1644 N Linkside Ct re-roof permit ";SS 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
JOB INFORMATION:
Job ID: 17-ROOF-3615
Job Type: ROOF PERMIT
Detscription: re-roof FL1956.3 & FL2569-RlO
Estimated Value: $8,000.00
Issue Date: 3129/2017
Expiration Date: 9/25/2017
PROPERTY ADDRESS:
Address: 1644 N LINKSIDE CT
RENumben 172374-6260
PROPERTY OWNER:
Name: FITZSIMMONS, SHEILA
Address: 1644 IN LINKSIDE CT
GENERAL CONTRACTOR INFORMATION:
Name: PIMENTEL ROOFING INC
Ramon 0. Pimentel,CCC1330935
Address: 321 4Th AVE
Phone:
FEES:
BUILDING PERMIT FEE $90.00
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $94.00
PERIKIT IS APPRO'VED ONLV IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORIDINANCES AND ME FLORIDA
BUILDING CODES.
Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FIL 32233
Phone: (904)247-5826 Fax:(904)247-5945 C)0 (0
Job Address: Permit Number.
Legal Description
Valuation of Work(Replacement Cost)$ �3j QC0. Heated/Cool,dSF *21;-00 Non-Heated/Cooled_
• Class of Work(Circle one): New Addition lj�lterafio Repair Move emo Pool Window/D
• Use of existing/proposed structure(s)jorcle one): Commercial esidenti
Yes No No
• If an existing structure,is a fire sprinkler system installed?(Circle one): /A Tree Removal
• Submit a Tree Removal Permit Application if any trees am to be removed or davit of No
Describe in detail the type of work to be performed:
I-e
X�Ieri I- 3e>,,z. Ac�.
Florida Product Approval If I formuA' JeKoclnuuse product approval form
Property Owner Information
Name: I'4-Z Address:
CitviA��-'--.':'S�V,, ._StateV-1 Zip '3 Z�33 Phoneao!o e,2 07 -12-9,0 9
E-Mail
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required)
Contractor Information
-t' I Agent: T, '.2fZ1
Name of Company: irvlt�jylf T-o&:�, -TIOC, Qualifying RA x,0,2
Address '3 1 tS-"X`ALfP. A2. 4't �Iwe lr�L1. zip -5
city 7-2-t'a
Office Phone_CEO V I Aq !E6irli! _Job Site/Contaict 1�4..b.l
State Certification/litegistration# r C C,14 3 04 b E-Mail
Architect Name&Phone If
Engineer's Name&Phone#
Workers Compensation Exempt Insurer I Lease Employees/Expiration Date
Application is hereby made to obtain a permit to work and installations as indicated.I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
construction in this ju riscliction.I u nclerstand that a separate permit must be secured for ELECTRICAL WORK,PLU MBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I perilty,that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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
RECO UR NOTICE OF COMMENCEMENT
OT' OF LUMMtPiL"
(Signature of Contractor)
J' 4
Co of ow e
(Signature of nar ,Ag mclRdl."Con'r
I'igned an"n"Jum to for Fir I 'fore m"Cmnrjt�day of Signed and sworn to(or affirmed)before m this day f
-1-1 �,,n to(or affir )before me this
MAM 1,b17 by- by
EXPIRES S.R.arbar 18,X18
I Personally Known OR idpersomally Kro.n OR
[Omduced Identification I I Produced dantlfikatib�
Typeof Identification: li:/. P1,'tor-g Type of Identification:
NOTICE OF COMMENCEMENT
Strueof Ell Countyof TaxFoHoNo.
To Whom It May Concern:
The undmigned hereby mimms 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
Legal Description of property being improved: V�!-0319-
Address of property being improved: I&gy J'J�. ]E�/-�91,A� -3Z77,3
General description of improvements: J—!e J A �A�ej '1W(4
A, 1, A)
7—
Owner: 9. 1�2�1 1A1( Address:
4 k Owner's interest in site of L improvement: 14, L11-I A Ali'
Fee Simple Titleholder(if other than owner):
Name;
Contractor.
Address: '315' J6'T*Ajje,A), A F�'
TelephoI Frsr�No:
Sorely(if my)
Address: Amount of Bad
Telephone No: Fax No:
Name and address of my person making a loan for the construction of the improvements
Name:
Addrees:
Phone No: Fax No:
Name of person within the State of Florida,other than hirnselt designated by owner upon whom notices orath6r 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 Lima'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):
TMS SPACE FOR RFCORDERIS USE ONLY OWNER
Sign Date: 3 — ;?o—/ 7
B me this_day in the County of DuvaL State
Florida,has persocally appe
0.#2017071W.OR BK 17926 Pa,,e 1528, Personally Known: or
'4umber Pages,I Produced Identification:
Recorded 03(A2017 at 12:24 PM. NotaryPublic: . .... ...
Rmnte Fussell CLERK CIRCUIT COURT DUVAL
COUNTY My commission expires: s
RECORDING$10.00 RE"
I