361 5th St - Metal Roof Over I
s CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
\9111 " ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- ROOF -82
Job Type: ROOF PERMIT
Description: NEW METAL ROOF OVER EXISTING SHINGLES
Estimated Value: $5,000.00
Issue Date: 1/12/2016
Expiration Date: 7/10/2016
PROPERTY ADDRESS:
Address: 361 5TH ST
RE Number: 169870 -0000
PROPERTY OWNER:
Name: FROHNE, CHARLES
Address: 361 5TH ST
FEES:
BUILDING PERMIT FEE $75.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $79.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
0► BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845 (6 —ROOF _ 8 U 2.
Job Address: �3— (
slit SZ .
Permit Number:
Legal Description -6 6 -25 -42 Q6 .400 F oor Area o r � �" Parcel # /6 pg .Qf — //e '.. ,�
Valuation of Work $ 500 0 Proposed Work he ted /cooled 22 t
non - heated /cooled 44$3
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window /d
Use of existing /proposed structure(s) (circle one): oor
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes
Florida Product Approval # r 17 7 -� N /A
For multiple products use product approv orm
Describe in detail the type of work to be performed: Atte i A itie f e‘
Pro er Ow ner Information:
Name :� T /�4l1 a 36/ 5 3r
City -TZ4 f ig Address:
E -Mail . Fax # (Optional) StaterZip _ j� i Phone "p - -- 24 ,
- •r
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name:
Address: Qualifying Agent:
Office Phone Ci f' State
State Certification/Registration # Job Site/ Contact Number - -__Zip
Fax #
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and A • c A ss
Bonding Company Name and , . T ress
Mortgage Lender Name , e Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I cert 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�Worlc, 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 WIH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF H
COMMENCEMENT.
hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
pe of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to vio late or cancel the
~ovisions of any other federal, state, or local law regulating construction or the performance of constructi ty on.
gnature of Owner ∎ • —
Signature of Contractor
int Name - 7;' y 2 d f
Print Name
Q
S i 1 of 4 n 20 1 •.� : , T• 3 .- ?, - .'.4: ER
:t . ,., . 2�
r r: ; EXPIRtober , 20 won. taffy Pu.lic .:.......& _ ,, ' Boded- ES: NotxyOcPubic ters
ary a tic
.�
Revised 01.26.10
CITY OF ATLANTIC BEACH
WNER / BUILDER AFFIDAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION
CONTRACTING" REQUIRES OWNER / BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED
CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT
LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY, TO ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE — OR
TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING
MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT
IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT
HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND /OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455 - 228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT (247 -5826) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER- BUILDER PERMIT.
3 6 / 5 57Z c7 fov f3 - .2i2 9
ADDRESS
Aiezes-
PHONE NUMBER
PRINT NAM
SIGNATURE i
//^ DATE
Before me this 1 (Oday of- Q (N. 20 I,e county of
Duval, State of Florida, has personally appeared herin by himself / herself and affirms t at
all statements and declarations are true and accurate. 1
Notary Public at Large, State of �� C ounty of 1(' t[Q
❑ Personally Known rod � Ow O
uced Identification �i � = •
4� ,i ; fit, TONI GIN
Notary Signature. • - +- i° + COMMISSION 0 FF 924951
EXPIRES: October 6, 2019
'tiff',;(\' Bonded Thru Notary Pubic Underwriters
F: BLDG / Owner- Builder Affadavit; REVISED: 4/16/2009 _ _
Florida Building Code Online file: / / /C: /Users /century metals /Desktop /Florida Building Code Online.htm
- AyfIlgrII !! t
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Code Version 2014 FL# ALL
Application Type New Product Manufacturer Century Metal Roofing Supply, Inc.
Category Roofing Subcategory ALL
Application Status ALL Compliance Method ALL
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Approved for use in HVHZ ALL Approved for use outside HVHZ ALL
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Search Results - Applications
Type i Manufacturer Validated By Status
4 FL17777 New Century Metal Roofing Supply, Inc. Locke Bowden Approved
Category: Roofing (334) 300 - 1800
Subcategory: Metal Roofing
*Approved by DBPR. Approvals by DBPR shat be reviewed and ratified by the POC and/or the Commission ',necessary.
Contact Us :: 1940 North Monroe Street, Tallahassee FL 32399 Phone: 850- 487 -1824
The State of Florida is an AA/EEO employer. Coovrght 2007 -2013 State of Flom.. Statement :: Accessibiity Statement :: Refund Statement
Under Florida law, email addresses are public records. If you do not want your e-mail address released in response to a public - records request, do not send electronic
mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section
455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have
one. The emails provided may be used for official communication with the hcensee. However email addresses are public record. If you do not wish to supply a
personal address, please provide the Department with an email address which can be made available to the public. To determine if you are a licensee under Chapter
455, F.S., please click here .
Product Approval Accepts:
*SI
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1 of 1 1/11/2016 11:20 AM
•
rr NOTICE OF COMMENCEMENT
State of O"/1e/Aig County of ,Thr'te4L Tax Folio No.
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: 5-6 f /G :?5 ay6' .41-7z / 3
Address of property being improved: 3(p ( 5*' St , VTL M , c. 1.4_,,VC- 3 2-2.-3 3,
General description of improvements: /j/eve/ /f r AV Ai le edeg Q i '1 -- Qw.c. 6 ii.S4n
t Q Owner: Ohari s ?•' FR.0,h to Address: 3a./ 5+4 Sr A4/q,7 *. , Bch ,3 M
t � Owner's interest in site of the improvement:
1111 Fee Simple Titleholder (if other than owner): •
Doc # 2016006502, OR BK 17424 Page 1799,
Name: Number Pages: 1
Recorded 01/12/2016 at 09:51 AM,
Contractor: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Address: RECORDING $10.00
Telephone No.: Fax No:
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: ._----- /0
•
Address: .--_____________
Phone No: _Fa 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: / V4
Address:
Telephone No: ax 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:l___ , _ Date: 4 L•
Before me this day of • ,& in the County of Duv , State
• • ly appea ed A 0...t-- € f— • Gam( co
, , , , g ; , P Y , T Q� VII:
� v 1 , / �r. or
F7'.:'; 4.,.' MY CP�QB' 5� '• O
1.4 e °< EX ' r "C , "1 y '' . � � ' 1 t+ � �� = r
or1. Bonded ^-- u -...._ OeM��fl�
s /
Page 1 of 1
111101011111011111111111111111101101111
.. Q tNE gR
Print Date:
1/12/2016 9:51:45 AM
,
Transaction #: 2945730 f
Receipt #: 2863964 Ronnie Fussell
Cashier Date: 1/12/2016 Clerk Circuit Court
9:51:43 AM (DOAKS) Duval County
501 West Adams St RM 1051
Jacksonville, FL 32202
(904) 255 -2000
Customer Information Transaction Information Payment Summary
DateReceived: 01/12/2016
Source Code: BEACH
() MR CHARLES FROHNE Q Code: BEACH
Return Code: Over the Total Fees $10.35
Counter Total Payments $10.35
Trans Type: Recording
Agent Ref
Num:
1 Payments
CP1= CREDIT IPASS 14638156
$10.35
IPASS Convenience Fee 1 101 $0.35
1 Recorded Items
BK/PG: 17424/1799 CFN :2016006502
(N /C) NOTICE COMMENCEMENT Date:1 /12/2016 9:51:42 AM
From: FROHNE CHARLES T. To: FROHNE
CHARLES T.
INDEXING 2 $0.00
RECORDING 1 $10.00
1 0 Search Items
1 0 Miscellaneous Items
file: / / /C:/ Program% 20Files /RecordingModule /default.htm 1/12/2016