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427 INLAND WAY - ROOF � � t, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD s-) ATLANTIC BEACH, FL 32233 �� v INSPECTION PHONE LINE 247-5814 ROOF PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-ROOF-1726 Job Type: ROOF PERMIT Description: RE-ROOF Estimated Value: $9,000.00 Issue Date: 8/1/2016 Expiration Date: 1/28/2017 PROPERTY ADDRESS: Address: 427 INLAND WAY RE Number: 169463-1526 PROPERTY OWNER: Name: TILLMAN, STANLEY W Address: 427 INLAND WAY GENERAL CONTRACTOR INFORMATION: Name: BRANNAN ROOFING, LLC Address: 1024 PEBBLE RIDGE DR QA RONALD EDWARD BRANNEN, JR Phone: - - FEES: BUILDING PERMIT FEE $95.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $99.00 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 Uti 31- Office:(904)247-5826 • Fax: (904)247-5845 1 (0 Job Address: t4 )-1 Lj Permit Number: Legal Description OC Elim WA W-- &JYII 1 b+ 13 obi g RE# �r7 " j�'" 31 - a - 9 C- 10 Valuation of Work(Replacement Cost) $9 oO'c : Heated/�oo ed 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 Residential • 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: R Florida Product Approval# c L � C)61LI e-ko for multiple products use product approval form Property Owner Information Name: 54 Oki a 1.1 I I PrAI Address: L 1 It'll AM(9 w City 1 q }l Lkbeile44 State clip Phone ej 04- 6'01 - ')(51.4A 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: VbCkt Name of Company: J�' rle� Qualifyi Agent: 9UI k) �il Address: !OJ`{ T Q IL cCcj e Di City F State Zip r Office Phone 9 Ulf-c313-q94,7 Job Site/Contact Numberl CIO - ' I - State Certification/Registration# I'Qa O E-Mail b#• u NAN( o Kik 4 5-1 NET Architect Name& Phone # Engineer's Name&Phone# Worker's Compensation Exempt I 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 ju installation has commenced nor to the issuance of a permit and that all work will be performed to meet the standards of all laws regulatingconstruction this on in risdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned fqr 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,Heat -, T and Air Conditioners,etc. Signature of Pro.- Own- : Signature of Contractor: Befoke_me g this.A5 Day of • - Before me this Day of Notary Public: / ; -t_"Q-t--) Notary Public: I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinance • y- •-• • • • . - • •e complied with whether specified herein or not. The granting of a permit does not presume to th•HERYb : AN cane the provisions of any other federal, state, or local law regulating construction or the performai7certeryj{N #FF 933216 • " �+ Expires February 15,2020 Rev.3/14/16 n '•• ,;m- Bonded TWuTroy Fain Inanc.E00.39'17019 NOTICE OF COMMENCEMENT State of T (0-(©i4 County of Tax Folio No. 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: L Z - I - 3-7 - 9 S dl L j q 1.0,4 ) 3 ' O/r2 6Y- (93.51 — .??10 Address of property being improved: Lia 1 -ail,AN a1 wAti b HC.t i /FL, `3 2 2 3 3 General description of improvements: `i;Q (Oo"c Owner: & A,4 �i I I YvI'°fA4 Address: q) 1 1.41 kid 1..) h,, A1144,14(-- Ati1C ) I Ft- Owner's interest in site of the improvement: L 3 Fee Simple Titleholder(if other than/owner): Name: IIAW fN All $ltractor: 1‘1# nnj I1iti KtvS/✓9 [CL- Iciri,, 9 Address: IOD(-1 Te 66 k9 E, De 'p��, Telephone No.: Cl0Y'03`i/96 7 Fax No: Surety(if any) Address: Amount of Bond$ 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: 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: 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 7I3.06(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 (1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Sign Date: V9 S �� •,,, Before is a25tf•. day of ���i�. , vCCI(, the �ty of Duval,State ,:ti�'"�%ry�. CHERYL L.BRANNAN ! Q�' f r•� .*s Commission#FF 933216 Of Florida,has personally appeared [v.., t Personally Expires February 15,2020 Known: or '4Bonded Thai Troy Fain Immo 800J8S7818 Produced Identificj�ippn_: Notary Public: ( ,'4t ..s My commission expires: , i S l�)-0 L Doc#2016175236,OR BK 17654 Page 257, Number Pages: 1 1 C; _ I_ I/Zl� �l Recorded 08/01,2016 at 08:41 AM. I 1 v V Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING$10.00