501 Atlantic Blvd 16-ROOF-1136 roof over permit r_„t\J\J.„
1 , ,
"'�� �\i, CITY OF ATLANTIC BEACH
'' �y " 800 SEMINOLE ROAD
JV il ATLANTIC BEACH, FL 32233
>N. INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-1136
Job Type: ROOF PERMIT
Description: ROOF - ROOF OVER SHINGLE
Estimated Value: $13.980.00
Issue Date: 5/17/2016
Expiration Date: 11/13/2016
PROPERTY ADDRESS:
Address: 501 ATLANTIC BLVD
RE Number: 170678-0000
PROPERTY OWNER:
Name: GRFA PALMS LLC
Address: 501 ATLANTIC BLVD
GENERAL CONTRACTOR INFORMATION:
Name: TOWNSEND ROOFING &
Address: 10418 NEW BERLIN RD APT 115 QA RANDY CRISS
TOWNSEND
Phone: - -
FEES:
BUILDING PERMIT FEE $119.90
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $123.90
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
_ BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic:Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 1 (0 —Roo I — 1 ( 3 Co
.Job Address: 56 I .4-f-IA it-1 Ic- e f of Permit Number:
Legal Description)C- 7--1-Z$ Z9� 54-Fairf.-1. twfis 797, 798,79 ` Parcel# /70 67$- (t 0
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ )3l 1 O0 Proposed Work heated/cooled non-heated/cooled
I Class of Work(circle one): New Addition Alteration cRepaip Move Demolition pooVspa window/door
Use of existing/proposed.structures)(circle one):_ merci Residential
If an existing structure,is a fire spnnkler system cast. e . e one): Yes No N/A
Florida Product Approval# 115 , /
For multiple products use product approval form
Describe in detail the type of work to be performed: 5)4`..),-,!,e 4is oo-1di �—o ver " (ro ex r,Altmf= re-tow/4 1)ZS5Q 5
0-42y,e- .P.,4- rco4= r-191h4enctkd- (5 5p) w'o'k 69-F tie Aioc1I ea( F cb g0 fl
Property Owner Information:
Name: 64-1-e fe-4-ra Jet1 (n-if A hy Address: 9505 k .J. 5<_ A/1/
Ci � G SG,t 1t'v l G 7
city a k ( State FLzip 3.-.�s7 Phone /0/—737-?ZZ o
E-Mail orax
F (Optional)
Contractor Information: l p --" ,/� a 1
Company Name: TW�Setnd RDolit\ `-(,ssJi�ck i Se/Nce5m--Quali�fymgAgent: RP'ilAy cc,i s ,
Address: IDK( { New (Set.. !-I. (1S City —aotCksr).ti /fat State PL Zip 3ZZz 6
Office Phone °}C —6457-S157 Job Site/Contact Number „--;-s 147z--wilt Fax# el b el—r 41.5"—5 zi yz
State Certification/Regist►ation# GLC 1.4 Z-6 Z 89
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 pe onned to meet the standards of all laws regulating construction in thisjurisdiction This permit becomes null
and void f work is not commenced within sir(6)months or if construction or work is suspended or abandoned for aperiod of six L6)months at any time offer
work is commenced. I understand that separate permits must be secured for Electrical Works Pltunbins 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 cert that!have read and examined this cpplication and know the same to be true and correct All provisions of 1, - • ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to : _�,'tiiori to violate or cancel the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
.// _�
Signature of Owni7e , < (L/ll// Si afore of Contra I �'' / 7...,
�' to
Print Name 18��HAMILTON -^
Print Name �atn, I -F SeK ( _
Sworn to subsc,-il before me _ _ _
� , � r sworn .d su• ��1 ;r;,,.. .
this ; t k t ba f I ,{I\'- 20 -{' this ,l., ••y of //t;; :.':''�,, wiaTM1 ,0 -
II par''V ori
Notary Public N. .. ' lc. •-.,;.1t
le:NI.%
!`: ...
n• g IYPIRYM.ES:NoiaryhmDecemberre18,2016
i3aid.dUndr -
Doc # 2016110484, OR BK 17564 Page 148, Number Pages: 1, Recorded 05/17/2016
at 10:17 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
iPREPnRE Ys DUPLICATE)
Permit No. Tax Folio.No. 170678-0000
State of Florida County of Dual
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: 10-8 21-2S-29E SALTAIR SEC 1 LOTS 797,798,799
Address ofpropy g+mpro :501 Atlantic Blvd Atlantic Beach,FL 32233
General description of improvements:Roof Replacement — ——
a„r,er GATE PETROLEUM COMPANY
•
, Address 9540 San Jose Blvd Jacksonville,FL 32257
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Townsend Rooting and Construction Services,Inc
Address 10918 New Berlin Rd B115 Jadcsonvilie R 32226
Phone No.a04' 'SW Fax No.904-645-5442
Surety(if any)
Address Amount of bond S _
Phone No. Fax No.
Name and address of any person malting a loan for the construction of the Improvements.
Name
Address
Phone No. Fax No.
Mame of person within the State of Florida.other than himself.designated by owner upon whom notices or other
documents may be served:
Name
Address
?hone No Fax No.
In addition to himself.owner designates the following person to receive a copy of the Lienors Notice as provided in
Section 713.06(2)(b).Florida Statutes_(Fdl in at Owners option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recorrkng unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY Win wry+ l 1`;
Stood,
pod, JCaiw y.S, /14-447/Vel-7 i _ DATE "T(
` erki CIr��' amee'w herein� ..
!lima/terset and alms that all statemeres
--
are true and amiaaea [TN Dgyl Dammam
�� •1 a' .f MYcomma III 819275
• • /\ OPINES: thou i8 2016
t 0 Number
_ BadidlM11aV1PO �
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Notary Puone at L • .sato of armarp.7 • of VTIvt
trly co runisslm=pints:
Paro°^elly Krq..•n or
Produced Merndcation