820 14th Street West ROOF r ''' s, CITY OF ATLANTIC BEACH
9 800 SEMINOLE ROAD
Iv _: ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
\0131 .
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2770
Job Type: ROOF PERMIT
Description: ROOF
Estimated Value: $9.140.00
Issue Date: 11/30/2015
Expiration Date: 5/28/2016
PROPERTY ADDRESS:
Address: 820 W 14TH ST
RE Number: 171047-0000
PROPERTY OWNER:
Name: SIMMONS, DEBRA A
Address: 820 W 14TH ST
GENERAL CONTRACTOR INFORMATION:
Name: SUNSTATE ROOFING CONTRACTORS
Address: 1946 BEACHSIDE CT THEODORE W ALESCH
Phone: - -
FEES:
BUILDING PERMIT FEE $95.70
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $99.70
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233 /�
Office(904)247-5826 Fax(904)247-5845 1•S - Re)o F ' Z 7 7�.J
Job Address: 820 14th Street West,Atlantic Beach 32233 Permit Number:
Legal Description. 18-34 38-2S-29E.281 ATLANTIC BEACH SEC H LOTS 1.2 BLK 222 I# 1 7104 7-0000
Floor Area of Sq.Ft.
2278 Sq.Ft
Valuation of Work$ 9,140.00 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial t`Residenti;D
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 4x,
Florida Product Approval# FL 7006-R7
For multiple products use product approval form
Describe in detail the type of work to be performed: RE-ROOF EXISTING SINGLE FAMILY RESIDENCE
Property Owner Information:
Name: SIMMONS.DEBRA A Address: 820 14th STREET W
City ATLANTIC BEACH State FL Zip 32233 Phone (904)349-2218
E-Mail or Fax#(Optional) davidbandrewsOgmail.com
Contractor Information:
SUNSTATE ROOFING CONTRACTORS INC THEODORE W ALESCH
Company Name: Qualifying m A
Address:
1946 BEACHSIDE CT City ATLANTIC BEACH State FL Zip 32233
Office Phone 904-945-5421 Job Site/Contact Number 904-613.6517 Fax# 904-247-9330
State Certification/Registration# CCC 1330039
Architect Name&Phone# N/A
Engineer's Name&Phone# N/A
Fee Simple Title Holder Name and Address_
Bonding Company Name and Address NIA
Mortgage Lender Name and Address N/A
4vplication is heanit ude to obtain a Permit tp do the work and installations as indicated I c•ertifi•that no work or instillation hug csonrmenc d prior to
i re issuance of 0 p melt and that all work n-i/t be Performed to meet the stanc/anis of all low's regulating constnrction in this jurisdiction. this Permit
becomes mid ynd.rid if work is not .onrnrenced within six(6)mronths.or if construction or work is suspended or abandoned fora period of six( m.nihs
Boilers,Nea t�Ta ki a d Air�,y.d. I n dersttand that separate permits must he secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,
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 ME BEFORE RECORDING YOUR NOTICE OF
I hereby c-erttj•that I have read and examined this ap lication and know the.sanie soo he time and correct. All provisions of laws and ordinances governing
iphro+r/o a of c nn oihehe c o rpli s drill m wlacaf la.+rg+rld hnr inn Ina iaT ru'gr a/x r)or i per f c oeis not presume to gate authority to violate or cancel the
Signature of Contractor I Ctie/
Signature of Owner b ►
Print Name DPW'4 A- /'l�/ '3 P' Name r-CjQ'jV 1
S • . . sup. ri,•� fo e '
Sworn to and subscribed before me 20 1 S� thi ♦ i:y of
�_Day of l■1py QthSL�j1/4
Notary Pub is
SPERGER `'' 01.2_6.10
:j TONI GINDLE i
,., r MY COMMISSION*FF 924951
di!'"v , PATRICIA J.JACKSON �a EXPIRES:Oc Pole6 Z I —8 1�
N c.. MY COMMISSION*FF 202473 ti �yd:'' [�„�d n,ru tiro an Jnrc U C/1
`.-°�'a EXPIRES:June 14,2019 R•r, `
q,, .�•' Bonded TAtu Notary Public Underwriters
Doc # 20I527I520, OR BK 1738I Page 393,
Number Pages: 1, Recorded I1/30/2015
at I2:I0 PM, Ronnie Fussell CLERK C IRCUIT COURT DUVAL COUNTY RECORDING $I0 . 00
NOTICE OF COMMENCEMENT
shoe of FLORIDA
---- ---- ' --
m, 6,U.`No. /r,ou�0ou0
County v[_ ouun�_ _ _ ' - -- -__--_
-'_-
To Whoiti It May Concern:
The undersigned hereby intbrms you that improvements will be made to the'wnd«n�/ou�uwxV is ( -- ^~~''^ ~ v~ ='"n'nnnun«�w/my,cmn7|3*[
Legal Description of prny � �---^ ' NOTICE OF COMMENCEMENT.
property being improved: -18734 3u-2o-29E.241ATLANTIC BEACH AEC H iLOIS 1,2 eix 222L--__-__-
__-----__ _- _--- --_- -_� - --- _
Address of property being improved:. _820 14TH ST
W������__-___-________ _
- -_ - _ '
General description^fimprovements: RE-ROOF ---------- '--'------------
__' - -_-____________ -
�� �����x __-_____�--____--
________- _-_ __ _ _ Address: ann,4nvS7m/A7l�w7��fu�C��Fcu�c�
«wn: ����min�ev[the impwv'mmm`: pss�wpc� . ------ ----- ----
Fee Simple Titleholder(if other than vwo,r): _ • _ - _ --_-_-------_---------�
Name:
�� -��������� - -
_ _ _ �� � _ . _
Address: __1946 CT FL -------- —'-' --------
Telephone No.: e0*613-6517 Fax No: 904-247-9330 ---- ------ -----'---''--
Su��(if vny _/V� -__--- ' - ' - - -- - ' -'- ------
Address:
--
--------
�d -----------'--�
.'_-- �-- Amount
--___ Fax No: -________-- '-
Name and address of any person making a loan lhr the construction ol'thc improvements '-------�'
Name: wm____________ _______
Address: ----------�--- '---
Phone No: ---- -- - '-------------------
_ _ . Fax
Name^[p;�nowkhin �e�m^o[H^hdx wh�than hho^�[�s�oo�Juy - - --------
mmu|� N�m~� N� ___ ' `'"'e' upon whom»^tn« mmm��numeom may he
Address: _ _ __ � _ _ _ __ ---------�--------
Telephone No: __________----_. _ Fax No: _ __ _ �---- -------------
--m addition to himself, owner designates following person to receive a copy of the Lie»* s Notice as provided in3,�kw na��ZVh}Fkv�u�mvv� (Fill Owner's option)
Name. N/A
Address:
—'-----�--- ----- -----'-'
Telephone No: - - Fax -----•--- ------------
doov[N^hc*orCnnnenxwnru (the*`�on�wdhu�one� 0y*v- ' ' ' - ' - -
'p�i0od�__ ________�_ `~� _m»nm'«ouv*,�n�h�un�o o�A�w«dou �
•fl5 SPACE FOR RECORDER'S USE ONLY OWNER -------------
Of Florida,has personally appeared"
PATRICIA J.JACKSON Noiary al Large,State of Florida.Conn y of Duval.
,4■ :‘,1 MY COMMISSION It FF202473 .My commission _
EXPIRES:June 14,2019 Personally Known: _ _ _ _ or
&Mod Puy Notary Pubic Undenwiirs