1545 FRANCIS AVE - ROOF -S r\j`.1\.
f `Sf CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j r 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-2803
Job Type: ROOF PERMIT
Description: RE-ROOF - MODIFIED
Estimated Value: $4,300.00
Issue Date: 12/3/2015
Expiration Date: 5/31/2016
PROPERTY ADDRESS:
Address: 1545 FRANCIS AVE
RE Number: 172284-0000
PROPERTY OWNER:
Name: LYLES. TOMMY & SHIRLEY, *
Address: 13925 HUNTERWOOD RD
GENERAL CONTRACTOR INFORMATION:
Name: TAYLOR MADE ROOFING, INC
Address: 87513 Creekside DR
Phone: 904-251-5490
FEES:
BUILDING PERMIT FEE $71.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $75.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
State of I
Tax Folio No.
County of
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved:
__J5 5 Fe-.44 it)
�� S 4Y
Address of property being improved: j[/5 62/4-r\i'C l S / 4�.4-� T 7� 4 ,LL .3 x'33
General description of improvements: I��.J eexoi� /' L
Owner:m+es/ ,�%,q��f S Address: S /6?-474‹:', kill,
Owner's interest in site of the improvement: (p,rt� =s ;
Fee Simple Titleholder(if other than owner):
Name:
Contractor: 7`,q y Lam,(L 41-A . vv;r rt) (�
Address: 1-S'1 3 C�.E,-EkS tb q'
Telephone No.: 04—2- i— L1 j O Fax No: 9 Ott - 8'-1
Surety(if any)
Address:
Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address: Doc#2015275121.OR BK 17386 Page 1047,
Number Pages: 1
Phone No: Recorded 12103/2015 at 10:44 AM,
Fax No: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
Name of person within the State of Florida,other than himself,designate COUNTY
RECORDING$10.00
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: IytE.�?� '"`� J`"' `�L Date: ///, 3�l>
Before me this Y'/ day of NOGI yNbey 24.in the County of Duval,State
Of Florida,has personally appeared ;c -) • spy S
" Notary Public at Large,State of Florida Cou of Duval.
SHELLEY SHAFFER
11�a= Notary Public-State of Florida expires: NOV. I W. I'^]
My commission ex it
'.•1.My Comm.Expires Nov 18,2017 Personally Known: or
s
,� � Commission#FF 39054
v Bonded Thraqt National Notary Assn.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233 i rJ -�OO 3 Office(904)247-5826 Fax (904)247-5845
Job Address: i�h / N/C\S A vE 32.2_33 Permit Number:
Legal Description 2-b-3-0 11 2. S -Lcle CD sMlT/I 5/i) Parcel#
L-1, .,,,,Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 3 0v Proposed Work heated/cooled 13 00 non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed strncture(s)(circle one): Commercial Residenti
If an existing structure,is a fire sprinkler system installed?(Circle one): o N/A
Florida Product Approval # r 1. 5(qd - f j s
For multiple products use product approval fform
Describe in detail the type of work to be performed: RC-V-N,0 Di l 3-'l /V 6,- ` nrvod.cC�
g‘,vor 6`i57F L
Property Owner Information:
Name: ///1 V -,./4-A/e. O $ �1 Addres
s: I 1�Gi i�'v c l S ,4 e.
city L,g►vnc A4 Statefc Zip,3a)33phone 90Y- a3--03s3
E-Mail or Fax#
(Optional)
Contractor Information , (ati 10 c cia Roo F c 1J
Company Name: 1 OD ix.) Qualifying Agent: 3Z 09
Address: -r City f66 1 State f 1- Zip 3
Office Phone Job Site/Contact Number y fjlee., Fax#
State Certification/Registration# 9(24 -1-5 S-419 d
Architect Name& Phone# 8 75(3 CI r-o ek S,d e_ Li-
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 ofa 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 tf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for as period of six(6)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,eta
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 certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting ofa permit does not presume to give authority to violate or cancel the provisions
olanv other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner 1 Al
Print Name A't J, t ...._._2o y.$
/ f rr SM ILEY SHAFFER
Sworn to and subscribed before me Pii• _ Noury Pu�c.$��of Fk�
this D of . -, :...Q ,20 15 t : My Come.Erp&es Nov tS,2017
,� �/� Commlufon#�IT 99051
1
otary Public � _� _ Moral=
' .
Signature of Contractor • •/ ` 'Print Name P.4.1.1.4.? R .a.. eZ tIC(L
Sworn and bs t •ed before me (----(----thi D.k, o .�' A' ,20 i
CA./ railk. ..,Notary Public tier
Revised 01.26.10