161 16th St re-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 NEXT DAY INSPECTION: 247-5814
305 INFO MATION:
Job ID: 17-ROOF-3179
Job Type: ROOF PERMIT
Desaiption: re-roof FL10674-R7 & FL17420-R2
Estimated Value: $11,517.00
Issue Date: 2/3/2017
Expiration Date: 8/2/2017
PROPERTY ADDRESS:
Address: 161 16TH ST
RE Number: 169543-0000
PROPERTY OWNER:
Name: AYERS, RICHARD J & CYD L,
Address: 161 16TH ST
GENERAL CONTRACTOR INFORMATION:
Name: PRIME ROOF CONTRACTING LLC
Mark Andrew Young,CCC1329SOS
Address: 13792 HERONS LANDING WAY APT 9 QAMARK
ANDREW YOUNG
Phone:
FEES:
BUILDING PERMIT FEE $107.59
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $111.59
PERMIT IS APPROWD ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND ME FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,AtIonfic Beach,FL 32233
Office(904)247-5826 Fu(904)247-5845
Job Address- 161 16th St PersaitNeumber:
.—T&W7f)-.�N GROVE UNI I NO 1
Legal Description LoIA plu,rel# 1695434)(1001
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Valumissis of Work 511 517 Proposed Work IaNt�sltesbaled 3702 non-lasiaballcoolead
Aneration Repair Move Demoluest pool/spa windoevoloor
Class of Work(circle me): New Aildition E��)
iden
Usedettisthig1poctf:,adiurtichano(s) locle one): Commencral "IEW PRN.
Ifasterhathingstruc re,brifleesprin er system installed?(Circle one): ED
FlinobtProd.otASporeal# FL10674-R7 FL17420-R2
For multiple pro nets use product—approval form
Describe in detail the type of work In be performed:Sinale Family Norms Re-roof
Flowers Owner Itifinumtkon
N.: Richard Ayers Address 161 16th St
City Atlantic—� SWW—Ez-rp �z;w hade,
&Mail or Fax#(Option
Contractor Information:
Company Nunn:unions Pont Counselling Qualifying Agme
Addocan:372"Pal.Or —CiLy Atlantic Ba Boom FL zip BmfB
Office Phone(M)630-1,146 Job Sitel Carbon Nuartaw_M�� Fim#
Suite Cin-fificaticarea.,uminfical# CMI Als
t,urchitaet Name&Phone#
Engineer's Name&Phone Is
Fee Simple Title Halter Name aral Adilem
funding Company Name and
Mortgage Leader Name and Address
Appluese-a hereby made on subman ap,.mat some the nook and numalreums ae indicates
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....kawartmenced I understand ahat se,wareonesurs most be Won, am ag, sm
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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.
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NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
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: 15112 9-2S-29E .14 OCEAN GROVE UNIT NO 1 LOT 1 BILK 1
Address of property being improved: 161 16th St Atlantic Beach,�32233
General description of improvements: R.,c.f
Owner Richard Aye.
Address 161 16th St Atlantic Beach,FL 32233
owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Prime Roof Contracting,LLC FL 32224
Address 13725 Beach Blvd Suite 13,Jacks
Phone No. (914)615-1446 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 owrter 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 date is one(1)year from the date of recording unless a
different date is specified):
OWNER
THIS SPACE FOR Signed:
Before n�.t�hwd 01 1 In
County I St do u!f P�,erda,�hp.,. silly�spo...d
V=1 I I hemin by
Doo#211702,1873,OR 3K 17863 Page 671, hInuslinna,moTanceememasue. --sents and declarations herein
Number Pages I am true and accurate
RacxPd0do2t0I120l7atI225PN1.
Ronnie F-s-0 CLFRKCIRCUIT COURT DUVAL
COUNTY 0.
RECORDING$10-00
—Iff —., rij,s Qourdy of Wvvd.
�Wcomrnwlon expires:
Pioraonali,y M—n MWETA.UVIM
Produced Idenaffication
T�Nsisq Puble Uns�u
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