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1760 SEA OATS DR ROOFING " •�' CITY OF ATLANTIC BEACH z� s l 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 -903 Job Type: ROOF PERMIT Description: RE - ROOF Estimated Value: $10,880.00 Issue Date: 4/18/2016 Expiration Date: 10/15/2016 PROPERTY ADDRESS: Address: 1760 OCEAN GROVE DR RE Number: 169618 - 0000 PROPERTY OWNER: Name: ACKERMAN LVG TRUST, JOHN Address: 1760 OCEAN GROVE DR GENERAL CONTRACTOR INFORMATION: Name: Llc, Kayco Roofing Address: 1966 Lakeshore DR Phone: - - FEES: BUILDING PERMIT FEE $104.40 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $108.40 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 q Office (904) 247 -5826 Fax (904) 247 -5845 6 (, - t o0 F _ / 0 3 Job Address: 1760 Ocean Grove Rd. Atlantic Beach, FL 32233 Legal Description 1 20 -20 09- 2S -29E 2 G CEAN GROVE UNIT NO 2 3 LOT 23 Parcel # 169618 -0000 Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ 10,880 Proposed Work heated /cooled 2067 non - heated/cooled 2860 Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door Use of existing/proposed structure(s) (circle one): esi Commercial entia If an existing structure, is a fire sprinkler system installed? (Circle one): o N /A Florida Product Approval # RIO 61 y 1 f� /&( 2, 9 For multiple products use product approfal form Describe in detail the type of work to be performed: Re -Roof Shingles Property Owner Information: Name: Charlie Ackerman Address: 1760 Ocean Grove Rd. City Atlantic Beach State FL Zip 32233 Phone 904 - 246 -9764 E -Mail or Fax # (Optional) Contractor Information: Company Name: Kayco Roofing Qualifying Agent: Clark Briggs Jr Address: PO BOX 66385 City Orange Park State FL Zip 32065 Office Phone 904 - 375 -0798 Job Site/ Contact Number 904 -424 -6125 Fax # State Certification/Registration # CCC1328803 Architect Name & Phone # Engineer's Name & Phone # 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 f work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of six _(6) months at any time after work is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo 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. 1 hereby certify that 1 have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this type of specified work will be complied with whether speced 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 r lating construction or the performance of construction. Signature of Owner Qom` d ff--2-4, ^`` Signature of Contractor \_/' P I Print Name �© n �� c-6 Ac--10-1 ;. a ' Print Name j S CYNTHIA TAGLIARIN1 CY 7 CI;L S w o r r y , t and sub c ibed p Swo to and subscri, : e ' reamer COMMISSION 0 FF. 50 this '1)510 Day of % • MY COMMISSION - -Vi 50 this Day of 4 !::.L., „, , : ! 1 �� sin � ' 19 1 , ..... ,p, 53 floridaNco7Nrvloetern Nota Public • No 1,, 'u, Ic II n__.c___1 ni •+t in NOTICE OF COMMENCEMENT State of FL Tax Folio No. 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: 20 -20 09- 2S -29E OCEAN GROVE UNIT NO 2 LOT 23 Address of property being improved: 1760 Ocean Grove Rd. Atlantic Beach, FL 32233 General description of improvements: Re -roof Owner: Charlie Ackerman Address: 1760 Ocean Grove Rd. Atlantic Beach, FL 32233 Owner's interest in site of the improvement: Fee Simple Titleholder (if other than owner): Name: Contractor: Ka./ co Address: p o 6.0,‹ c U ra.� � .e_ 1 v ( 6- Telephone No.: g (2.-t ?-2...) 7SO'7 Fax No: '7 °i ' T1 / 3 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: Address: Phone No: Fax No: Roadserved: Name: Address: Telephone 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 Statues. (Fill in at Owner's option) Name: Address: Telephone 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 OWNER red: ( Date: e 1069, ire this `1q day of .4 CV A in the County of Duval. State Doc # 2016086529. OR BK 17530 Pa9 lorida, y ' has personally appeared � 0.rr, Number Pages: 1 .ry Public at Large, State of Florida. Coun y o(i vval. Recorded 041812016 at 11:16 AM, ;ommission expires: CYNTHIA TAGLIARINI Ronnie Fussell CLERK CIRCUIT COURT DUVAL )pally Known: = -`3 MY COMMISSION # FF942250 COUNTY aced Identification: 'l ∎ - EXPIRES December 09, 2019 RECORDING $10 00 . ♦O7 Q6.O�63 ►I� Ue\ 1(1. I • • aRIV 1