1887 Mayport Rd roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
_... ze ATLANTIC BEACH,FL 32233
1. INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 17-ROOF-3291
Job Type: ROOF PERMIT
Description: NEED NOC - re-roof FL10674-R12 & FL15216
Estimated Value: $3,500.00
Issue Date: 2/21/2017
Expiration Date: 8/20/2017
PROPERTY ADDRESS:
Address: 1887 MAYPORT RD
RE Number: 172051-0000
PROPERTY OWNER:
Name: MITCHELL, RONY
Address: 1887 MAYPORT RD
GENERAL CONTRACTOR INFORMATION:
Name: Industrial Commercial Roofing Inc
,CCC 1330880
Address: 3 Kimberly Ln ST
Phone: -
FEES:
BUILDING PERMIT FEE $67.50
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $71.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
•--) /,- Offim r/(9,04/I)247-5826 a Fax:(904)247-5845
Job Address: i (6I f"�cY 1— F ty' • Permit Number: n- few^ SAc I
Legal Description 11 -25-,A ( ) t ff Lwi LO 7 f er 0 RE#
Valuation of Work(Replacement Cost)$ 3S 00 Heated/Cool�edSSF-- Nan-lleated/Cooled
r
• Class of Work(Circle one): New Addition Alteration � Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial _Lesidotiat
'
• 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
/iin detail the type of work to be performed:
l` C �ILr� S'h lny�fs .
Florida Product Approval# i' L I C) — for multiple products use product approval form
Property Owner Information rL p
Name: bin. (h,( �C`� Address: 6M rllt»IA4 R� .
City State L Zip3d9�3 Phone �Qq- til, -J1+7
E-Mail
Owneror Agent (nAgeN,PosaofAnom,ymAge,cy l.alLLr ti,quirek)
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
RECORDING YOUR NOT1CrE OF COMMENCEMENT. LENDER OR AN ATTORNEY BEFORE
Contractor Information:/] �PP / QQ�
Name of Company: TNGYu Sl�l 1, . Aei 1.1 P dAf;l Qualifying gent: Ffnr'iC
Address: 3 1C M 6..1., N. City .r State Zip [-L
Z aox
Office Phone V - qgy�- N Job SiW)ContactNumber Nn - 774-091a
State Cetification/Registration# fri / I IOfYJ E-Mail -Sue /: _ AAr Rs ffl&llfe. .NPI
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation
xem osisrcer mP oYem� xps.pon e
Ap licotion u hereby made to obtain a permit to do the work and installations or indicated I certify that no unrk or installation has commenced
Nvo,''h
w the issuance ofa peal,and that all wank unit he performed to meet the standards efoll sous reguiming construction in thisjurisdiction.
u permit Ixcom.null and vold irnark b nm commenced with.sir(6 months,or ifcom,mMon or work tr sur aded or abondmed(or a
period arrsu(6,momism anythr,e f,,xorh iscommeneed. lis derstand thatsepanne,permitamustbrecouredfor hurriral Work,Numbing.
S(gns, Wdls,Pools,Fnrnacrs,Buff te.,T aF,fTI it Condition,.,eh.
Signature of Property Owner:! Signature of Contractor
Befo (
this, Day of t7 ff�:_"sshury
Before me this y of 1
NotaryPublic: Public: C./
l hereby err 1 application and know rhe some to he rote and correct All provisions a�! 's and
onlhmnces r s d8/G DE#1 he .plied wish xherher speer//+�,d herein ar nut The grunting o/a permit does not
pre"re"to y rite NYFFaM9A1 rl prov&inns of any other jcdernh .care, or local law regulating consnrnction or the
perfonnan UddirdFmr pE90clobera 2119 ^
Lv'C;�> 6onaca rnry w.ary ccex ureerrmen 3q�"'`•'.e+}'"+., Toto GlNnfE3PEflGFROM. 4/16
;.: ._ Mr(YJMMISSIONr FF924951
''.a - EXPIflE9:Odohm&2119 -__
?Ri,t� 9ontlaaiAry No1M'PuucUNrmiim. __..
I�
NOTICE OF COMMENCEMENT
Stateof—L I, County Of
Y Tax Folio No.
To Whom Rmay Concern:
The undemigned hereby informs you that impmvemmm will be made m certain
real Property,the Florida„!utas,the f0powing informative is stated in this NOTICE OF COW jENCEEAPNfnd in accordance with Section 713 of
Iegal Descriptionofpmpenybeiagimprovad:,�� - S - .'�Ct a� I/7 / 0 i l *c a
� /Y(31 ,) n a
Addy—ofpmperlybeing improved: 37 q
�r 1 r2 3 3
General description ofimprovemen';_
Ownm: t�C1,P Address:
" a �c 4 L 3aa7>
Owner's interest in aim of We improvement.
Fee Simple Titleholder(ifodw than m am):
Name:
'Contractor. 4 I I MMlf qc V Int f
Address: INb+rI �wwt Gr 1�.... .1. rl3y O
TalephoneNo: 910'+ 5S4- x1t( Feet No:
safety(if my)
Address:
Telephone No: pmt ofBoW
Fax No'
Name and address of my person malting a loam,for the construction of the im
Name: Doc#2117040473,OR BK 17883 Page 2494,
Number Pages:[
Address; Recorded 02/2112117 at 10 35 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
Phone No: In No: COUNTY
Nance of -
RECORDING$10,00
person within the State of Florida,Other than himself,designated b;
served: Nome: --..•••—as may no
Address: .
Telephone No: Fn No:
In addition to himself, owner designates the following person m focalve e
7I3.06(2NamFlorida Sta'es. (Fill in at Ownm's option) copy of the Liawes Notice as provided in Section
Name:
Address: .
Telephone No: Fu No:
Expiration date of Notice of Comma, ...a d(the expimtion date is one(3)year from We dem of
specified) recording unless a different date is
TRIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: Dye z. z
Before 's ay of F ia thefum4'oflluval, rye
Of am
basperaon ly appeared
Personally Known: „
P uoedldenti6mtion:
Public:
roH,,,i IESPERGER
WCOUMSSIONYFF9211 mmimion espirea:
. i E%%RES:CclrNer 6,21119
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