655 SAILFISH DR ROOF 2015 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
JJ�I9
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 _
JOB INFORMATION:
Job ID: 15-ROOF-1670
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $5,000.00
Issue Date: 7/14/2015
_ Expiration Date: 1/10/2016 -
PROPERTY ADDRESS:
Address: 655 SAILFISH DR
RE Number: 171224-0000 - - -
PROPERTY OWNER:
Name: JASON, BETZ
Address: 655 SAILFISH DR
GENERAL CONTRACTOR INFORMATION:
Name: THE ROOF DUCK WATERTIGHT ROOFING SYSTEMS
Address: 6095 Shadehill RD
Phone: - - _ --
FEES:
PLAN CHECK FEES $37.50
BUILDING PERMIT FEE $75.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $116.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 655 SAILFISH DR Permit Number:
Legal Description 30-6038-2S-29E .170 Parcel # 17.12,4-0000
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 5000 Proposed Work heated/cooled 1453 non-heated/cooled 286
Class of Work (circle one): XNew Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure, Is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval # FL11651.17
For multiple products use pro uct approval orm
Describe in detail the type of work to be performed: METAL ROOFING OVER EXISTING
Property Owner Information:
Name: SAM YOUNG Address: 655 SAILFISH
City ATLANTIC BEACH State FL Zip 32233 Phone 615-351-6569
E-Mail or Fax # (Optional)
Contractor Information:
Company Name: The Roof Duck Watertight Roofing Syst Qualifying Agent: Cord Poe
Address: 3948 3rd Street South Unit 195 City Jacksonville Beach —State FL Zip 32250
Office Phone 904-345-0663 Job Sitei Contact Number 904-345-0663 Fax#
State Certification/Registration# CCC1330589
Architect Name& Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
IppGcalij is hereby made to obtain a permit to do the work and installations as indicated. /certify that no work or installation has commenced prior to the
issuance of'p permi!and that all work will be petfornted to meet the.rtandcu ds of all laws regulating construction in this jurisdiction. This permit becomes null
and void rJwo,k is not commenced within sir(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
wank is commenced 1 understand that separate permits must be secured jor ElectricarWork, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
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 YOUR NOTICE OF
COMMENCEMENT.
l hereb cerlifi,that 1 have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type ofvwork will be complied with whether speci red herein a•not. The granting of a permit does nor presume to give authority to violate or cancel the
pr•ovtsions of any other federal,sta e, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name S�nL . o C Print Name
....................... ....................._..........................._........_.............
_............ _..................�....... ...... . ..
Sworn to and subscribed before me Sworn o and subscribed before me
this ► Day of 20 this Day of^ 20 /J
h
No aly Pub ; Ic' CA MIA L KORN
•+' CARM11A L KORN :r MV COMMISSION X FF22 71
:p E�e3i ed 01.26.10
'- My COMMISSION 4 FF224712 EXPIRES April 27,2019
.; EXPIRES April 27,2019 ,lctratr+ty' 3 clur,lanoa'•survl.,wn
.4,;r,3W+G'.:.. F4r.YNo '.Sa hW u,.:
at 08:59 AM, Ronnie Fussell CLERK CIRCUIT COURT D0eJAL COUNTY RECORDING $10.00
NOTICE or COMMENCEMENT
(PREPARE iM QUPLICATEj
Permit No. Tax Folio No.
State Of PLQM 1 _ County Of UUL`AL
To whom It may Concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and In
accordance with section 713 of the Florida Statutes,the following Information Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of pfopeiiy being improved: -6f)3R-2-.=E,1'u
Address of properly being improved:. E+iSJAILFI�H QRAtlxeitieBe.�:lr Ft.52?33
General description ofirnprovements: �tr.rnf.xoc>t c>✓rt:f:xis tx� _—__ —
Owner sAt Yots+lG
Address a555AiLFiSHQRAdazitfc8eachFL3.23
D.vner's interest in site of the improvement
Fee Simp'e Titleholder(if other than Owner)
Name
Address
Contractor TL.IE120C>{=1:?L'•CK SV%'rER7°ftiTF7:R( ?1=(\'GSY rE;viS
Address �S saQ Sig sit*rR tTrz'i ss
Phone No. Fax No.
Surety lit any;
Amoufti of Lord$
Address
Phone No.
Fax No. ---- --—
Name and address of any person making a town for the construction of the itizprovements.
name
Address
Phone No, Fax No.
Name of person,,,?ithin the State of Florida,other Char himself.designated by ov,rer upon whom n.olices or other
documents may be served:
Name
Address
Phone No, Fax No.
In addition to himself,owner designates ttie foilovring person te,receive a copy of the Lienors Notice as provided in
Section 7113.06(.2)(b).Florida Statutes.(Fill in at Owner's option).
Name -------- .___.-.
Address
Pt-?one No. Fax No.
Expiration este of Notice of Commencement(the expiration date is one(,1)year from the date of recording untess a
different date is specified): ---
THIS SPACE FOR RECORD R'S USE ONLY ��NINERDATE
z.
Sigr ed —1.1
: Barore raze i33, say o`• --
ca !Guva Siete 01:Fiorida has pe naUy appeared yarofn t y
a q ants and de^-farations he-air.
are true and ac CAMMIA L IMN
.
Uy
COMMISSfON if;zF224712
tach �s EXPIRES April 27,?019 -
Notary:plc^fie at Large.Stat
re
io,w cc.mm:ssion expires +L?^ or
Personally
Produced mono"cavon----- ---- --- - --