920 CAMELIA ST - ROOF C)1 . CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
'.-0/1 INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0003
Description: re-roof FL10124 & FL15487
Estimated Value: 6820
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 920 CAMELIA ST
RE Number: 170971 1100
PROPERTY OWNER:
Name: PAYNE JAMES W
Address: 920 CAMELIA ST
ATLANTIC BEACH, FL 32233-2500
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: TOWNSEND ROOFING & CONSTRUCTIONS SERVICE
Address: 10418 NEW BERLIN RD APT 115 QA RANDY CRISS
TOWNSEND
JACKSONVILLE, FL 32226
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$7,500.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845
Job Address: Z0 ( ene-(i" � Permit Number: L -e- 'I 1 - cce)�
Legal Description 6-39 3 q-5-Z1F . 1 A41 +.c et4AN Cet,H arcel# 1-70, -?/—f l D 6
ou Floor Area of Sq.Ft. Sq.rt
Valuation of Work$ �f 0 L Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial •esidenti:
If an existing structure,is a fire sprinkler system installed?(Circle one): - No N/A
Florida Product Approval# LO 29
For multiple products use product approval form
Describe in detail the type of work to be performed: 6:-F eller y D re c 4-
(L 6..-F Th.e-r Paw UYVI4t-147 ,4 rL 15Lit -7
Property\\Owner Information:
Name: �Jc1 5 VVA..)he Address: CiZO 14City 01-1-14,vs-fi Q,pttc.L State fLZip 3Zz3 3 Phone 3ret
- 67 67
E-Mail or Fax#(Optional)
Contractor Information: p �" —� l
Company Name: 6Wv►Sein6 Rbo(in ¢(0 hL c on �c/Nce>i Quali ing Agent: RAkdy I CGoi O
Address: I D'I 9 New tZer l;h 1 • (i 5 City ac it-scriu%f(e State I L. Zip 31Z 2 6
Office Phone 10 LI-645--5 W7 Job Site/Contact-Num ber aris 47z-41971 Fax# I p q—(,y5-5 `/`/Z
State Certification/Registration# GLC i"4 Z L Zi) !'
Architect Name& Phone# r
Engineer's Name& Phone#
Fee Simple Title Holder Name and Address MAY - Q 2Q17
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 f work'is not commenced within six(6)months, or if construction or work is suspended or abandonedfora period of six(6)months at any time a t'er
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.
I hereby certify that I have read and examined this a,pplication and know the same to be true and correct. All provisions of I,. %
Doc # 2017093766, OR BK 17956 Page 296, Number Pages: 1, Recorded 04/24/2017
at 10:02 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
i PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 170971-1100
State of Florida County of Out
To whom It may concern:
The undersigned hereby informs you that improvements will be made to certain real properly,and in
accordance with Section 713 of the Florida Statutes,the following Information Is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 18-34 38 2S20E.11 ATLANTIC BEACH SEC H LOT 4 BLK 164
Address of property being improved: 920 CAMELIA ST. Atlantic Beach,FL 32233
General description of improvements:Roof Replacement
Owner_lames Payne
Address 920 CAMF.i.TA ST.Atlantic Beach FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Toy/mend Roofing and Construction Services,Inc.
Address 10418 New Berlin Rd#1 l5 Jacksonville,FL 32226
Phone NO.904.M6-6887 Fax No.904-645-5442
Surety(If any)
Address Amount of bond$
Phone No. _ Fax No.
Name and address of any person mating a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida.other than himself.designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. _ _ Fax No.
In addition to himself,owner designates the followng person to receive a copy of the Lienors Notice as provided in
Sect 713.06(2)(b).Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone 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):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
signed.: DATE VA/1}
Bela.me Qn } in ale
Ccuay of D . e of nortO;,ries l/ersorteily appearee
al.'i' A n[ herein ty
{tdmse5 herself and alms that renis artiteftevatie
are true no accurate tp;•'•y h FF 092654 "1".7„/
092654
* * EXPIFIES:Meech 25,2018
."4reI �A gerdedipre lltgethe y Saviors
hoary Public at barge.stave Cr County of
Aly commission ex*ae: 3 •Z7 s. g
Personally Known X .. ... or
ProA.ICetl Identncetlon