017
(407)398-0153 FloridallotaryService.com
08/25/2013 11:28 FAX Z001
DURABLE POWER OF ATTORNEY
By this Durable Power of Attorney, I, ROBERT D. ELF, of Duval County, Florida, appoint my
children,LEE E.TAYLOR and BRYON F.ELF,as my attorneys-in-fact to act severally and not jointly, as
more fully provided below,to manage my affairs. I hereby revoke all other powers of attorney, durable or
otherwise,previously made by me.
This Durable Power of Attorney shall not be affected by any physical or mental disability that Inlay
suffer, except as provided in§709.08, Florida Statutes, and it shall be exercisable from this date. All acts
done by my attorneys-in-fact pursuant to this power shall bind me, my heirs, devisees and personal
representatives. Thus power of attorney is nondelegable.
All of my property and interest in property are subject to this Durable Power of Attorney.
Without limiting the broad powers conferred by the preceding provisions,I authorize my attorneys-
in-fact to:
1. Collect all sums of money and other property that may be payable or belonging to rne, and
to execute receipts, releases, cancellations or discharges.
2. Settle any accounts in which I have any interest and to pay or receive the balance of that
account.
3. Borrow money on such terms and with such security as my attorney-in-fact thinks fit and to
execute all notes, mortgages and other instruments that my attorney-in-fact finds necessary or desirable.
4. Draw, accept, endorse or otherwise deal with any checks or other commercial instruments,
specifically including the right to make withdrawals from any checking or savings account.
5. Redeem bonds issued by the united States Government or any of its agencies, any other
bonds and any certificates of deposit or other similar assets belonguig to me.
6. Sell or redeem any of my assets, including but not limited to real es-Late, bonds, shares of
stock,mutual funds,annuities, warrants and debentures,and to execute all assigrunents and deeds or other
instiuments necessary or proper for transferring them to the purchaser or purchasers,and give good receipts
and discharges for all money payable with regard to them.
7. Manage, lease,and superintend any of my real estate.
8. Purchase bonds, shares of stock, mutual funds and any other securities, annuities, or real
estate, as my attorney-in-fact thinks fit.
9. Vote at all meetings of stockholders of any company and otherwise act as my proxy with
respect to my shares of stock or other securities or investments that now or hereafter belong to me, and
appoint substitutes or proxies with respect to any of those shares of stock.
08/25/2013 11:28 FAX 0 002
10. Execute on my behalf airy tax rettu-n,make any tax elections or consents that I could make,
and act for me in any examulation, audit, heating, conferences or litigation relating to taxes, including"
authority to file and prosecute refund claims and enter into any settlements_
11. Engage,employ and dismiss any agents,clerks,servants or other persons as my attorney-in-
fact, in the sole discretion of said attorney-in-fact,shall deem necessary and advisable.
12.. Prosecute,defend and settle all actions or other legal proceedings respecting any of my assets
in any manner.
13. Organize,either singly or in conjunction with others,a corporation,partnership or other entity
and to transfer assets to such entity.
14. Make gifts or transfers of arty of my property in connection with estate, gift, income or
generation skipping tax platuiing procedures for me consistent with my general testamentary intent.
Provided,however,gifts to the attorney-in-fact shall not exceed the annual exclusion as described in Section
2503(b)of the Internal Revenue Code of 1986,as amended from time to time,if the attorney-in-fact isnot
my spouse.
15. Exercise any power ofrevocation or amendment retained by me over airy living trust ofwhich
I am or may become grantor, as may be required or advisable to better accomplish my intent as expressed
therein,transfer any of my assets to the trustee of any living trust of which I am or may become grantor,and
create a living trust for me consistent with my general testamentary intent.
16. Disclaim any assets passing to me.
17. Make all health care decisions for me (except those specific decisions to be made by my
surrogate under my living will).
18. Authorize my admission to a medical,nursing,residential or similar facility and to enter into
agreements for my care.
19. Authorize my admission to a mental health facility for psychiatric or psychological
evaluation,treatment or care and to release me from such facility.
20. Have access to any and all of my medical records, medical history, billing and other
information related to my medical care and to execute releases authorizing the disclosure of such
information. For purposes of the Health Insurance Portability and Accountability Act (HIPAA), my
attorney-in-fact shall be considered my personal representative and shall have the authority to access and
disclose my protected health information.
21. Enter any safe deposit box standing in my name(alone or jointly), and to remove any or all
contents.
-2-
08/25/2013 11:28 FAX 000
22- Collect and receive all slues of money and other property that may be payable to me by reason
Of my participation in a qualified retirement plan or by reason of my being the beneficiary of a participalnt
in a qualified retirement plan,or that may be payable to me from an Individual Retirement Account as owner
or beneficiary.
23. Make on my behalf any elections or choices available to me, and Dive on any behalf any
consents required, by reason of my participation in a qualified retirement plan or by reason of being the
beneficiary of a participant in a qualified retirement plan and make any elections or choices available to me,
and give on my behalf any consents required;under any Individual Retirement Account of which I am the
owner or beneficiary including the right to withdraw money and make investment decisions.
24. Establish for my benefit one or more Individual Retirement Accounts with any Trustee or
custodian.
25. Transfer any of my assets to the Trustee or custodian of any Individual Retirement Account
established for my benefit and/or change any designation of beneficiary for any insurance or aruiwty policies
in which I have any interest, consistent with-my general testamentary intent.
26. Execute and fund an Irrevocable Income Cap Trust on my behalf to enable me to qualify for
Medicaid benefits or any other governmental assistance programs.
27. Do anything regarding my estate,property and affairs that I could do myself,if competent.
The powers conferred upon my attorneys-in-fact extend to all of my right, title and interest in
property in which l may have an interestjointly with any other persons,whether in aii estate by the entireties,
joint tenancy or tenancy in common.
My Durable Power of Attorney, which is granted severally to two attomeys-in-fact by the same
instrument,does not require the concurrence of my attomeys-in-fact on any act in the exercise of the power.
Any attorney-in-fact who has not participated in the exercise of any authority granted hereunder shall not
be liable to me or any other person for the consequences of the exercise by any other attorney-in-fact.
Third parties who act in reliance upon the authority granted to my attomeys-In-fact under this durable
power of attorney and in accordance with the instructions of either or both of the attorneys-in-fact shall be,
and are hereby,held harmless by me 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 death of me.
My attomeys-in-fact shall exercise this Durable Power of Attorney only for my benefit,and not to
benefit themselves (except as provided in paragraph 14).
vly attomeys-in-fact shall not be liable for any acts or decisions made by the attorneys-in-tact in good
faith and under the terms of this durable power of attorney.
-3-
06/25%2010 11:29 FAX 0004
This instrument is executed by me in the State of Florida,but it is my intention that this power of
attorney shall be exercisable in any other state or jurisdiction where f may have any property or interest in
property.
Photostatic copies of this instrument shall have the same force and effect as the original.
I hereby confirm all acts of my attorneys-in-fact pursuant to this power.
Any act that is done under this power between the revocation of this instrument and notice of that
revocation to my attorneys-in-fact,LEE L. TAYLOR and BRYON F. ELF, or the sw-vivor of them, shall
be valid unless the person claiming the benefit of the act had notice of that revocation.
IN WITNESS WHEREOF,I have set my hand and seal, thiszQm� day of 2007.
Signed; Sealed and Delivered
in the Presence of:
ROBERT D_EL
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this _day of
2007; by ROBERT D. ELF, who is personally known to me or who has produced a driver's license as
identification.
Signature:
Print Name.
NOTARY PUBLIC, State of Florida
Comnussion
d�2�Z'CTB
Julie Snyder
Commission 9 a• Expires es I�arct!D2652010a
L%.,O Y To,non.,y„�w,nr 60PNSTC+9
-4-
06/25/2013 11:29 FAX 01005
NUTIL;L U1+- l:U1V11V1z11U6iV1E1NT
;PREPARE P;CUPLICATF,
Permit No. Tax Folio No.
Star of Count% of
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:77.c IG-2S-LGt sea:,Maritia Unit 2
Address of property being improved: 1,2120 semmnle Road
A /I q.V AC -e- c-f, l— ( 3 Z 2 L (1
General description of improvements:Rtxtf Replac rna m
O:rner Robert 1).Elt'I'mi'l
Address 1816 SSV 81 Terrac r,Gainesville.FL 326117
O:rner's Interest in site of the improvement Feer simple
Fee Simple Titleholder(if other than o. ner)
Name
Address
Contractor RRC Rooting&Constmctioii.Inc.
Address 11250 Old St.Angti•tinr Rd.:13313.Jacksonville.FL 32237
Phone No.904.289-0431 Fax No.91 1?W!1,3111)
Surety(if any)
Address Amount of bond S
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,desionated by o.vner 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 cony 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( yea from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLYAryof '.
Ov.:.cR
3Doc#2014240473.OR BK 16953 Page 68'1 Cma.o „I,s,nary appearsNumber P es: 1a9 nat a stat±mens anc aersrstxs herein
Recorded 10x2212014 at 02:30 PM, �n„„ ._
Ronnie Fussell CLERK']IRCUIT CCUR”CLVAL p�P°°�%`•. SHANNON KINARD
COUNTY �p `_
RECORDING$10.00 '€ MY COMMISSION#FF014697
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