1949 BRISTA DE MAR CIR - ROOF 4 xq...: fl
��
r CITY OF ATLANTIC BEACH
C800i r
SEMINOLE ROAD
r
ATLANTIC BEACH, FL 32233
"% -
r / INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0018
Description: re-roof FL16305 & FL16226
Estimated Value: 12546
Issue Date:
1 Expiration Date:
PROPERTY ADDRESS:
Address: 1949 BRISTA DE MAR CIR
RE Number: 169506 1662
PROPERTY OWNER:
Name: KLEPPER BRIAN R
Address: 1949 BRISTA DE MAR CIR
ATLANTIC BEACH, FL 32233-4525
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: AMERICAN ROOFING OF JACKSONVILLE
Address: 1720 Wildwood Creek LN
JACKSONVILLE, FL 32246
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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 RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
I
.rNply Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
'`s'I' ( Phone: (904)247-5826 Fax: (904) 247-5845
Job Address: {9 119 81"1 SrA t , Ma"- Ci {�t c Permit Number: 1`C (Z
- E i i -00
Legal Description 410-31 09-.2S•-Z1E- $•e. N04G 01.4 L01 SCe RE# (09 6.°61 -1 bfc2
Valuation of Work(Replacement Cost)$ 12, 5"�° Heated/Cooled SF .t • Non-Heated/Cooled Z5.50
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool 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 /A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type/�of work to be performed:
re".-re, .- Gjr'cr s 12•t 2.O0C , Z S4-0 r) (e: IL [���-k Aspha.1.1' s►+• its
Florida Product Approval# /43f 5 el/,e-t L26 for multiple products use product approval form
Property Owner Information
Name: Broe*n 14141eppGe Address: 14'aC) B r'stA De M40- Ci r
City Mln.4l-:L ESt/a(. 1 State FL- Zip 317.33 Phone
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information �_ I,
Name of Company: AneAC.rArj goo(L$,9 Ysoi(. IIC Qualifying Agent: b44t �' xLII
Address SØ441 H•7 SI- &kits ii -4 Rd 5 City 1.411 State Ff;,,. Zip 311-440
Office Phone 904 3 S5 4515 Job Site/Contact Number
State Certification/Registration# QC 2gat,s46' E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation _
Exempt/Insurer/Lease Employees/Expiration Date
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 AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT. V
44---
(Signature of Owner or Agent including Contractor) (Signature of Contr'ctor)
Signed and sworn to(or affirmed)before me this p; day of Sj ned and sworn to(or affirmed)before me this 0 day of
S01V6 , aO[.7 ,by 131 A ' V-L fak .,0.-t-e .d) 7 ,by
.t 0 Nin (Signature Notary)
;;n+?u¢• MATTHE G
,.. 4;11 Commission#GG 025007
Expires August 25,2020 •:�"" JENNIFER JOHNSTON
••:f,..g.• Bonded Rev Troy Fain Insurance 800.3857019
I., ti: MY COMMISSION#GG 042984
[ ]Personal) {(�y{p� Personally Known OR ` EXPIRES:October 27,2020
,L)]Produced Identification [ ]Produced Identification af«a,".:' Bonded TtruNotary Public UndenerWrs
Type of Identification: Of�AC. IALZKi Type of Identification:
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 163509-1662
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):
40-37 09-2S-29E SELVA NORTE UNIT TWO LOT 86
1949 Brista De Mar Cir, 32233
2. General Description of improvements:
Complete Tear-Off and Re-Roof
3. Owner Information:
a)Name and Address: Brian Klepper- 1949 Brista De Mar Cir, 32233
b)Interest in 100%
c)Name and address of simple titleholder(if other than owner):
NA
4. Contractor Information:
a)Name and Address: American Roofing of Jacksonville
3047 St Johns Bluff Rd S, Suite 7, 32246
b)Phone Number: (904) 385-4375
5. 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
therein are true t the best of my knowledge and belief.
Ell^^1 r .," Brian Kolepper
Signature of Owner or Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The foregoing instrument was acknowledged before me this b3#� day of 50NE ,20 17,
by Brian Kelpper as Owner �rfor NA
•
(Name of Person) (Type of Authority,i.e.Offi;r/A orne
y) (Name of Party Instnument was Executed for)
:a¢••; MATTHEW NGUYEN N T R PUBLIC STA E OF FLORIDA
t;:Commission#GG 025007 n
• ,;
j . .!ExpiresAugust25,2020 Print Name: 1)'\V�'TT )V h7U t rV
• ;1°• Bonded Thru Troy Fain Insurance 800.385.7019 I
"°•"" ® Personally Known
® Identification'Type: f(.._ 0 k--
Doc#2017135072,OR BK 18012 Page 333,
Number Pages:1
Recorded 06/08/2017 at 04:10 PM, Revised 2/01/16
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
IRECORDING$10.00