871 SHERRY DR - ROOF U' 0,- \s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Ii JY1�r'
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2516
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $10,600.00
Issue Date: 10/22/2015
Expiration Date: 4/19/2016
PROPERTY ADDRESS:
Address: 871 SHERRY DR
RE Number: 169982-0000
PROPERTY OWNER:
Name: PALMER ET AL, CHRISTY L
Address: 871 SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: PATRIOT ROOFING SERVICES, INC.
Address: 3326 GAY RD
Phone: - -
FEES:
BUILDING PERMIT FEE $103.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $107.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AM) "I I11•: FLORID:X
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: g 7/ $L-'TL
1 - e_t�J Permit Number:
Legal Description . (oy '_ �o � '2 6 , J L( Parcel# e- !6 s ? -E
Valuation of Work$ 10 Floor Area of Sq.Ft. S f.t
1 (op(� Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteratio, Repair ove Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Comm- a Resides
If an existing structure, is a firr,++��,,sprinkler s gem 'nstal d? (Circle on , es NoT/A
Florida Product Approval# f� # r,/ R*2
For multiple products use prodduct approva orm
Describe in detail the type of work to be performed: a-ROOF w/ t -hpr(
Property Owner Information:
Name: tLd4C ✓1 Cute l a-1,-(4"
Address: 17( - i Di:.
City &A�-j L ,��, StatetUip(3,0 33 Phone `'�
E-Mail or Fax#(Optional) -T -rr-,line c t •cO^1
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: -RF-11210+ 'Roo-an ' - (c.eS Qualif?inglA,gent:�� AT>ew)t
Address: ■�T1r-n . �i City /"1dd-(C Statep 368
Office Phone 'pce _155^7-}3a Job Site/Contact Number Fax# f—gip a7,2 --/g M.
State Certification/Registration# tc3 OCC/'2'
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 installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a_period of six 16)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,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.
I hereby cert fy that I have read and ex.I
-ed this a placation and know the same to be true and correct. All provisions of law and ord' antes governing this
type of work will be complied with w er sppecs ied her-' or not. The granting of a permit does not presume to give ./ . violate or cancel the
7rovisions of any other federal,state, o al Law re: ati f onstruction or the performance of construction.
A / /
signature of Owner S!i_ °_/ ■ ■l Signature of Contractor t�
'rant Name--I-- I��
er l Print Name .�4n VC,/ /
iefore me Before me
:iis ZZ D y of C 'set_ , 20/Sri this 22 ay of /fit_ ,20 1.5--
`�-. . wiLuE C.RicHARpsoN
„z'.:._...t ARY PUBt.1 SON �' A A31'PU
lotaly Public - , `. otary Public `' �6
S,,JA STATE OF FLORIDA ; FOF FLORIDA
w... . Carr*FF138858 1 1 b11�bir ()
Expires 8/12/2018 2/2018
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. l(Mt3E-r_.-GC)
State of County of l:�j,
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.
(4--/(0 -- �< 1�
Legal description of property being improved: 5- ^�Z 6 .3
Address of property being improved: S'2-6 C .
General description of improvements: ►� ll �� ,
Owner -S 1 (1- �^ { C_lire i Ft-0 if-
Address •L,'"`'E� '-ii 3 �'16(AL
Owner's interest in site of the improvement / C.)&7(...)
Fee Simple Titleholder(if other than owner) ----><
Name
Address
Contractor f ' •• 70_ I/ ..1 C(2 _ _• c•Address 1(634 -- l . �..� try ' T fi•
Phone No. C'Cl 1" r —.'1 7Jc� Fax No. 1 t -,�-c -- 'S'1�j
Surety(if any) t
Address Amount of bond$
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, a ignated by owner 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 copy of the Lienor's Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name ,,,...\c„....._________
Address
Phone No. No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a 4"••.i1 ■
different date is specified): 'Ril! :
..! -r,a
THIS SPACE FOR RECORDER'S USE ONLY •. E-•
;'o�„rt: .
W
•
Signed: '_' _�(1, N DATE
Before me this i day of •'f.2 We V In the / m cKi f
County val,S e of da,y6:•=sonelly appeared 2 Alb.
rY 1 O herein by a" —0
Doc#?015244095,OR BK 17345 Page 611, himself/herself and affirms that all statements and declarations herein
NLmoer Pages:1 are true and accurate ' • o
Recorded 10;222015 at 03:40 PM
Ronnie Fussell CLERK CIRCUIT COURT DUVAL i *;'°
FT;
COUNTY a o m
RECORDING$10.00 °'
Notary Public at Large.S-t • me . County of x1111 f I
My commission expires: A 1.1 l'4111•I ,
Personally Known - or
Produced Identification "ZMOI72 afra2r.AT