1848 FORSYTH CT - ROOF j t•' "'r
i, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j Jz: 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-3866
Job Type: ROOF PERMIT
Description: RE ROOF - SHINGLES
Estimated Value: $6,500.00
Issue Date: 5/1/2017
Expiration Date: 10/28/2017
PROPERTY ADDRESS:
Address: 1848 FORSYTH CT
RE Number: 172097-9815
PROPERTY OWNER:
Name: Parks, Cheryl
Address: 1848 FORSYTH CT
GENERAL CONTRACTOR INFORMATION:
Name: RIVER CITY ROOFING CORP
, CCC1325973
Address: 5018 SPRING PARK RD STE 2 CHAD DAVID BELL
Phone: - -
FEES:
BUILDING PERMIT FEE $82.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $86.50
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
Office(904) 247-5826 Fax(904) 247-5845 7 - ROOF- 3v
Job Address: 1$48 FoR3'TH CT A71.4MTIG BEACH FL Permit Number:
3aa.33
Legal Description 5(.-16 11-o25-eZW.O8b FitazipsCot*THREE(37'T_ Parcel#
Floor Area of Sq.Ft. . y. t
Valuation of Work$ 6j,..<Dls.bZ Proposed Work heated/cooled non-heated/cooled
-moizini
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial
If an existing structure,is a fire sprinkler system ins ed?(Circle one)• a No N/A
Florida Product Approval # L -R4 eriay�►�ji► / /jJ0 leof 0020
For multiple products use product approvalorm A 7Q6� 1S
Describe in detail the type of work to be performed: RE-= Poor'AIG
Property Owner Information:
Name: etieI A J . Ajk 5 Address: ?4 $ Fo y-14 d
City /Q•f/r,zM/ i, -OccztJ / State Zip 32x33 Phone 90iF-S77Lo?SJf
E-Mail or Fax#(Optional) Ca-phks ® q/nk//'Gam
Contractor Information: �J
Company Name: RIVER CITY AcoF/NG Qualifying Agent: CHA4 &LL
Address: 5015 .5PAIN4 PARK RD City .McKSONVILLE State FL Zip 3t2ai07
Office Phone 904- 74 -3444 Job Site/Contact Number 90 4-59B —46.149 Fax# 904-5'79- 3138
State Certification/Registration# CCC I3a5973.
Architect Name& Phone# N _
Engineer's Name& Phone#
Fee Simple Title Holder Name and Address N Q
Bonding Company Name and Address Al A
Mortgage Lender Name and Address N A
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 f work is not commenced within six(6)months,or if construction or work is suspended or abandonedfor aperiod 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, Furnaces,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.
/hereby cert fy that/have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type pj work will be complied with whether spec fled herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state,or local law regulating construction or the performance of construction. /
Signature of Owner 1 . / Signature of Contractor LZ=�/'73`e-'u
Print NamePrint Name
Gil e .... l Ark 11 d� 1/
Sworn tend subsc i ed b fore me Sworn to and subscribed before me Catalina
this ► y of 1� .. , Cef?aMir�e✓Gim thi Day of Ar'C 1 `. ' ARY
NOTARY PUBLIC ,F �/
�• !�f -STATE OF FLORIDA /i / et, �1� ,, TE of FLORIDA
Notary Public -�""�,a,;- Camt�CiO01FI39F) .ry r r '�:''�•' Cotm�lte t3ti01
0389
No Pu �c
•,-.•• Expires 8/3/2020
Expires 8/312020 Revised 01.26.10
Doc # 2017089143, OR BK 17950 Page 86, Number Pages: 1, Recorded 04/18;2017
t 01 :33 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10 .00
NOTICE OF COMMENCEMENT
iPF.EPA E tr:t>Iln!.f:.a^L•)
Permit No. Tax Folio No.-71
_
Sea or R Rd?n. Cc niy of 1LJ VAL.
To whom It may concern:
The undersigned hereby informs you that Improvements we 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.
I odd dcsct:'ntinn o1 papery t sag improved: I7415-cx al • 0010
fiRA�tCt cove 7'> RE7 '
Lor
!«nrires:or Frwerty using imaroved: le FOR 5'I/TH T�
General desctiptdan::1 Gtiprovementt;• Re-ROOF
vrner PARKS 6 .1QYL.. __....._ ._.._.._._.....___....._._.._
Addft.s _ c: r? -r i4 C7- rc.AN roc c.%t._-7"4 1 33
O.stet's interest t'1 Site of the improvement
Fee 81/WAe TiU.Ch Eder fit other than o:•rr.Ctt
Address
Contractor.,. _. RIVERt al Y ROOFING
Adaress 5018 Sprung Park Rd #2,3acksonviIle, Fl 32207
Phone No 9N-766-3464 Falx No. 904-sir-313e
Surety Id any'r ._
Asrkess ...._..Amina of trend S _
Phone No. _.. Fax No.
Narae and adcrea'::of any p.t on making o loan for the construction of the improvements.
Name
Address
- « .,..
Phone No. FuNo.
Name of person:vstnin the State of Cionca.other than himself,Caenrtoted by aviner upon wtWm notices or other
documents may be,ertrr'rr:
N.intc RIVER CITY ROOFING
r+'= ._Q1_l . triii9 PJMJk}�� #2. Jacksonville F1-3�'p�..._.r.. _—
Phone,
.___._o -,_..904766-3464._—._..._..... Fax No. � 313A _______
in addition
in?noised',owner designates true fallowing potion to receive e copy of the Llerwr's Notice as provided in
Section 713.0E(2i(di.Florida Statutes_(Fill in at Owner's aptice.0.
Name RIVER CITY ROOFING
Amara:, _50113 Spring Park Rd #2, S,gk claville, FL 32207
more. o..___..904-766-3464 pax N*. 904-579-333:_ w _
Fxpirat an dote of Notice of Conuncrcement(the expiration date is one 1.1)year from the date tri rece diro unless a
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„ STATE OF FLOR#CiA
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Expires';8/3/2020