541 SHERRY DR 16-ROOF-470 roof permit f;j�r\i``J�,
( CITY OF ATLANTIC BEACH
'J1 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
' ..0.219‘r-
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-470
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $8,260.00
Issue Date: 2/24/2016
Expiration Date: 8/22/2016
PROPERTY ADDRESS:
Address: 541 SHERRY DR
RE Number: 169880-0050
PROPERTY OWNER:
Name: MCCULLUM, WILLIAM R &, *
Address: 541 SHERRY DR 541 SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: JOHN GILMORE ROOFING, INC.
Address: 11647 GWYNFORD LN QA JOHN CHARLES GILMORE
Phone: - -
FEES:
BUILDING PERMIT FEE $91.30
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $95.30
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Feb 02 04 10:05a Information Sbstems 247-5845 p. 1
C ISPe
a ` - CITY OF ATLANTIC BEACH
��,, ROOFING PERMIT APPLICATION
Date:
Job Address: 5 4/ herr'le OQI �� CJ it.t i G Fea
r h �C_ -
Owner of Property: 14-)1 I� rt e- /14 / ' '4---\
Address: `// 6 C2;7 4 r- l,-A3 C L //Telephone: [D tf - t/c- 7)//
Contractor:J Oh t) G,I,yif rr ROi)F1)15 i zn e State License Number: (I CCU S 74070/
Contractor's Address: 1()95G - San Jose 'S(ud-ill44/ J4,< Ft 3.222 3
Telephone: q 0`f- g Y G 1 - R-O4L51 Fax: 90 V- 810 le go
ScopeofWork ;- -!�ti A .i• � - i IUEw Ari✓h -3o S e
AS poi tvt4p( (k s sec
Deck Slope: �- l 2_ Greater than 2:12 ✓ Less than 2:12
Valuation of work: 2()_°C
Product Name(Example:Timberline): raha1 _So )'r2 Arch/4c hua-x I
Manufacturer(Example:GAF): 0W I75 ('O rnir-29 - Aunali ir-
ASTM Designation(s): 1?) 1 (a A r1,-/0(074- N I
Required Inspections: Sheatthingand� /
Signature of Owner,�' /i)
Date: �/ / t
,/ / 1 r/ //
�� 1
Signature of Contractor: tN.��i `�i, `(. . Date: 7 7 /�
2�
AS TO OWNER
Sworn to and subscribed before me this u day of J ,20 / (o.
State of Fl untyof Duval_ a Q
,,,,,,,,' 's Signature �-�--�J`
I
969Z0Z 33#uoissiwwoj ,`,V io.';;,
9LOZ'6Z BIN saildx3•wwo ,S °•��'• `'
O W • rii� •s= 0 Personally known
epuolj!o aIeIS-ollgnd d jeJoN :C"' 'c DI ONVla3Hif1S NMVOectl`or; Produced identification
Type of identification produced !vim b L-
AS TO CONTRACTOR: W\ 2
Sworn to and subscribed before me this `{ day of J ,20 ( .
State of Florida,County of Duval
Notary's Signature — e..)
.:- „,
sci''' �O4 DAWN SUTHERLAND Personally known
Produced identification
,,; . Notary Public-State of Florida
. ii r,,.,1-My Comm.Expires May 29.2016 Type of identification produced /'L�D(--
Commission#EE 202898
—9* • oad •Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ciatlantic-beach.fl.us
Page 1 Rcviscd 2/21/03
•
NOTICE OF COMMENCEMENT
State of 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: R S Lp 5- 7 ? .- A C
Address of property being improved: 'z-i/ 5 i-rcJ ✓e '11. Cud N C.
General description of improvements: Re - ncj Re 51 ode(" .
Owner.•.2
Address: ':?"--• r �y�IIIIWAIMO
Owner's interest in site of the improvem- : f, a Fee Simple Titleholder(if other than owner):
Name:
Address:
Contractor: l 017,1 C-7 IkrA -r! / c.0 ci•
Address: e, C Si , .)i;.x'J tsi ti a t (cf Cp
AFL Z,2Z3
Phone No: C, - SQL -` L v Fax No: `'S" , =L 2 c-l1
Surety(if any):
Address:
Amount of Bond S
Phone No: Fax No:
Name and address of any person making a loan for the construction of the improvements.
Name:
•
Address:
Phone No: Fax N.,-
Name of person within the State of Florida,other than himself;designs —--
documents maybe served: Dec#2016040978,OR BK 17470 Page 635.
Name: Number Pages:
Address: Recorded 02'24!1 20 AM
Ronnie Fussell CLERK 16 at CIRCUIT COURT DUVAL
Phone No: Fax COUNTY
•
RECORDING$10.00
In addition to himself;owner designates the following person to meek,
Section 7I3,06(2)(b).Florida Statues. (Fill in at-Owner's option).
Name:
•
Address:
Phone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(I)year from the date of recording unless a •
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY }' ,
5igoed X� Date:L.Vc2 L(//c
Before me this •2'4 day of )- �, r,- in the CnU:v
o Duval,State ofFlorira,has . ,peared iA.. (I' w-- ✓</1(1c•6
` b°- DAWN SUTHERLAND Notary Public at Large,State of Flori•
'�• = County of Duval.
i .• ,�
E. Notary Public-State of Florida My commission expires:
•" '�'aj.%: My Comm.Expires May Personally Known:
':mrn salon#EE 202898 016 Produced Identification:Identification: 1Z- L— °f
A Sign