414 SHERRY DR - ROOF r /-j rA/VJ/
,(2
rJ �S CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
\ ,�;" 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-520
Job Type: ROOF PERMIT
Description: RE- ROOF
Estimated Value: $7,317.00
Issue Date: 3/2/2016
Expiration Date: 8/29/2016
PROPERTY ADDRESS:
Address: 414 SHERRY DR
RE Number: 170481-0000
PROPERTY OWNER:
Name: MARCHIOLI, LORENE H
Address: 414 SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: BENTON INTEGRITY ROOFING
Address: 5570 S FLORIDA MINING BLVD QA ALBRITTON, JOHN
FRANKLIN IV
Phone: - -
FEES:
BUILDING PERMIT FEE $86.59
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $90.59
PERMIT IS APPROVED ONLY IN ACCORDANCE WIl'H ALL CITY OF ATLANTIC BEACH ORDINANCES AND Fill: 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 ( (0_ 10oF-, 5 zo
Job Address:/4 1"( S0E2 Pa.t L/,� 3.Pa--33 Permit Number:
,, Legal Description lO-hp )V aS-c9-,E S't-7-,1!2- Sec 3 Z-or v- Parcel# I r7 d(E/- 0000
_ Floor Area of1.04Sq.Ft. i x'4O //// ,` Sq.Ft
Valuation of Work S 3 7 ' . . ,- e • 1 . het d/cooled �`f(p 7 non-heated/cooled
Class of Work(circle one): New A..' •:- t ti pair Move Demolition poollspa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residentia
If an existing structure,is a fire sprinkler system installed? (Circle one : •es To N/A
Florida Product Approval it Fl.. /O j, q-
For .multiple products use product approval form nn _ � r( /�����
Describe in detail the type of work tb be performed: f`-OO f- K � -/Y13' T -' 884-Ui t KIJ A-4
ICU 9't L. DeC4 .1L.ti 7o Cope - A) . n71 GTE U't4G2t VL t , f.lt'tc;cdtJ.SIT,
Property Owner Information: ' I
Name:��__ULA e V-LLB-- Address:^F 1LI S� �- '�Q •
City AT1 '1C1L F,--94--if------- State F-Zip-g aa-3Phone (S05) 3S0-9S74,
---
E-Mail or Fax# (Optional) __'-
Contractor Information:
Company Name: Benton Integrity Roofing Systems Qualifying Agent: John Albritton
Address: 5570 Florida Mining Blvd.,#310 City Jacksonville State FL Zip 32257 •
Office Phone 904 262-7663 Job Site/Contact Number-904 260-1372_Fax#_904 260-1355
State Certification/Registration# CCC1329868
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address r •
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 sus ended or abandoned for a period of six(u5)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,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 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 of a permit does not presume to give authority to violate or cancel then •
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner / �/! Signature of Contractor • /
Print Name / �� Print Name �O �1 /1�p,-L TT�'`- r
Swot tc�a d subscribed before me Sw. to and subscribed before me
this y of. I ,20/1 t .. no-Day of_Lf ,_ 20 / -on.
,� ►�vy��,�, AI / . N ry 2 lie y 1�>
"'env JOY MARIE BALDRY , , . A'. Notary Public-State • o ida
'/_ .' '� Notary Public-State of Florida F • fi •o� My Comm rOigeti{tja�,�gi�1
viii My Comm.Expires Jul 8,2018 "F„,`,o Commission a FF 127411
-E,, „O;.' Commission # FF 127411 , q
Doc # 2016043614, OR BK 17473 Page 1643, Number Pages: 1, Recorded
02/26/2016 at 12:36 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
S,at;:ci P 02/fig- --- Tax Folio No. 1 70/Bl- C.)606
County of OO
.1 Whom It May Concern:
l iii 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.
l..ekal l:esctiption of property being improved: 10 -l b lb -2s ?,q e
S alto;R__Sa.c._3 . - --- --
Address of property being improved:, She IQ Q'1 t) Q T�Q ytt'i�, .gae EJ.. 3 3----._ •._
(:ens aI description of improvements: kgiSl�111
t i -- •-• Address:LivISktitkii be._0}i.(1f�1 C.BLarif1.3.2.233
(;wacr'i interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Kama
Contractor: Benton Integrity Roofing•Svstcros —
Address: 5570 Florida Mining 131vd_,Ste#310.Jacksonville FL 32257 -
Telephone No.: 90:126,2-7663.. .—__—_..—_Fax No: 904260-[355. --
Surd) (d any)
Address: Amount of(fond S
Felcphorc No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
•
Phone No: . . Fax No:_ --- - — ----
�.rhie JI person within the State of Florida.other than himself; designated by owner upon whom notices or other documents may be
sere CL:: Name:
Address:
elephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the !Armor's Notice as provided in Section
7!".C(r(2)(b).Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: — Fax No: - -
l. piration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different dare is
specified). . ----_
TIIisSPACF: FOR RECORDER'S USE ONLY' OWNER " �/
r3005";' dypf--__day of �� ,, --0#in the County of Duval.State
i. orida.has personally: cared- , .t14°_!�•— __ _
Notary Public ut Large.St 110 I'lori.a.C.unty of D
My commission espins: c
Personally Known: �//
Produced ldentification: lJ '.QI¢ ee. •
' ---Jer re on-
yao �(t A-\\'. ..1 Notary Public State of Florida
• /:c My Comm.Expires Jut 8.201e
Cmn•-riss..•, •FF 127411