1158 Ocean Blvd roof permitCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 411M FOR NEXT DAY INSPECTION: 247-5814
306 INFORMATION:
lob ID:
16 -ROOF -2265
lob Type:
ROOF PERMIT
Description:
re -roof
Estimated Value:
$5,500.00
Issue Date:
10/10/2016
Expiration Date:
4/8/2017
PROPERTY ADDRESS:
Address:
1158 OCEAN BLVD
RE Number:
170287-0000
PROPERTY OWNER:
Name:
SHAD ET AL, KERRY A
Address:
202 FALKNER DR 202 FALKNER DR
GENERAL CONTRACTOR INFORMATION:
Name:
RELIANT ROOFING INC RYAN SHOUPPE
Cameron Ryan Shouppe, CCC1330615
Address:
528 Millhouse Lane Orange PARK
rnene -
FEES:
BUILDING PERMIT FEE $77.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $81.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BDILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Reach, FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address:
Legal Description G ' 16
_,a
����,/..y-/'' 40moor none m oq.rt. a .,y...
Valuation ofW.rk S� Proposed Work beated/cooled LGW ( noo-bested/cooled 1?5K
Cleasmf Work(circleone): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of exiatlng/pmposed struetare(s)(clrcle anal- Commercial demi
Ifan exWfing structure, is a fl prinkler ate. ii Wiled? (Circle one): r u No N /A
Florida Pmducl Approvalk c( o I I (
For multiple products use product approval form n /� '
Describe in detail the type of work to be performed: /C c' rbu A- I'L h 4;
City
E -Mail or Fax d (Oti nal.
Contractor Information:
Once Phonn NLY'yb-Yb4YU Job $eN lonlad Nmn r /� r.
State Certification icgisuetionp
Archucm Nem. & Ph.ac M
Engineer's Name & Phone q
Fee Simple Title Halder Name and Adhas
Bonding Company Name and Address
Mortgage Under Name and Address.
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�nor o/wr&nldmr . r m dna.alra rr,a marMaa� ar oma a. a. rrvewd.wren ,tn/,.wmmewrw,mramm as a av
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$sgootme cfOmer
PnN Name YLp ii � J,Id�
$wmnto and subscnbedbefamme
mi.LDaynf oc-r n - .20 IL
Jennger Rrwl
NOTARY PUBOC
ST�OPORIDA
C A
5 564
Expires 111912020
Signamm of Contre,x. n � ^^�
Prins Name�� -� t
Swam to and sabreibcd before mn
the. a—DayofGX.<vn Co -
Nolary Pall
Revised 0116. 10
r JerWfer Kmul
NOTARYPUBLIC
ESTATE OF FLORIO;
Canmq FF951584
Expires 1/19/2,:
09/30/2016 at 02:50 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
..w.:„...............NOTICE OF COMMENCEMENT
PREPaeE M WPVCAIFt
Penna No. Tex Fdlo
Slate of tau, County d
To whom It may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property, and In
accordance with Action 713 of IM1e Florida Statutes, the following Inform itlnn Is stated In this NOTICE OF
COMMENCEMENT.
Legal dmoiption of Wn any beingimpwed.6-116-2S-29E ATLANTIC BEACH LOT 4 BLK 44
Address of property being btpfovedf 1158 OCEAN BLVD Atlantic Beach FL 32233 -
General description 0 improvemente Re22L
O,,wr Kerry Shad
Add. 202 FALKNER DR CHAPEL HILL NC 27517
owners merest b indefinite imprcvemeM
Fee Simple Titleholder (a other man uamer)
Lmtremor Rchem Roolm, Inc
Addmis 822. AIA Higlrm Smte 310 Ponta Vedra Rech. TL 32082
Phone No. awea"men Fax No. 904 S7A7972
Surety (if any)
Address Amount of bond S
Phone No. Fax No
Name that address of any person makirp a ban for the nomlru slm of me improvements.
Felt No.
Name of person withln In. Stab of Florida. other then himself. dominated aY owmr upon weave notice. or omer
documents may be served:
Plena No ”
In Station to bhmseR. owner des,,ru s the taoowing Parade to receive 8 copy or the Lleners Nmice as provided In
Section 71306 (2) (b). Florida Ste,csa (Fill in at Peter's option).
Md.. _
Phare No.
Fax No.
Expiration date of Notice of Commemarcom (me expiration dela Is one (1) car from IM1e dale d recording unless
different data is epedeedy.
THIS SPACE FOR RECORDEWS USE ONLY
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