2340 Oceanforest Dr W - Re-roof w/shingles j. /
per ►,.r\J`j J � ,
"'" 1, CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
\' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
\ ,01119`'
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 15- ROOF -2957
Job Type: ROOF PERMIT
Description: RE- ROOF WITH SHINGLES
Estimated Value: $26,970.00
Issue Date: 12/29/2015
Expiration Date: 6/26/2016
PROPERTY ADDRESS:
Address: 2340 W OCEANFOREST DR
RE Number: 169463 -1566
PROPERTY OWNER:
Name: SANDARG ET AL, MICHELLE
Address: 2340 W OCEANFOREST DR 2340 W OCEANFOREST DR
GENERAL CONTRACTOR INFORMATION:
Name: SCHULTZ ROOFING COMPANY INC
Address: 216 N 20TH ST QA DOUGLAS ARTHUR SCHULTZ
Phone: - -
FEES:
BUILDING PERMIT FEE $184.85
STATE DCA SURCHARGE $2.77
STATE DBPR SURCHARGE $2.77
Total Payments: $190.39
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 5 — Roo C_ Z 57
Job Address: :) 3 4 0 U• 0 C €ct.nl s+ b Permit Number:
Legal Description `I a - 1 « 37 - QS - A9 E Ocear, u ek) K �+u t a rcel #
Floor Area of Sq.Ft. L ° ' Sq.Ft
Valuation of Work $ D (F 9 -1 ° • O O 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 Resid-1 • •
If an existing structure, is a fire sprinkler s ste installed? (Circle one): • es No N /A
Florida Product Approval # F L. S `-I 4-1 '•-I.. m d - S C2 J_ (It) U.4
For multiple products use product approva form , / FL* i7 01 , I
Describe in detail the type of work to be performed: J Pa - U
Sc ( c" 8
Property Owner Information:
Name: 'm I tC- e-< < ao - d Address: a 3 1 / 4 1 t' I. OC e ar, Fore 0' 0 r
City -1;-"4 , 13 c l.-, State F1 Zip 32.2 3 3 Phone q 0 4 - (Q 31 - 1 1 (0 1
E -Mail or Fax # (Optional)
Contractor Information: /� ,/� 4 Company Name: 7 - • • • ne CZ. irr1C • Q ualifying Agent: 1. L.z� ct S 1 — t - • SC �t 1 �---
Address: . # V a0 CityjaccSonv1 \1e QeoL'-State F l Zip 3 2 2 SO
Office Phone Q(7 3 Q L to - a 3 i 3 Job Site/ Contact Number -- I 5 9 - 00( .? Fax # a 4) - 3 8 O &
State Certification/Registration # C, C. C, 0 3 (p a g 0 1
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 (6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical !fork, 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 certify that I have read and examined this a placation 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 of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner 1 l /,(740.Q.0 it4 S ignature of Contractor
Name L" I ff k4 LL E- POLL, i Print Name L ' ' cJC (tt.k_i't._
Sworn to and subscribed before me Sworn to and subscrib d before me
this Day of tUe- , 20 /S is / 4 5 Day of Lov , 20 /-
g u
% , . 6, , • . (*Z- c. -���` •.
..
Notary Public D r ∎,.e •, ,: . o s ROBIN C MOORE Notary Public ; v --I ROBIN C MC!''-r "•' . .
-ti MY COMMISSION At FF245% • � � , C �f i9e 6i- :.,61
'-t • EXPIRES June 30. 2019 • .. , 2019
(4o7) se.0l5Xi . �vi •• ` 7l1-0/�1. frkifdHMory vk. .eM
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE) // /
Permit No. Tax Folio No. '� �P �' ct ? - /3
State ofr�i;��Q County of V�vyl -e
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: y ' - 1 I - cp. S
ce_ar wc; L — y 3 3
Address of property being improved: R '3y O u . (9C c Yom ; e S � t,—
i4-44,A i 1 223
General description of improvements: 12Q_ -
Owner 4 -9.x.,€_ ctrl oi
Address c.3L4 0 - Q CQa- -�'-�- 15'x, . a-0 Rci 2233
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name
Address
c Contractor C.�n c u rrg n Co
i f A Address i (�, /�.I . 'Z' 4 c 6 , f 2 2 CO
Phone No. I CI 1 J Fax No. e l u y 7 "- 3 g O
Surety (if any)
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, designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself, owner designatesl 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
Address
Phone 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: Ni!-}� DATE (I - , 3 .00i 5
Doc # 2015293777 , OR BK 17411 Page 896, Before me this l . "� day of - z __ in the
Number Pages: 1 Coupty of,Duval, State of Florida, has personally appeared
Recorded 12/29/2015 at 10:42 AM, t'tt ( H herein by
Ronnie Fussell CLERK CIRCUIT COURT DUVAL himself/ herself and affirms that all statements and declarations herein
COUNTY are true and accurate
RECORDING $10.00 t ROBIN C MOORE' ;'
• • MY COMMISSION 0 FF240774
e EXPIRES Juno 30, 2019
•
Notary Public at Large, State of ' : ti..v uniy
My commission expires:
Personally Known or
Produced Identification /l L/5 3 - s`I 5 - 4 7 - -