1927 Mary St roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NE)Cr DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-2518
Job Type: ROOF PERMIT
Description: re-roof 22 squares of architectural GAF shingles
Estimated Value: $7,085.00
Issue Date: 11/9/2016
Expiration Date: 5/8/2017
PROPERTY ADDRESS:
Address: 1927 MARY ST
RE Numbmer; 1171236.0-0.000
PROPERTYOWNER:
Name: MILLER, RICHARD J
Address:
GENE RAL CONTRACTOR INFORMATION:
Name: B. SMITH ROOFING, INC.
Brian Eugene Smith,CCC1326912
Address: 13525 SAWPIT RD CIA SMITH, BRIAN EUGENE
Phone:
FEES:
BUILDING PERMIT FEE $85.43
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2�00
Total Payments: $89.43
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE MORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 1927 Mary St,Atlantic Beach, Fl.32233 Permit Number:
Legal Description 24-92 17-2S-29E.064 Lewis Subdivision Parcel# S 1/2 LOT 8 BLK 3
Floor Am Sq F Sq.Pt
Valuation of Work S 7,085 Proposed 4;,,k he�tt�dlfcooled non-heated/cooled
Class of Work(circle one): New Addition Repair Move Demolitim pool/spa window/door
Use of existing/pro used structu=s �ccircle one): Commercial a..)
If an existing struefore,is a fire sp I er system installed?(Circle 0 R7A_1
Florida Product Approval#
For multiple products use product approval Form
Describe in detail the type of work to be perfornted: Residential re-roof,22 sguares of architectural GAF shingles
Property Owner Inflannation:
Narne:Richard Miller Address: 13432 Aquiline Rd
City Jacksonville State LL_Zip 32224 Phone
E-Mail or Fax 4(Optional)
Contractor Information:
Company Name: B.Smith Roofing, Inc. Qualifying Agent: RrmanF.Smith
Address:13525 Sawpit Rd City Jacksonville State Fl. Zip 32226
Office Phone 904-378-8605 Job Site Contact Number 904-378-8605 Fax:# 90Z7378-8606
State Certi fication/Registration#CC-CI5269 12
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lendff Name and Address
AAahanion is hereby made to obtain apermil so&the work and installations ar indicated laertify that es,workor installation has comemearcedinior to the
is..tperodtaod that.11 work will bepTarmedo,meet the standards qfaJ1 laws regulating amstruettlan in thisjurisdiethes. Aitsmilbecomesnull
f
i months,or ifamseermsion or work is sus
gm*d or almemkosedfor 7riod ofsaj6),months at ano,tim1per
el
work is commenod. i understand that separate pemits man be weuredfor Ebairica Work, Plumbing,Slins, d/4 Pooft, Menem Ronem HFI,
Tanks andAir Conditioners,da
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 V6U NOTICE OF
COMMENCEMENT.
lhereVowiffy that Ist.remlandmumthwalthis ioationanalknowthesametobetrueandonma. 411�v�iomofl�sandor&�c�gowrn�glhis
I r),10"hermin or mt. 7he growing of a permit does mt presuaw,to gn,e authority to violate or wesoll the
provisions of any miterjederal,mate,or local law regulating cmsmr�tion or the perforeanswe ofoanstruction.
Signature of Owner 40" — Signal=of Contractor
Print Name dichard Miller Print Name Brian Smith
.....................__ I .............. ........... .....................................................................
me Swom to and subscribe4 before
,20 /4 this -a-Day of 20 1
PUBLIC
bTATIE OF FLORIDA
Comm#FFNU26
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida,Comfy of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
I. Description of property(legal description of property and address if available):
24-92 17-2S-29E .064 Leviiiis Subdivision S 1/2 LOT 8 BLK 3. 1927 Mary St.Atlantic Beach, FL 32233
2. General Description of improvements:
Residential re-roof 22 scivares
3. Owner Information:
a)Name and Address: Richard Miller 13432 Aquiline Rd,Jacksomille,FL 32224
b)Interest in property:General
c)Name and address of simple titleholder(if other than owner):
4. Contractor Information:
a)Name and Address: B. Smith Roofing, Inc. 13525 Sawpit Rd, Jacksonville, FL 32226
b)Phone Number;(904TI79-8605--
5'. Surety Information: Doo#2016256800,OR8K1TT70 Paqe655,
Nurnloer Pages:I
a)Name and Address: ReconJeol I 1fflaf2016.t 12:25 PM
b)Phone Number: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
c)Amount of Bond: $ COUNTY
RECORDING$10.00
6. Leader information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (lXa)7,Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to himself/herself,Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713.13 (1)(b),Florida Statutes.
a)Name and Address;
b)Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement(die expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMIvIENCEM[ENT ARE CONSIDERED INWROpER PAYMENTS UNDER CHAPTER 713,PART I,
SECTION 713.13 FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
MIPROVEMENTS To YOUR PROPERTY. A NOTICE OF COMNENCEM[ENT MUST BE RECORDED AND
POSTED ON THE jOB SITE BEFORE THE F13LST INSPECTION. IF YOU INTEND To OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE CONRAENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have mad the foregoing notice of commencement and that the facts stated
therein are true to the best of my knowledge mud bulief
d Offi,,�/Dimvto
ISA of Owner or�O��wner's Au�thori. r/Partner/Manager Signatory's Printed Name& i itle/umce
The foregoing instrumentwas acknowledged before me this dayof 20-L(2,
by as my-p—eof- )for . @
(R..of—P..n) Autlioty,I e o arty Instrument was Exccuwd for)
:A
C��� K IC,STA OF FLORIDA
'UC. 'y ,§Pi
'F �2 370 Print Nam
4,44,1 Me, 03, 2019 Eipersonally Known
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(AfrmNotay SeM Abow)
Revised 3/15/12
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