568 SEASPRAY AVE - ROOF r ` I'' `S, CITY OF ATLANTIC BEACH
F � 800 SEMINOLE ROAD
U� . 1 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-536
Job Type: ROOF PERMIT
Description: RE-ROOF
Estimated Value: $7,012.00
Issue Date: 3/3/2016
Expiration Date: 8/30/2016
PROPERTY ADDRESS:
Address: 568 SEASPRAY AVE
RE Number: 170703-0424
PROPERTY OWNER:
Name: LANIER, WANDA
Address: 31 WINDING RD
GENERAL CONTRACTOR INFORMATION:
Name: PRIME ROOF CONTRACTING LLC
Address: 13792 HERONS LANDING WAY APT 9 QA MARK ANDREW
YOUNG
Phone: - -
FEES:
BUILDING PERMIT FEE $85.06
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
1 Total Payments: $89.06
I
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233 (-- f�
Office(904)247-5826 Fax(904)247-5845 i l , •—I\ODE — S j
Job Address: 568 Seaspray Ave Permit Number:
Legal Description 35-64 17-2S-29E SEASPRAY LOT 29 BLK 4 Parcel#
7 012 Floor Area of Sq.l•t. Sq.l-t 652
Valuation of Work$ Proposed Work heated/cooled 1240 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 40 *
If an existing structure,is a fire sprinkler system inst I e ?(Circle one): es""No 7A
Florida Product Approval# FL10674-R7 F , (-piZ6-R2
For multiple products use product approval orm
Describe in detail the type of work to be performed:Single Family Home Re-roof
Property Owner Information:
Name: Wanda Lanier Address: 4951 Windward PI
City Femandlna Beach State Fl-Zip 32034 Phone 904-321-7674
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:Prime Roof Contracting Qualifying Agent:
Address:372 Royal Palms Dr City Atlantic Beach State FL Zip 32233
Office Phone moo 452-8440 Job Site/Contact Number (904)625-1446 Fax#
State Certification/Registration# CCC1329505
Architect Name&Phone#
-
Engineer's Name&Phone if
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
Nark is commenced I understand that separate permits must be secured for Electrical. 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 qoplication 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(���-dil.� �,, wr+ Signature of Contractor _. //_ /�
Print Name _._\ L . l�ri T Print Name Ai'.
Swo o and subsc i d before me 1/ SwoiF and subscri d befo e me
this Day of pQPG 1
h ,20 6 this IS D y of G 20
Notary Public ® Notary Pu c
Revised 01.26.10
„Q�t"641,1, Andrew D. Davis _
tai = COMMISSION I FF160849 449."6"I'/,
Andrew D. Davis
at— S pe
.;�_ EXPIRES: Sept. 17, 2018
...--1-.' ,., '�'= COMMISSION FF160849
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EXPIRES: Sept 17, 2018
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NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No Tax Folio No.
State of Florida County of Duval
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: 35.64 17-2S•295 SEASPRAY LOT 29 BLK 4
Address of property being improved: 568 Seaspray Ave Atlantic Beach,FL 32233
• General description of improvements: Re roof
Owner Wanda Lanier
• Address 4951 Windward Place,Fernandina Beach,FL 32034
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor PRIME ROOF CONTRACTING,INC.
• Address PO BOX 50247 JACKSONVILLE BEACH.FL 32240
Phone No. (904)625-1446 Fax No.
• 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 designates 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
b/G
. Signed: S (-- i/ DATE 3/ill('
Before me tins IR day ofMak 12 in
countyuva State L F .has . :.ly appeared Andrew D. Davis
p/�o. La Ate( by
himself'herself and affirms that all statements and decla •���4w i ��
Doc#2016048669,OR BK 17480 Page 1226, are true and accurate ,11 �" COMMISSION•FF160849
Number Pages: 1 �•, S: 17. X18
Recorded 3/03(2016 at 12:21 PM, (/ .�`� tfrWW AARONNOTARY.COM
Ronnie Fussell CLERK CIRCUIT COURT DUVAL r��' 1/
COUNTY o ary Public at Large.Sta v
f County of DVA
RECORDING$10.00 My commission expires: �]
Personally Known—_---.-- -__---� or..
Produced Identification___ft. DL