1765 BEACH AVE - ROOF -S Ai'j.
,,
�' r� �S, CITY OF ATLANTIC BEACH
�;-.10v,... .\\ j 800 SEMINOLE ROAD
J r.`... �`' ATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247-5814
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ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ROOF-3751
Job Type: ROOF PERMIT
Description: RE ROOF SHINGLE
Estimated Value: $25,500.00
Issue Date: 4/12/2017
Expiration Date: 10/9/2017
PROPERTY ADDRESS:
Address: 1765 BEACH AVE
RE Number: 169673-0000
PROPERTY OWNER:
Name: SHAPIRO, JOEL R & SYLVIA, *
Address: 1765 BEACH
GENERAL CONTRACTOR INFORMATION:
Name: B. SMITH ROOFING, INC.
Brian Eugene Smith, CCC1326912
Address: 13525 SAWPIT RD QA SMITH, BRIAN EUGENE
Phone: - -
FEES:
BUILDING PERMIT FEE $177.50
STATE DCA SURCHARGE $2.66
STATE DBPR SURCHARGE $2.66
Total Payments: $182.82
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TILE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904) 247-5826 Fax (904) 247-5845 -" Rop F-
Job Address: 1765 Beach Ave, Atlantic Beach, FL 32233 Permit Number:
Legal Description 15-10 09-2S-29E N Atlantic Beach Unit 1 Parcel # Lots 33, 34
Floor Area of Sq.Ft. Sq.Ft `,
Valuation of Work $9,x,500 Proposed Work heated/cooled non-heated/cooled i#710000 1pia
75 SOO
} Class of Work(circle one): New Addition A teration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval# /03 f 3',/ 24-13 3,/
For multiple products use product approval form
Describe in detail the type of work to be performed: Residential re-roof. Remove metal roofing then replace with
architectural asphalt shingle roof
Property Owner Information:
Name:Joel &Sylvia Shapiro Address: 1765 Beach Ave
City Atlantic Beach State FL Zip 32233 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: B. Smith Roofing, Inc. Qualifying Agent: Brian E. Smith
Address: 13525 Sawpit Rd City ,[ cksonville State FL Zip 32226
Office Phone 904-378-8605 Job Site/Contact Number 904-378-8605 Fax# 904-378-8606
State Certification/Registration#CC-C1326912
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
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 laws regulating construction in this jurisdiction. This 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, urnaces, Boilers,Heaters,
Tanks and Air Conditioners,etc.
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.
I hereby certify that I have read and examined this pplication and know the same to betrue and correct. All provisions of laws and ordinances governing this
type ofwork will be complied specified with whether speced herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federales ate, or local law egulating construction or the performance of construction.
Signature of Owner f A � t • • ignature of Contractor
Print Name c.ko! 1>(Q Print Name Brian Smith
Swor1 to and subscribgkbefore me Sworn to and subscribed before me
this-en Day of Kg- 20 this 1/ Day of O / ,2017
.�irJVly? 11 . L' [+1 maim
Nota Public '
DONNA All,SETARO • q, %( gevisATHLEEN R.BEARDSLEY-
pgy COM IISSION u FF24t�'80 • • .I ;d 01.26.10
. � cT EXP
August 20,2019 I Expires November 16,2020
n9 "„�' 9or QKd TM Troy Fikl Imam 500.315.103
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legal description of property and address if available):
1765 Beach Ave, Atlantic Beach, FL 32233 15-10 09-2S-29E N Atlantic Beach Unit 1 Lot 33, 34
2. General Description of improvements:
Residential re-roof, minor interior renovation, cosmetic exterior renovation, and replacing existing deck
3. Owner Information:
a)Name and Address: Joel&Sylvia Shapiro 1765 Beach Ave,Atlantic Beach, FL 32233
b)Interest in property:General
c)Name and address of simple titleholder(if other than owner):
v1c)
4. Contractor Information:
\ NA a)Name and Address: Bosco Building COntractors, Inc. 2158 Mayport Rd, Jacksonville, FL 32233
b)Phone Number:(904)241-0320
5. Surety Information:
a)Name and Address:
b)Phone Number:
c)Amount of Bond: $
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a)7,Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to himself/herself,Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713.13 (1)(b),Florida Statutes.
a)Name and Address:
b)Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
t in a to the b to y knowledge and belief. o�� R . Sh o� Ido
x--,— , pi 1 Sy l yr a ?S. sa..Plc-d� 0�S
Signature f Owner or Owner's Authorized • r cer I i ector '4/1-r� 4.nager Signatory's Printed Name&Title/Office
The foregoing instrument was acknowledged before me this v--2, day of MC(`G(41 ,20 /7,
by 30e 1 r cvIuia Ooi1W as Ownefor .
(Name of Pe son) (Type of Authority,i.e.officer/Attorney) (Name of Party Instrument was Executed for)
-TErtitA4a, pirla)
NOTARY PUBLIC, STATE OF FLORIDA
Print Name: O(Ot t(l SPA'"0
Doc#2017084020.OR BK 17943 Page 78, -
Number Pages:1 NPersonally Known ►, pBp M.SETARO
Recorded 04/12/2017 at IRC IT Identificatiorffype: tar ssioN
Ronnie Fussell CLERK CIRCUIT COURT DUVAL pEutr5•A.p�
COUNTY 441140f Fs,
A 2019
RECORDING$10.00
Revised 3/15/12