366 6TH ST - ROOF r Jai
f CITY OF ATLANTIC BEACH
., 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Ly
'"-ri;3 ... INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0007
Description: SHINGLE ROOF
Estimated Value: 16000
Issue Date: 5/11/2017
Expiration Date: 11/7/2017
PROPERTY ADDRESS:
Address: 366 6TH ST
RE Number: 169871 0000
PROPERTY OWNER:
Name: PAULA CHUNN
Address: 366 6TH ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: A.J. WELLS ROOFING
Address: 5432 WELLER PL QA ARTHUR J WELLS, JR
JACKSONVILLE, FL 32211
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$7,500.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 34,(-I (? s-1- Permit Number:
' Legal Description 5-L 9 to- 2 S -29f I� 1 Parcel# it�I gi I— 0600
/ Floor ea of� Sq .Ft. q,Ft
Valuation of Work$ /4')O( , 00 Proposed Work heated/cooled ILL"7 non-heated/cooled /9f(O
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial esidential
If an existing structure,is a fire sprinkler system installed?(Circle one): es o N/A
Florida Product Approval #F2106.74./
For multiple products use product approval form
Describe in detail the type of work to be performed: e'
&rove am,-/607bee Q„S'iotLe.-
Property Owner Information:
Name: ?Qui& Cl.onn Address: 3(1,q (lib S-(-
City I4-1-Ian4;c Btor h State FL Zip 32233 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: A.' We113 Qoc�•C;n9 and eonz4cocL or- Qualifying Agent: f rTur We ik
Address: 3'(o SI CO`I cad Ave. City T eKsonI i 11c State R. Zip 32211
Office Phone %kJ-St3-d0Gq Job Site/Contact Number +4L -0(a 16, Fax# qo -SS 1-c,283
State Certification/Registration# COC .132 71-7
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 ofa 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 tf work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor 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, 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 herebycertify that I have ad and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work rework will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other fe ral,state, or local law regulating construction or the performance of construction.
Signature of Owner J `- USignature of Contracto
Print Name �I
...... (,� l(��j'�►`^"A.1. Print Name ....A411.v.1C We 113
Sworn to and subscribed before me Sworn to and subscribed before me
this j _Day of MON ,20 I 1 this J Day of (no,y ,2011
l' ,DAA- t4triitlir4LL
Notary!'ublic N
KELLY SHOTT I KELLY SHOT '
MY COMMISSION#G0094622 MY COMMISSION#GGO 3d 01.26.10
o„�;; EXPIRES April 16,2021 .,p. ,,• EXPIRES April 16.2021
Doc # 2017103731, OR BK 17970 Page 33, Number Pages: 1, Recorded 05/04/2017
at 09:44 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPUCATE)
Permit No. Tax Folio No.
State of FLORIDA County of DUVAL
To whom it may concern:
The undersigned hereby informs you that Improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following Information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: (6 911 __ ( tp-•Z S - Za£ . 189
t 4-,, 4 4 C �kGrf k
L/ /L�4- 21 , E. s+�- Le#29 std 1
'/
Address of property being improved: 5' 7� T
General description of improvements:ROOF REPLACEMENT /
Owner / C c:,/yJ
Address 3 Y' O?V 5-11—
Owner's interest in site of the improvement PRIMARY ESIDENCE
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor X11 WELLS ROOFING AND CONSTRUCTION
Address 5651 COLCORD AVE JACKSONVILLE FL 32211
Phone No.904.553.0068 Fax No. 904-551-4283
Surety(if any)
Address Amount of bond$
Ph a No. Fax No.
Name and a ress of any person making a loan for the construction of the improvements. �.-
Name r-�
Address
Phone No. Fax No.
Name of person within the State of Ron. other than hi r .f designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. F: No.
in addition to himself er designates the following person to r...' a copy of the Lienor's Notice as provided in
Section 713.06 (b),Florida Statutes.(Fill in at Owner's option),
Name
A. ass l
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date Is one(1)year from the date of recordia
e
different date is sped): ng unless
THIS SPACE FOR RECORDER'S USE ONLY i OWNER ' „,'••'
Signed: � DATE
ee7
was , J day of e.runr C1 �m obi 0
County•, al.•'-to of F•-•...hes.. • appeared
- n by 171
- 'her a •- - ai-...-moots and declarations herein
are true and accurate ip Cl) r
D
i ac =
464
Notaryt u at'.arn. '• 'aof, 1'L . Cotntyot Orvc 1 _ 1
•
Ay ren iigei•-. ...oi:
2
cad identlftaton ! __