133 BELVEDERE ST - ROOF rt rAJ\1
(:)" 'fr � . CITY OF ATLANTIC BEACH
0 800 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-936
Job Type: ROOF PERMIT
Description: reroof
Estimated Value: $5,395.00
Issue Date: 4/22/2016
Expiration Date: 10/19/2016
PROPERTY ADDRESS:
Address: 133 BELVEDERE ST
RE Number: 170587-0000
PROPERTY OWNER:
Name: BENNETT, THOMAS J
Address: 385 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN ROOFING OF JACKSONVILLE
Address: 1720 Wildwood Creek LN
Phone: - -
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $76.98
Total Payments: $80.98
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 f( f e0d/ ' 136
133 Belvedere St
Job Address: Permit Number:
10-8 17-2S-29E SALTAIR SEC 1
Legal Description SCOT 6 0 0 Parcel # 17 Q.5 8 7-0 0 0 0
Floor Area of Sq.Ft. q.kt
Valuation of Work$5 , 3 95_ Proposed Work heated/cooled 2160 non-heated/cooled 2372
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures) (circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N'/A
Florida Product Approval# 16305
For multiple products use product approval form
Describe in detail the type of work to be performed: Re-Roof
FL 16226—R2 Summit 60 Synthetic Underlayment
Property Owner Information:
Name: U_S_ Bank NA Address:3217 S. Decker Laker Dr
City Salt I aka City State Upip84119 Phone Rhonda Nevyberry 623-516-2700
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: American Roofing of Jacksonville Qualifying Agent:__Daniel P. Kinkel
Address: 101.5 Atlantic Blvd,Suite 352 City Atlantte Bear:h State FL Zip 32233
Office Phone Job Site/Contact Number Fax#
State Certification/Registration# RC29027546
Architect Name&Phone# NA
Engineer's Name&Phone#- NA__
Fee Simple Title Holder Name and Address NA
Bonding Company Name and Address NA
Mortgage Lender Name and Address NA
Application is hereby made to obtain a permit to do the work and installations as indicated. I certl 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
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,_ WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF •
COMMENCEMENT.
I hereby cernfy 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 the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner (1....\ 1-1 1- I Signature of Contracto• ■ __
Cindy Hili EO Sales Manager
Print Name Print Name DAN I P KEL
Sworn to and subscri.ed be ore me "wo •""a an' bscri,ed "Ali,-this D of 'j./ s t 20 1 (0 Da f _._._._.f � _ 20 fir
alTirt) �_ 011) I grAr ...r.„* .,..._
Note Public.
'f YANDERLINDEN � ,� 2�
.:,,,„, � V t •
€/_ ___rIo.26j' Notary Public State of tltah oar°os, Notary Public Flor ��•26.10
Shrley L Grah% � oR t�ty Commissn FF 086990
"
Doc # 2016089744 , OR BK 17534 Page 1836, Number Pages: 1 , Recorded
04/21/2016 at 09: 14 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 170587-0000
State of Florida,County of Duval •
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legal description of property and address if available):
10-8 17-2S-29E SALTAIR SEC 1 LOT 600, 133 Belvedere St,Atlantic Beach,FL 32233
2. General Description of improvements:
Re-Roof
3. Owner Information: U.S. Bank NA,3217 S. Decker Lake Dr, Salt Lake City, UT 84119
a)Name and Address:
b)Interest in property:100%
c)Name and address of simple titleholder(if other than owner):
4. Contractor Irrfornation:American Roofing of Jacksonville
a)Name and Address: 1015 Atlantic Blvd,*352,Atlantic Beach,FL 32233
b)Phone Number:904-385-4375
5. Surety Information:
a)Name and Address: NA
b)Phone Number: _ —._-.--
c)Amount of Bond:S _. .-
6. Lender Information:
a)Name and Address: NA
b)Phone Number.
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by'713.13(1)(a)7,Florida Statutes:
a)Name and Address: NA
b)Phone Numbers of Designated Person:
8. In addition to himself/herself,Owner designates NA of to receive a
copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes.
a)Name and Address:
b)Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement.(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF T1lE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I.
SECTION 713.11, FLORIDA STATUTS, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated
t t�m,are true to a best of my knowledge and belief.i'' kkA LjI Cindy Hill, REO Sales Manager
Signature of O)er or Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The foregoing instrument was acknowledged before me this 7 day of 1110 —t •20 '
by C1 i t t( as 11:C° Sees mat .v for Sel Portfolio Servicing,Inc.as Attorrt y ih fact
(Name of P n) type of Authority,i.e.Officer/ omey) Nam of party lnstrwnent was Executed for)
C.N.-5.—sz_.)::(-)-Th
*� TVAPIDERUNDEN NOTARY PUBLIC,Sr1ATEOF1x
L��'9�;. Notary Public Safe of Utah \(
tti�4 '!5 My Commis'ion E::pires on: Print Name: j .\16 -U- i Ot.ct Y" i.
r r` . ` October 10,2716
Comm.Number:658983 i!fPcrsor.airy Known
❑Ideniftcation'Type:
(Affix Notary Seal Above)
Revised 3/15/12