1547 LINKSIDE DR - ROOF J
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J 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: 17-ROOF-2980
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated Value: $4,975.00
Issue Date: 1/11/2017
Expiration Date: 7/10/2017
PROPERTY ADDRESS:
Address: 1547 LINKSIDE DR
RE Number: 172374-6065
PROPERTY OWNER:
Name: COX, LORRAINE CAROLYN
Address: 1547 LINKSIDE DR
GENERAL CONTRACTOR INFORMATION:
Name: PIMENTEL ROOFING INC
Ramon O. Pimentel, CCC1330935
Address: 321 4Th AVE
Phone: - -
FEES:
BUILDING PERMIT FEE $74.88
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $78.88
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
�r
CioBUILDING PERMIT APPLICATIONJSri
CITY OF ATLANTIC BEACH
. 800 Seminole Road,Atlantic Beach FL 32233
�st1�r Office:(904)247-5826 • Fax: (904)247-5845 �.�
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Job Address: /S-.y7 St d P ern;lit Number:
i7448)-/.9&; 4de ii
Legal Description I/?-8 /74J= A-,/6-7 ?r/ g3ff/ RE#
Valuation of Work(Replacement Cost)$ 7/ )( �"fTeated/Cooled SF Non-Heated/Cooled a Q
• Class of Work(Circle one): New Addition Cteratioln Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial sidenti
• 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:
v`cm 601L. of(Q rpvrlye-A)a.; .S 1i.ee :0.0 ht)617V/ Sdu„>410,3Ort/14th,
Florida Product Approval# _�/, / 7 5-G. 3 -ra for multiple products use product approval form
Property Owner Information Ar-Z... Z6 9, R D n-dc kit(m? :€
Name: J,., p 1^IrI►-%N0 /D.I( Address: / S 4/7 A .,vk5 .44 2)t.
City ,4-r�.,s,�t 4;e, 2 e A_AA Stated,Zip Phone 8 f ,- 2// g
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:
Name of Company: "Pt rn.ee 4-w€ Qualifying Agent: 1?4,en e„)4-At
Address: 315' j c>M A I/r. AJ, Ai+-Pt I ' City �', . $�,4c% State Zip FL 7 74-6
Office Phone(9,9V) 903 Job Site/Contact Number 5q - 5-4/0e
State Certifica ion/ egistration# CCf /3A 04 3g' E-Mail
Architect Name&Phone #
Engineer's Name&Phone#
Worker's Compensation y ,e s $ / '
Insurer / Lease Employees / Expiratio(!Date2 o/B
Application is hereby made to obtain Ana it to do the work and installations as indicated. I certify that no work or installation has commenced
rior to the issuance rade
permit and work will be performed to meet the standards of all laws regulating construction in this jurisdiction.
his permit becomes null and void if work is not commenced within six(6)months or if construction or work is suspended or abandoned for 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,Heaters,Tanks and Air Conditioners,etc.
Signature of Property Owner: ���Nfa,w . Com; Signature of Contractor. J.,,,_,_ L1 _
Befo a ,� 1iti�"ii, ANN MARGADONNA
this /j Day of U A ;., 'K/ MY COMMISSION,FF 161400 Before me this / ( Day of 'AIN/ 7-0(`f
a EXPIRES:September 18,2018
/ //� ?' dv� Bonded Thru Nota Public Under*rten
Notary Publi Notary Publi
- I—
I hereby certifr that I have read and examined this application and know the same to be true a t c•W '4; f pr1,k r'. f; i
ordinances governing this type of work will be complied with whether specified herein or no i s'..�Hnli ; feC i4 . .9 n,
presume to give authority to violate or cancel the provisions of any other federal, state, or loc r�;`eg,rl 1°p e I•er :' I
performance of construction. ?' Bonded Thru Notary Pudic Undenvdten
NOTICE OF COMMENCEMENT
State of !"li County _Jici.eia_t_____q
—
To Whom It May Concern: TaxFolio No.
The undersi ned hereby •
g 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:_ 2 _/ -2.
•
sc Address of property being improved: /$-
General description of improvements:
.i , 0,/ re--Aro. .(
\\\:
Address:15 7 L �ner's interest in site of the improvement: -��n � O :i .v.e✓Simple Titleholder(if other than owner):--_ ----_
Name:
-
• Address:3 ,�- / / ` .
Telephone No.:- JCS. 0f
Fax No:
Surety(if any)
Address:
Amount of Bond$
Telephone No: Fax Ivo.
Name and address of any person making a loan for the construction of the improvements
Name:
I
Address:
I
•
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)(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
Signed: .) � �.c,.ti.c� -.,%..p Date: 1\ q
\ ( ‘
Before me this a day of Co in the Coyntyy of uval,State •
•
Of Florida,has personally appeared • d Y►"� .6, L_
Personally Known:
°-^-laced Identification: / or
ry Public: !!- 4- a
Doc#2017008363,OR BK 17841 Page 668, ommission expires: „ • „� /
Number Pages:1 �`�� .1��AZAM _
Recorded 01111!2017 at 02:24 PM, a , s
ANN MAR e.'s NA
Ronnie Fussell CLERK CIRCUIT COURT DUVAL �, ;- MYCOMMISSION#Ff 181400
COUNTY -4 - EXPIRES:September 18,2018
RECORDING$10.00 .., ,„0' Bonded ThruNotary Public Underwriters