420 Whiting Ln roof permit 'rS I'APJ7lrS
CITY OF ATLANTIC BEACH
sj 800 SEMINOLE ROAD
s 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-2162
Job Type: ROOF PERMIT
Description: RE ROOF SHINGLES
Estimated Value: $6,000.00
Issue Date: 9/27/2016
Expiration Date: 3/26/2017
PROPERTY ADDRESS:
Address: 420 WHITING LN
RE Number: 171446-0000
PROPERTY OWNER:
Name: PERSON, TIFFANY
Address: 420 WHITING LN
GENERAL CONTRACTOR INFORMATION:
Name: Birkholz Roof Mechanics, Inc.
,CCC1327125
Address: 12728 Daryl Hill DR
Phone: -
FEES:
BUILDING PERMIT FEE $80.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $84.00
PERMIT IS APPROVED ONLY M ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLOMA
BUILDING CODES
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845 I (0 -Roo
Job Address: Na() WHtgqTtNG GAr[E p Permit Number:
Legal Description LOT ,3 VICU' ).3 QFJ'rRTOF Qoykc PA(WIS 0mir as Parcel# 1-7 t 44 6P
F oof ria of labs.—Sq.r
Valuation of Work S l0 000 Proposed Work heated/cooled /659 non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pooltspa window/door
Use of existing/propUmd structure(s)(eirele one): Commercial es
If an existing structure,is a Tire sprinkler syste installed?(Circle one): es No N/A
Florida Product Approval# FC 11 5-le 7
For multiple products use p uct appml arm
Describe in detail the type of work to be performed: ?,E Rogic - a 0 690 AnJ5Z 4fi. #4 S/fiNd'CE
3 Sg,,,gn6S 'ioart .Dow �(
Property Owner Information:
Name: l(FFa�ly PERSON Address: y9D t.JNr l7-'q LANE
City RrzshtTic SC- I H Statea Zip,3aa�.3Phone 90cj - 7,2 9 - / G 7
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: -6,"Ifolz 1206,C /YIEc&4" Qualifying Agent: ,S16g,,tE 6/2CHoLZ
Address: / C City .TiYl.KStWU[CCE state Ft- 3,22,2,14'
Office Phone 9a44tt4 /�&aa Job Site/Contact Number Q0(4441 &3a Fax# 9043,28 ,J1g4
State Certification/Registretion# CCC /3a 7/.?,S-
Architect
/ta,SArchitect Name&Phone# —
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address —
Bonding Company Name and Address
Mortgage Gender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated f certify that no work or installation has emnewncedprior to the
usuanceo apermit and that all work will baps armed to meet the standards ofd/haws regu/sting construction in thisjurisdictiom Thispermitbecomesnu//
and void work is not commenced within six(6 months,or ifconstsuction or work is swpended or ahandonedfor a period ofsix/6)months at any time a ter
work it commenced I understand that separate permits most be secured for Elect ' Work,Plambing,Sigm; Wells,Pools, Furnare%Bollers,H as,
Tanks and Air Conditioners,de
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.
l hcmb mrtify that l h.readandesenaned Jb' wation and know the same to be true and correct. Al/preanal.ofJows act ordinances governing this
type of work will be complied with whether spec*ne min or mt. The granting of a permit does not premnme to give awhoriry to violate or Careel the
provtsnons ofary other federal, te,or loco(Jaw re to ng construction or the performance ofconstrvcno.
Signature of Owner (`�'� "�,,� ' \ Signature of Contracto / I
Print Name _.._......._ .5 '�Aa��-C "C `LJi�''.._...__.. Print Name ............_S1. _�..._J,.,.:. ./ . [_�.............
Sworn to and subsc 'had before me•S SworFttel subsc ' rid before e
this�Day of, JA this C, y
d "'^ "ti" JENNIFER I BENDETTI
6. Gtr-. 3fy �Ecman. ..
PUbIIC Commixslon I FF 901388 ' °
:n my Comm.Expim Amp r,2019 1.26.10
EXPIRES'.October fi.2019
som.emm w�,nv�erKu.a..nu' ise
NOTICE OF COMMENCEMENT
State of FIort-I hA Tax Folio No.
County of 7U VA/
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: LoT' 3 ALDC- 102r r2EPcAT DF IZO)AC PAU»S
UNIT d' ,4
Address of property being improved: q a O I.t7FF I T I Al Cr L AAIE 9-r4 AAJTI(. AEAG3+ C-L 31)X33
General descriptionofimprovements: ROOD aeeLACE,*A6Ar(-
Owner. TIFF"V PER-SOrL Address: y4aOLaRmAILr LAs1EA ArLA'4'rtL8& Ei FC 3).133
Owner's interest in site of the improvement: OW mct- / ouwl &L
Fee Simple Titleholder(if other than owner):
PAYf�ntmctDr: �L 2ekDL,z r2^oo� /✓IEGKyt*�IrCS
/ I Addross: Io'Z7aB �LJI}{LyL (-�/CL JLD . r JAC3GSONJILLE FL 3aa1P
Telephone No.: 904- L14�T -/Le 3o2- Fax No: QGLf .302$ �/8�
Surety(ifany)
Address: Amount of Bond$
Telephone No: Fax No: D.#2016723538 OR SK 17723 Page 659,
Name and address of any person making a loan for the construction of the improvements Numner Pages:l
Recorded 09127/2016 at 10:43 AM.
Name: — Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Address: RECORDING$1000
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
713.06(2)(6),Florida Statues. (Fill in a[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
Sited: Dater
Before me this ?,Cz day of Sf9 r m the County ofDuval,State
Of Florida,has personally appeared 'Ti rr.�'4V t-1 2SCA
;g i^ - JENNIFER L.BENDETfI Notary Public at 1sr64 State of Florida,Co 2 Duval.
Notary Pu80e-State al Florida My commission expires: (0 11 VS� 9 !i\`\
Commission/FF 904388
Personally E°°w^' or
,"•'• ?;' My Comm.Expues Aug r,2019 Produoedtificffii Lr - o --7 - G - pay+ 'I-q-z