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,
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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
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d e
A44,1 6111 20 1
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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.