578 Beach Ave re-roof permit !jam-� 1%n
?� CITY OF ATLANTIC BEACH
y 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-3602
Job Type: ROOF PERMIT
Description: re-roof FL15216-R2 & FL006741R6
Estimated Value: $5,000.00
Issue Date: 3/28/2017
Expiration Date: 9/24/2017
PROPERTY ADDRESS:
Address: 578 BEACH AVE
RE Number: 170148-0000
PROPERTY OWNER:
Name: Woodrum, Michele
Address: 578 Beach AVE
GENERAL CONTRACTOR INFORMATION:
Name: BRANNAN ROOFING, LLC
Ronald Edward Brannan Jr.,CCC1328006
Address: 1024 PEBBLE RIDGE DR OA RONALD EDWARD
BRANNEN, JR
Phone: -
FEES:
BUILDING PERMIT FEE $75.00
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $79.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Building Permit Application
City of Atlantic Beach
e
800 Seminole Road,Atlantic Beach,FL 32233
(] //�/, I (Phone:(904)247-5826 Fax:(904)247-5845
Job Address: 519 +�/c ck Ayic.r __����11 Permitild Number: « "/OAF - `��03'
Legal Descripton ti 1A-16 -aS -a5t PrrT'Ic- ,(,, �S 6- 1 RE# 1701Ne-BOOu
Valuation of Work(Replacement Cost)$ 50D0 '" Heated/Cooled SF Now Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Orde one): Commercial Residential
• 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 data![the type of work to be performed: 1 'C'1 I —
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Florida Product Approval# for muitiple products use product approval form
Property Owner Informatlon Q �1 _
Name: I C 1A.)QjrlAca1 Address: Jt �L 6wil Av1„
City PN (r State Zip 3Ll j�>�Phone /O— L�
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor lnformatio p/� per'
Name of Company: - 041r Oualit& Agent: kfa Ip'
Address 10 7'y f It Z r Cityl State Zio l LLd
Office Phone Job Site/Conbct Number 90 —�i/tJ7
State Certification/Registration if E-Mail
Architect Name&Phone If
Engineers Name&Phone#
Workers Compensation
Exempt/Insurer/lease Emple ars/Expllation one
Application is hereby made to obtain a permit to do the 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 jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify 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 A/%N,�JATTORNEY BEFORE
xRECORDING YOUR NOTICE OF COMMENCEMENT. ^ �� !
/ W)l bt/ )A AAS
(Signature of Owner or Agent including Contractor) (Signature of contractor)
Signed and swom to(or affirmed)before me this�day of$,,Signed and swam to(or affirmed)before me thdsZ day o tWfyy,
Asloa��, ;011 .by MwCh 2V01'-T by ss
aSlgnature W Notary) U (Sign tures lotary)
z
^m
F1(Personally Known OR ( i Personalty Known OR $ P+
F1 Produced Identification Type of Identification
Identification w i€
Typ Type of Identification: Gt/�J lis �.Ct-rtJt 7't nay
�7 Cammissbn#FF 933218
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NOTICE OF COMMENCMENT
State of Florida PERMIT#
County of DUVAL
The undersigned herby informs all concerned that improvements will be made to certain real property,
and in accordance with section 713.13 of the Florida Statues,the following information is stated in the
NOTICE OF COMMENCEMENT(1 r,, Q �I ( (7
Description of property J1U )" HV6 (� '(tGyl ) E\. ,3z23a3
Legal Description ��1+ I'�Q `(8 — CUOb .T7'� /6 '2.5 `29 L * FIAJ1Crt�,Ac�,
LB+ S W-11
General descriptions of improvements Ro-Roof
Owner NAIo df- 'IrpaojrLlm
Address Ol +tYIA44ii(.IDQAfkI (. 3?-L33
Owner's interest in site of the improvement SIMPLE Dec 4 2017070360 OR BK 17924 Page 1344,
Fee Simple Title holder(if other Utas owner) Number Pages:1Recorded 0:3282017 al 09:23 AM,
Name SAME Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Address SAML RECORDING$10.00
Contractor BR ANNAN_R_OOFING,if.
Address 1024 PEBBLE RIDGE DRIVE. ?A KCO 2 0
Surety(if any) NONE
Address N/6 Amount of Bond
Name of person within the State of Florida designated by owner upon whom notice or other documents may be
served: o
Owner M14k Q.. WDA-4�
Address rC L 6wk ift 3a31
In addition to himtherself,owner designates the following person to receive a copy of the Lienor's Notice as
provided in Section 713.13(1)(F),Florida Statutes.(Fill in at Owner's option).
Name rSAME
Address_SAME
TIES SPACE IS FOR RECORDER'S USE ONLY
My Commission Expires y2 11 S 1;lo
OWNER'S PRINTED NAME
Signed before me this.7' ' day of ]�i dAdL 2016
SignatureG 6L 7�f.1�✓ II,, / q, //O TrT TU
1, personally witness II?IP,k&�Ot1s: uo signed this NOC.
CHERYLL BRANNAN
'l u Comniasim0IFF933216
3 ` E(PIMSFebmary15,2020
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