591 SHERRY DR - ROOF S
" \' CITY OF ATLANTIC BEACH
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.. _ 800 SEMINOLE ROAD
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: v,, ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-1002
Job Type: ROOF PERMIT
Description: RE-ROOF
Estimated Value: $8,850.00
Issue Date: 4/29/2016
Expiration Date: 10/26/2016
PROPERTY ADDRESS:
Address: 591 SHERRY DR
RE Number: 169879-0390
PROPERTY OWNER:
Name: CRIMAN, CARL MICHAEL
Address: 591 SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: HAMMER TIME ROOFING
Address: 13465 SOLEDAD CT DR ANTHONY BETANCOURT
Phone: - -
FEES: - -- - - ----BUILDING PERMIT FEE $94.25
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $98.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE) t?
Permit No. Tax Folio No. /6,9,5)79— OA TO
State of r/ccid0 County of Ri '!
To whom it may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following Information is stated In this NOTICE OF
COMMENCEMENT. /
Legal description of property being improved: 5-69 /p -��- O l p
E
LO-Is s9) Lll /PI (A/ 7k reOc Ory,k 7
Address of property being improved: ?) Sh8Cry 4(.
General description of improvements: /f - deat`'F
Owner Car I ,41 (_4:16--1 n
Address SJier(V' , &os-A
Owner's Interest in site of the Improvement
Fee Simple Titleholder(if other than owner)
Name
Address 'role_Contractor ii / /Tie_ ,r'(l o j G ► L (' I/
0 /1 Address /3 LJ6 SOk tJ L�. �CrekSVrivt Daa
Phone No. ( qoq') 7I(?�-c,Li q Fax No.
Surety(if any)
Address Amount of bond$
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 ONL OWNER
Signed: At DATE
Before me this day of 9.-Ian
County o • val. -te or F• •a.ha-pers. NA J.MASON
Doc#2016096482,OR BK 17544 Page 1535, le . • Rar t!!/A herein b
Number Pages:1 himself/herself and affirms that all statement >'
9 ,.• hry ublic State of Florida
are true and accurate i
Recorded 04/29/2016 at 10:58 AM, ft -
Ronnie Fussell CLERK CIRCUIT COURT DUVAL ?� •= CCo m .Ex irre FF ct 5 COUNTY � �:' My Comm.Expires Oct 5,2019
''FOB m Bonded through National Notary Assn
RECORDING$10.00 .'4/1,=..,- �-�
N•tary0 blic at :7-• tats Coun of
fission express .•.�. ::_:►,•�/ . � .�. •771'.7 • S
Personally Known or
Produced Identification
.? BUILDING—RERMIT–APPLICATI0-N------- ----
ii
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
ono Office:(904)247-5826 • Fax: (904)247-5845
ICo _Roo F - InOZ
Job Address: 5k' Sic(cy p(, Permit Number:
Legal Description 5-6.9 1 b-, S-09 L-E Cdis , 4 41 ,P--tv RE#
Valuation of Work(Replacement Cost)$ ?,&s-t) Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Lsidentia
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: /
Re -46f /( e►>wvc old_ 4SP6/f 54r-tale / ti e,(.1c%t10,74,.e.�1-1-/,i(r�1,�3�
Florida Product Approval# J14-5/1's fZ 479 s-tt(/ (by /4"-.057,/-R c) for multiple products use product approval form
Property Owner Information
Name: .41iii,c CrL nl&n Address: 541 "V e(,-7 (0',
City A-664-tL a-6dr) State Ft Zip 3,a33 Phone
E-Mail
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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.
Contractor Information:
Name of Company: iki mme{ Time Rc1nq' LL( Qualifying Agent: /r Mtwi ,& ,arc, i I -
Address: 131ti,� E drul C€ -' City J ke..ru,i`/if State Zip /L 39ggy
Office Phone 71 l,-'l 1k 9 Job Site/Contact Number
State Certification/Registration# acc t?agq f-3 E-Mail An ,,-4-74,ervo ro SMa,1,6.•-)
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation Li rt A __I-vtsu.rc, re /Z- 3/— X0/,6
Exempt / Insurer Lease Employees, Expiration Date
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
tprior 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.
his permit becomes null and void if work is not commenced within six(6 months, or if construction or work is suspended or abandoned Anti. a
period o six(6)months at any time after work is commenced. I understand that separate permits must be secu , .r Electrical Wo ,Pluming,
Signs, Wells,Pools,Furnaces,Boilers,Heaters,Tanks and Air Conditioners,etc.
/
Signature of Property Owner: :ta Al e Signature of Cont : .t: J4T a�
Beforene
this 2 ! Day of (C) r.:1 ( 2.0 p Before me this 21■ Day a, • \ IP I (�ritenuo
Notary Public: 11 aD.1 Notary P i — �►', „. .'107iitt"3:,Iji,_
• = EXPIRES:
_ — _ _ _ '' n•:dIRE :°. PublicUrden�lters
I hereby cert a read an jll it SOS1,is appi'ration and know the same t r % ,;a:, . , • ions • s and
ordinances gov r t.r pi i ai u�jticpj ittl with whether specified hc -•--�--.a granting of a perm •oes not
presume to gii4 4 ft le yr fh tRi ric�l60100 :ions of any other,federal, state, or local law regulating constuction or the
performance of` . ii 1
•,,���.o My Comm.Expfree Oct 5.2019
1 "',8f.; Bonded through National Notary Assn. ( Rev.3/14/16