511 OCEAN BLVD ROOF S'
CITY OF ATLANTIC BEACH
r 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-558
Job Type: ROOF PERMIT
Description: FL 1956 R9 FL 13857 R2
Estimated Value: $16,250.00
Issue Date: 3/12/2015
Expiration Date: 9/8/2015
PROPERTY ADDRESS:
Address: 511 OCEAN BLVD
RE Number: 170143-0000
PROPERTY OWNER:
Name: GRISWOLD, SCOTT J &JANET H, '
Address: 511 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: SCHULTZ ROOFING COMPANY INC
Address: 216 N 20TH ST QA DOUGLAS ARTHUR SCHULTZ
Phone: -
FEES:
BUILDING PERMIT FEE $131.25
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $135.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 511 Qr-e` w Vr� tl Bch Permit Number:
S-b 9 I � m h
Legal Description 6M 19 Parcel# 1-101 `13-0000
Floor Area or—Sq.rt.�� —Sq Ft 1'
Valuation of Work S I I 'a 90. 00 Proposed Work heated/cooled 2— non-beated/cooled n 4
Class of Work(circle one): New Addition Alteration 90(—Move Demolition pool/spa window/door
Use of etdsting/prorosed.structure(s)(circle one):. Commercial eslden '
If an existing structure,is a fire sprinkler system installed?(Circle one): es, No N/A
Florida Product Approval 4f Tftr1-<n H-eriinoa FL- 195(a` R9 rn�d-st e1+Stick For multiple multiple products use p uct approves ori
Describe in detail the type of work to be performed: S I.
Property Owner Information:
Name 5r i-i- T. Grt swo J Address: Sit Ocee_t` 3 1 ✓� .
City a He StateFl Zip-a-4233-Phone 904 - a4b --75(a 4
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: COQual m -�g Agent: 1)Cua fns 1�� -Sc4, lid
Address: Q- nl aO+r Sfi. City " tt)(111 state I Zip ��aso
_ __ _hone o4 -a4b-a31s- Job Site/Contact Number 75cl-00( 3 Fax# Qq -i
State Certification/Registration# CIC C 0 3 b 9 3
29
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Tide 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 ar indicated /certify that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet the standards ofall laws regulating construction in thlsjurisdiction This permit becomes null
and void fwork is not commenced within six(6)months,or ifematruction or work is suspended or abandonedfor apenad ofsis/6)months at any time a sr
work is commenced l understand that separate permits must be secured for Eleddcal Work,Phnmbing,Signs. Weft,Pool;Furnaces,Bogen,H ers,
Tanks WdAir Conatdonen,dc.
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 YMi NOTICE OF
COMMENCEMENT.
!hereby certify that have rend act examined thv�plicathm and know the same to be true and correct. Aliprovisions oflaws act ordinances governing alas
type of work will be complied with whether sppeeci cd herein or not. The growing of a permit does not presume to give authority to violate or cancel the
Xi tions ofany other federal,state.or locallaw regulating construction or the performance ofcm m-twaon.
Signature of Owner 1:2,� Signature of Contractor L_l
-*Print Name SCa -r . _�2 dw.,e-p.. . ....._... Print Name ......a..9V-G_'4F •1.,{-L
Sworn�gand subscribed,bpfo a me Sworn to and subwribed�re me
this L Day of of 201S this -11 Day of 20
:No �Publicn�M��
otary Pu w.THCMASON#FF 118218 �Xd" ' Revised 01.26.10
124,2018P ����.....uo-vsvao p EiPire5 Apn124,2018
NOTICE OF COMMENCEMENT
Permit No. Tac Folio No.
State of Florida,County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property pegal description of property and address if available):
ri-(n� l(Q�<- das �l(M �1'3eacQ, Lo+J'- PT Lai-z. iPad a/ i2, rJP6 'teS1 (3) K 19
2. General Description of improvements:
3. Owner Information:
a)Name and Address: Sco{ F S --H(k'S w O 1 d S11 O up �
b)Interest in property: �..��
c)Name and address of simple tiitiaholder
(if
than owner):
k
4?.11
N Contractor Information:' a)Name and Address: Douglas A. SchulWSchuliz Roofing Co., Inc.215 N 20th St.,Jacksonville Beach, FL 32250
b)Phone Number:(904)246-2315
5. Surety Information:
a)Name and Address:
b)Phone Number:
c)Amount of Bond:$
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a)7,Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to himself/herself,Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713.13 (1)(b),Florida Statutes.
a)Name and Address:
b)Phone Number of person or entity designated by owner.
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN 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
YOUR NOTICE OF COMMENCEMENT. ATTORNEY BEFORE COMMENCING WORK OR RECORDING
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true to the best of my knowledge and belief.
A� �c S T-r Geis., L-mb
Srg rature of Owner or Owner's Authorised Officerrector/Partner/Manager Sr9nalrory's Printed Name&Title/Office
v
The foregoing instrument was acknowledged before me this L_day of1,6_x._-__.
rue
by. as OL,ir�.cv
(Name of for
(Type(Type of Au -mlifww of Part Instrument was&-.ted )
•.t CernmisAroe 181218
F Expire MF 2 24,,202018
u.mam.Tmvo.im..auwa+nr
Dan 2015055604,OR BK 17093 Page rise. Nul� bl�lz
/ F F ORIDA
Number Pages:l Print Name:
co />�Ph y pJ y�0?Jl
Rertled03/111a<72:07 PM,
Rennie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY Q Personally Known
RECORDING$10.00 Identificatiodrype: GC 2y -719o -5b_ ras- a
Revised 3/15/12