222 POINSETTIA ST - ROOF �, 'f; �
�� 7' ' ��t CITY OF ATLANTIC BEACH
tt1
- = A r " 800 SEMINOLE ROAD
- r ATLANTIC BEACH, FL 32233
2 INSPECTION PHONE LINE 247-5814
f 0321 9r
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-1785
Job Type: ROOF PERMIT
Description: RE-ROOF
Estimated Value: $2,550.00
Issue Date: 8/5/2016
Expiration Date: 2/1/2017
PROPERTY ADDRESS:
Address: 222 POINSETTIA ST
RE Number: 170573-0000
PROPERTY OWNER:
Name: HARRISON, KIMBERLY KAROLE
Address: 222 POINSETTIA ST
GENERAL CONTRACTOR INFORMATION:
Name: HAMMER TIME ROOFING
Address: 13465 SOLEDAD CT DR ANTHONY BETANCOURT
Phone: - -
FEES:
BUILDING PERMIT FEE $62.75
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $66.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
.(
---- j' % BUILDING PERMIT APPLICATION
A CITY OF ATLANTIC BEACH
\-,:iv, 800 Seminole Road,Atlantic Beach FL 32233
.`. Office:(904)247-5826 • Fax:(904)247-5845
�a Permit Number: 1(o- F-
1119
Job Address: t,,►n,4 e�'4 Ct.
Legal Description /0-/b I f,-a5.5 )4 c r Set 3
N u9 tot-54 I 7o,5-� - ria 1 U
Valuation of Work(Replacement Cost)$ 2,(0
,50 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): ew Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial �Residenti )
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N
■ 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:
Florida Product Approval# L/OY 7 , /-R 511 trye_'It for multiple products use product approval form
L I . t- p
Property Owner Information
/�
Name:i 4)/!hae)r,( �,ede l ct J(r Address: 1 ) 19 Pc«e l i.n c 6-1( L—
City C
T.r.kbon t i,')I t State cl-Zip ^L;tPhone (say 1 i - `t-13
E-Mail /tU j6X '1 Cuoicab4-• /tCF
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 TINA NOTICE CO CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORD YOUROF
Contractor Information: pp
Name of Company: offer /;r b e - /l C Qualif nng Agent: /`7`l71-hal .ecAnui t.r�
Address: /,317'‘)5.-�1 /C
dad G4. J't-t City J uc.-ksont„/)r State Lip FL 32.;-. Li
Office Phone (*Ai )'1i - c11 Job Site/Contact Number
State Certification/Registration# Cu 133-'4'8 3 E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation
Exempt / insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work a . ' stallations as indicated. I cert yy that no work or installation has commenced
pnor to the issuance of a permit and[hat l!work will be, rm= to meet the standards of all laws regulating construction in this jurisdiction.
This permit becomes null and void if wo/ is i t coii
, wit 'nsix(6)months, orif constrictionorwork issuspended orabandonedforaperiod of six(6)months at any timeaft r • co 1 u derstand that separate permits mustbe secur-• ,r Electrical ,rk,Pl ing,
Signs, WWells,Pools,Furnaces,Botle Air tondi[loners,etc.
Signature of Contractor: 1P
Signature of Property Owner:" 1 —��- S
this BeforQ:L Day of i_ a E 2 rz/L Before me this e me in Day •f , r 1' G
4111 ilb
Notary Public:
Notary Public: • .21 ...
I hereby certify di 1;11a ve read and examined this application and know the same to be true and correct. All provisions : aws and
ordinances goverMIWytakilwe of work will be complied with whether specified herein or not. Ti` __�_-
—...-- re.c not
ne to give[hl rpolate or cancel the provisions of any other federal,stat'r----: �..,1Pi�R a,/alor the
lrer mince of e(�j�: o itt r i ° MY COMMISSION#FF 924951
JtBtQ OT fllorida EXPIRES: tbeetl2KI6
My Commission Expires 06/05/2018 '" �„�aThruNoaryPublic underwriters
Commission No.FF 130188
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 170573-0010
State of Florida 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: 10-16 16-2S-29E
Salt air Sec 3 N1/2 Lot 547
Address of property being improved: 226 Poinsettia St.
Atlantic Beach Fl,32233
General description of improvements: Re-roof
owner Michael or Valeria Kerr
Address 1 1 19 Perregrine Circle E. Jacksonville,Fl 3259
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Hammer Time Roofing LLC
f Address
Phone No.
13465 Soledad Ct. Jacksonville,Fl 32224
r
(904)716'9149 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 d:to's one(1)year •m t- ate of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY • /n
Signed: Ah-ei‘411, DATE /4a � O
Before me. - day of d Zo 11 in e
C• n of Duval.S ate of Florida.h-."personally appeared
..,!n a' - IC,rtL herein by iiii E g
Doc#2016180633,OR BK 17662 Page 695, himself/he •affirms that all statements and declarations herein
Number Pages:1 are true an.Urate 9, o
Recorded 08/05/2016 at 10:37 AM, o • o -1
Ronnie Fussell CLERK CIRCUIT COURT DUVAL � n .
COUNTY _
4017.1//ara
RECORDING$10.00
•tary Public at ge. tate of LG►c• . County of /EMT ng
My commission expires: C)4/C2 S/Zoi A
Personally Known or
Produced Identification 7,(-601.1,474- DL o0