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91 W 11th St 2015 Roof Building 1,4,10 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ROOF PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-ROOF-472 Job Type: ROOF PERMIT Description: REROOF FL10674R-9 BUILDING 1 Estimated Value: $14,500.00 Issue Date: 3/5/2015 Expiration Date: 9/1/2015 PROPERTY ADDRESS: Address: 91 W 1 1TH ST RE Number: 170807-0000 PROPERTY OWNER: Name: EMPIRIAN DRIFTWOOD LLC Address: 25 PHILLIPS PKWY 25 PHILLIPS PKWY GENERAL CONTRACTOR INFORMATION: DIVISION Name: BRC HIGH TECH ROOF EMAN ROWE Address: 6372 GREENLAND ST STE 6 QA JERRY COL Phone: FEES: BUILDING PERMIT FEE $122.50 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $126.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. I I A \j- �u I ts CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ROOF PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-ROOF-473 Job Type: ROOF PERMIT Description: reroof building 4 Estimated Value: $14,500-00 issue Date: 3/5/2015 Expiration Date: 9/1/2015 PROPERTY ADDRESS: Address: 91 W 11TH ST RE Number: 170807-0000 PROPERTY OWNER: Name: EMPIRIAN DRIFTWOOD LLC Address: 25 PHILLIPS PKVVY 25 PHILLIPS PKWY GENERAL CONTRACTOR INFORMATION: Name: BRC HIGH TECH ROOF DIVISION EMAN ROWE Address: 6372 GREENLAND ST STE 6 QA JERRY COL Phone: FEES: BUILDING PERMIT FEE $122.50 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $126.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ROOF PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-ROOF-474 Job Type: ROOF PERMIT Description: roof building 10 Estimated Value: $14,500.00 issue Date: 3/5/2015 Expiration Date: 9/1/2015 PROPERTY ADDRESS: Address: 91 W 1 1TH ST RE Number: 170807-0000 PROPERTY OWNER: Name: EMPIRIAN DRIFTWOOD LLC Address: 25 PHILLIPS PKWY 25 PHILLIPS PKWY GENERAL CONTRACTOR INFORMATION: Name: BRC HIGH TECH ROOF DIVISION Address: 6372 GREENLAND ST STE 6 QA JERRY COLEMAN ROWE Phone: FEES: BUILDING PERMIT FEE $122.50 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $126-50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. NOTICE OF COMMENCEMENT COUNTY OF Duval STATE OF Florida To whom it may concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713.13 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Description of property 18-34 38-2S-29E Atlantic Beach SEC H 91 W. 11 th Street, Atlantic Beach, FL 32233 General description of improvements Roof Replacement Owner Empirian Driftwood LLC Address C/O Elon Property Mgmt., 590 W. Kennedy Blvd. 2nd Floor, Lakewood, NJ 08701 Owner"s interest in site of improvement Fee Simple Fee Simple Title holder(if other than Owner) Name Address Contractor BRC Roofing & Construction, Inc. Address 11250 Old St. Augustine Rd. #15313, Jacksonville, FL 32257 Surety(if any) Address --Amount of Bond Name of person within the State of Florida designated by owner upon whom notices or other documents may be served: Name Address 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 Aciclqms­-_� Owner/Contractor Signature Print Name Doc#20,15050932,OR BK 170871 Page 66, Sworn to and subscription before me this Number Pages� I Recorded 03,'05,2015 at 11:18 AM, day9f-_-121LLcL' Ronnie Fussell CLERK CIRCUIT'COURT DUVAL c— COUNTY RECORDING$10.00 Notary Public Signature County of State of Personally Known or Produced Identification Nots-y Flumc tdte of Florida 4P Jerry C Rom ri EE 8302 MY COMMIssio, EE 830205 OF Expires 08/26/2016 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 91 W. 11 th Street, Atlantic.Beach, FL 32233 Building 10 Permit Number: Legal Description 18-34 38-2S-29E Atlantic Beach SEC H Parcel# 170807-0000 F loor Area of Ft. sq.vt Valuation of Work$_/(f I !�00 Proposed Work heated/cooled 5-2(z non-heated/cooled Class of Work(circle one): New Addition Alteration(�R7e�pakirove Demolition pool/spa window/door Use of existing/proposed.structure(s) (circle one): Commercial ('R'_es­identia If an existing structure,is a fire sprinkler system installed? (Circle one . 0 Florida Product Approval 4 For multiple products use produ t app—roval form Describe in detail the type of work to be performed: goof ReplaQement Property Owner Information; Narne: Empirian Driftwood LLQ —Address:c/o Elon Property Mamt. 590 Kennedy Blvd. 2nd Floor City Lakewood State_*Zip 08701 Phone 614-873-2225 E-Mail or Fax#(Optional) Contractor Information: Company Name: BRC H gh Tech Roof Division, Inc. Qualifying Agent: Jerry Rowe Address: 11250 Old St. Auqustine Rd. #15313 —City Jacksonville State FL -—Zip 32257 Office Phone 904-288-043.1 Job Site/Contact Number 904-463-2952 Fax# 904-292-9390 — State Certification/Registration 4 CCC056398 Architect Name &Phone 4 Engineer's Name &Phone# Fee Simple Title Holder Narne 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 commencedprior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null months at any time after and void ff work is not commenced within six(6) months, or if construction or work is suspended or abandonedfor a Period of six at work is commenced I understand that separate permits must be securedfor Electricar Work,Plumbing,Signs, Wells, Pools, I urnaces,Boilers,He ers, Tanks and Air Conditioners,e1c. 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 YOVIi NOTICE OF COMMENCEMENT. I hereb certify that I have read and examined this a f laws and ordinances governing this pplication and know the same to be true and correct. All provisions o 17work will be comp M whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the , Vied wi � m ns ru ti provist.ons of any otherfederal,state, or local taw regulating construction or the pe for ance of co t c on. r Signature of Owne�aw_ Signature of Contracto Print Name z,-t.r&W r .................................. ............... ..........I................. .......................................................................... Print Name .....................Ph Sworn to and subscribed before me Sworn to and subscribed before me 20 this 5' Day of M an,�_ ?0/i—_ this 3' Day of 20 Notary Public State of Florkla 1Wq_tar . Y 911bWAN Hy N Pub Jerry C Rome MMISSION#FF055556"4 Revised 01.26.10 MY co Revised 01.26.10 my commission EE 830205 m rl 01 7. 7 or Expires 08126/2016 e. EXPIRES December 17.2017 S 39"153 FloridallotaryService.Com BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 91 W. 11 th Street, Atlantic Beach, FL 32233 Building 1 Permit Number: Legal Description 18-34 38-2S-29E Atlantic Beach SEC H Parcel# 170807-0000 P loo a of' Sq.Ft. Sq Pt Valuation of Work$4 ,6700, Proposed Work heated/cooled non-heated/cooled 1� Class of Work(circle one): New Addition Alteration epair Move Demolition pool/spa window/door Use of existing/proposed.structure(s) (circle one): Commercial esident' If an existing structure,is a fire sprinkler system installed? (Circle one):(;��No i I Z/A Florida Product Approval# 106 7 4/- 12 9 For multiple products use product approvafform Describe in detail the type of work to be performed: goof Replacement Property Owner Information: Name: Empirian Driftwood LLC Address:c/o Elon Property Mamt. 590 Kennedy Blvd, 2nd Floor City Lakewood State�#Zip 08701 Phone 614-873-2225 E-Mail or Fax 4 (Optional)— Contractor Information: Company Name: BRC High Tech Roof Division, Inc. Qualifying Agent: Jerry Rowe Address: 11250 Old St. Auqustine Rd. #15313 Citv Jacksonville State FL Zip 32257 – Fax 4 904-292-9390 Office Phone 904-288-0431 —Job Site/Contact Number 904-463-2952 State Certification/Registration 4 CCC056398 Architect Name&Phone# Engineer's Name &Phone Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address. A lica h re m d a n ermi, d he work and instal'ati�ns as indic or installation has commencedprior to the I law this jurisdiction. Thi's permit becomes null to 0 he sta ar at i )months at any time after 0 k is s a erodqfsix�6 y ae k 11 be 0 'ed to, t n� od Wells,Pools, jurnaces,Boileis,Heaters, 0 O't ' a p w t x s or s c truct r r f h (6), nt n n it w hi,s p 'o f ea, wd io s e is P t and tha p su ce o i t 0 , " ap k is ot com rid oid 's c ric 'o 'is, 0 nc, 'a 0 Ob ecured or Ele ,k me d. I understand that sepa te Perm u Tanks and Air Conifitioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEP TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING9 CONSULT YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE z COMMENCEMENT. z g lhere certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinance., gie2i it work will be coMp if7ed herein or not. The granting of a permit does not presume to give authority to violat cma Wed with whether ec provisions of any otherfederal,state, or localsfaw regulating construction or the peFformance of construction. 0 cr .2 X W Signature of Owner "�_j at, bi Signature of Contractor ! "", 2 ............. C6 PrintName BU&,s Print Name ................................ ........................................... ................................................................ Sworn to and subscribed before me Sworn to and subscribe befor me X z d e A44,1 6111 20 1 i D f this r-- this ay of H 20 IS– av o 0 lic N No N Ata lic L��Puby tarY Public State of Florida Jerry C Rome MY Commission EE 830205 Revised 01.26.10 Expires 08/2612016 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 91 W. 1 Ith Street, Atlantic.Beach, FL 32233 Building 4 Permit Number: Legal Description 18-34 38-2S-29E Atlantic Beach SEC H Parcel# 170807-0000 F loor Area of —Tq7 t. Sq.tt Valuation of Work$ &00.00 Proposed Work heated/cooled 5/44 �A:non-heated/coolcd Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No (N�/�-A Florida Product Approval A For multiple products use jr—oduct apffro—vafTo—rm Describe in detail the type of work to be performed: Roof Replacement Property Owner Information: Narne: Emi2irian priftwo d LLC Address: -873-2225 30 Kennedy Blvd. 2od Floor City Lakewood State Wip 08701 Phone 614 E-Mail or Fax 4 (Optional_ Contractor Information: Company Name:BRC High Tech Roof Division, Inc.—Qualifying Agent: Jerry Rowe Ziv 32257 Address: 11250 Old St. Auqustine Rd. #15313 City Jacksonville State FL — Fax 4 904-292-9390 Office Phone 904-288-0431 —Job Site/Contact Number 904-463-2952 State Certification/Registration# CCC056398 Architect Name &Phone# Engineer's Name&Phone Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address nd installations as indicated. I certify that no work or installation has commencedprior to the Application is hereby made to obtain a permit to do the work a issuance ofa permit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. Thi's permit becomes null or if construction or work is suspended or abandonedfor 17 eriod qfsixP6,)months at any time after and void ff work is not commenced within six(6) months, Signs, if,lis,pools, urnaces,Boilers,Heaters, work is commenced I understand that separate permits must be securedfor ElectricWWork,Plurnbing, 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 YOV]i NOTICE OF COMMENCEMENT. and know the same to be true and correct. All provisions of laws and ordinances governing this I hereb certify that I have read and examined this app ication rity to violate or cancel the type o7work will be complied with whether specified herein or not. The granting of a permit does not presume to give autho provisions of any otherfederal,state, or local law regulating construction or the peFformance of construction. Signature of Owneo Signature of Contractor CAYf-� , 4B�2 Print Name 'PA Print Name C-A�......................................................... ...................... .......... .................I.......................... i....................... Sworn to and subscribed before me Sworn to and subscribed before me 20.LC 200 this _5- Day of this 5/;j Day of 10 ES evised rOl.26.10 7 2017 EXPIRES(December 17 2017 ary P IN otary Public State of Florida Pubg?BRIAN HYNES Jerry C Rowe My coMMISSION#FF055564 evised 01.26.10 my Commission EE 830205 or Expires 08/2612016 FloridallotaryService.