1099 CORNELL LN - ROOF r�" 3 ' ' \
S CITY OF ATLANTIC BEACH
''•`�` � 800 SEMINOLE ROAD
" ` II 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-602
Job Type: ROOF PERMIT
Description: reroof
Estimated Value: $6,375.00
Issue Date: 3/11/2016
Expiration Date: 9/7/2016
PROPERTY ADDRESS:
Address: 1099 CORNELL LN
RE Number: 177545-0010
PROPERTY OWNER:
Name: WIDMAN, CONNIE A
Address: 3785 N UNIVERSITY BLVD
GENERAL CONTRACTOR INFORMATION:
Name: BRANNAN ROOFING, LLC
Address: 1024 PEBBLE RIDGE DR QA RONALD EDWARD BRANNEN.
JR
Phone: - -
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $81.88
Total Payments: $85.88
1
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904)247-5845
Job Address: 1099 Cornell Lane Atlantic Beach, FL 32233 Permit Number:
Legal Description 38-2S-29E.229B DE CASTRO FERRER GRANT PT RECD DR 12260-2112 Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 6,375.00 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 Residential
fire an existing structure, is a re sprinkler i
system nstalled? Circe one): Yes N/A
Florida Product Approval#FL 1-0674 r 1-/ 5S/d "" F�.� -0011 FL 18 YSORQ
For multiple products use product approval form
Describe in detail the type of work to be performed: re-roof I i Sq S l r„, )-e 3 Si a F 40,0,4
Do wNI
Property Owner Information:
Name: Connie Widmann Address: 3785 University Blvd.North
City Jacksonville State FL Zip 32277-1360 Phone 904-465-0766
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: Brannan Roofing LLC Qualifying Agent: Ronald E. Brannan,Jr.
Address:1024 Pebble Ridge Drive City Jacksonville State FL Zip 32220_
Office Phone 904-813-4967 Job Site/Contact Number 904-838-8193 Fax# N/A
State Certification/Registration# CCC-13280006
Architect Name&Phone# N/A
Engineer's Name&Phone#N/A
Fee Simple Title Holder Name and Address Simple
Bonding Company Name and Address N/A
Mortgage Lender Name and Address N/A
Application is hereby made to obtain a permit to do the work and installations as indicated. I cert fy 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 aperiod of six 16)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical 1Vork, 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 plication 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 regulatin nstruction or the performance of construction.
� 4........,_Si ature of Owne •l-W= Si nature of Contr for
&� Signature
Name Print Name 1,1/� 1( 64s Nti 1 qt...,
!fir) C �Liam 1
Sworn to and subscribed before me Swo o and subscf'ed •-fore me
this It Day of &Arc ,20 t(o this Day of III ii ,20/i'
6lakiels d i /
Notary Public �w y DEREKZARDETTO No
1r - Notary ublic,State of Florida
1 •AL ry : PHILLIP BIEGEL
Commission',FF 208573 _°�a� Revised 01.26.10
''�''' My comm.expires Mar.11,2019 :.,, ,'" las Commission#FF 229873
. _ aj} Expires May 12,2019
,81:1;, Bonded TM,Troy FM,%wrm300 4BS.7C3
Doc # 2016055280, OR BK 17488 Page 2438, Number Pages: 1, Recorded
03/11/2016 at 09:39 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCMENT
State of Florida PERMIT#
County of Duval
The undersigned herby informs all concerned that improvements will be made to certain real property,
and in accordance with section 713.13 of the Florida Statues,the following information is stated In the
NOTICE OF COMMENCEMENT.
Description of property 1099 Cornell Lane Atlantic Beach,FL 32233
Legal Description 38-25 29E.229B DE CASTRO FERRER GRANT PT RECD DR 12260-2112
General descriptions of improvements Re-Roof
Owner Connie Widmann
Address 3785 University Blvd.North.Jacksonville,FL 32277-1360
Owner's interest in site of the improvement SIMPLE
Fee Simple Title holder(if other than owner)
Name SAME
Address SAME
Contractor BRANNAN i3QOFING.LLC
Address 1024 PEBBLE RIDGE DRIVE, JACKSONVILLEJL 32220
Surety(if any) NONE
Address N/A Amount of Bond$ N/A
Name of person within the State of Florida designated by owner upon whom notice or other documents may be
served:
Owner Connie Widmann
Address 3785 University Blvd.North.Jacksonville.FL 32277-1360
In addition to him/herself,owner designates the following person to receive a copy of the Lienor's Notice as
provided in Section 713.13(1)(F),Florida Statutes.(Fill in at Owner's option).
Name SAME
Address SAME
THIS SPACE IS FOR RECORDER'S USE ONLY
My Commission Expires:
Q
OWNER'S PRIN NAME
Signed before me this (� day of Ala " ,2016
'�" <G�GL4� s.— O
C/� W
Signature OWNER'S SIGNATURE 1, i'c V 2r.seil g ,personally witness CY 1 U
"s i DEREK ZARDE TTO
Notary NW Stars of Florid*
Commissions FF 208573
My comm.mires Wr.tl.2018