465 AQUATIC DR - ROOF 4t.i.v.„,,,,
CITY OF ATLANTIC BEACH
aA°
'� 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
"74 r;3 !) INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0005
Description: FL10674.1-R12
Estimated Value: 3500
Issue Date: 5/11/2017
Expiration Date: 11/7/2017
PROPERTY ADDRESS:
Address: 465 AQUATIC DR
RE Number: 171818 5300
PROPERTY OWNER:
Name: FALCON RICHARD
Address: 465 AQUATIC DR
ATLANTIC BEACH, FL 32233-3835
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ALTON ROOFING SERVICES
Address: 532 Locust ST
JACKSONVILLE, FL 32254
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$7,500.
rt ;- Building Permit Application
r) City of Atlantic Beach
\� v 800 Seminole Road,Atlantic Beach, FL 32233
�t
Phone: (904) 247-5826 Fax:(904) 247-5845
Job Address: �f(0 S A'J.t r hC_ 7r. Permit Number:
Legal Description E.
if- 7/ / 7 -2 S'— ZC/e Aqua fic 6"i clen c IQ!Z'-DRE# 17/8i 25500
Valuation of Work(Replacement Cost)$ 25co. 00 Heated/Cooled SF I 4 b 0 Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door CC-Jr oa
• Use of existing/proposed structure(s)(Circle one): Commercial esidentia
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/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:
C 611119Ie-1-e re ro of
Florida Product Approval# 1: 11(:) (0-14 . i - K 1 a for multiple products use product approval form
Property Owner Information /� f n
ri
Name: l'I chard Falco tt---11 _ Address: +b5 l,� U G 3 , C i J
City cA f +i C ( e* 1-
State l Zip 3223 3 Phie Cin-1 - 2 .3S-• 5 a 4
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of company Ct 3 • Qualifyi g Agent: Of)fI n ..7`/�I I l 4-6-Y)
Address 537 LO Cu S4. v Gt-. L JSV- City OC x . State I. Zip 3g-OS---.1
Office Phone q0.1.- 33 S 3.D 4' Job Site/Cont1a Number Der\r. i S .
State Certification/Registration# C29O21Sf[� E-Mail (� #14(ZS @q mar (. ( (fel
Architect Name&Phone# N A J
Engineer's Name&Phone# N A
Workers Compensation Np
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.
,Y.A4Ai.t �-
( , 4
nature of Ow or Agent including Contractor) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this 9Th Q day of Signed and sworn to(or affirmed)before me this -Ii day of
frlry , Z 0 I 7 ,by __, "LOD , by (enNS ,4(
•w"%1"` TRACEY KLEIN !�V/` '
bOn.� I w�
• 1 18 (Signature of (Signature of r- .
+�1* Commission#GG 3 0 ( g Notary) ( g
My Commission Expires
t September 15. 2020
i! K 'ITTy GM
]Personally Known OR rsonally Known OR 4: .i MY'COMMII3 ION 0 MOM
[y}�roduced Identification [ ]Produced Identificatio t ''�i.j f. QXPNlE9�'IlOhility 12 MO
Type of Identification: p L Type of Identification: �t� -,
1
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATEI
Permit No. Tax Folio No.
State of •F or i d cc County of .0u1/4.i Ct t
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 improve :_3_2' — -1 1 7 r 28 - 2.9 C
I yCl1c ��arc• PnS 1_0+ 7.4 - n
4 t
Address of property being improved' 6 A I"7 , I •
General description of improvements: re r(a-t-
Owner 1 1 icd/ho C- (2 COn ( f r
Address 46.35 0 ��C1- ` C 01. , I ci ( (. R c h 1,- , 32233
Owner's interest in site of the improntW of
Fee Simple Titleholder(if other than owner)
Name
Address J) �ff� (.0r-)
(1r ( / I
Contractorc—( T U r 1 t-Q n�( e V. 1'i s eS rL- L C-
Address J . 'D . a C L S �sC� 0(2 x . 1 • 3 Q Q-5-G
Phone No. ' 13 S -5,.)Q�' Fax No.
Surety(if any) 1 JI.,"3
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name /ht
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 my/be served:
Names _A.�4
Address
Phone No. _ Fax No.__
r
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.0 (2)(b),Florida Statutes.(Fill in at Owner's option).
Name Y`
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 /� , �COWNER
Signed: (Z-P �'6 , �f DATE Y• 21"/7
Before me this a day of 4.4'6^
at,I — — —inihe_ — — -_ — -_
aunty•f Ouval a, •f Florida.Hes personally appear ,,,,,uu,
4 ' /' "A ° .: "O'' by MARGARET M.MANAHAN
himself/herself and affirms that all statements and declpa- 'tip
' �,%
Doc#2017107656 1 = Notary Public-State of Florida
OR 6K 17975 pa are true and accurate 1 r Commission#FF 2 4028
Number Pages; 1 Page 1245,
Recorded 05i0912017 at 01:08 PMI %.RA„>;,���`°, My Comm.Expires Sep 6,2019
Ronnie Fussell CLERK CIRCUIT /,A.A2, # — — —'
COUNTY COURT DUVAL
RECORDING$10.00 Notary Pu4 at Large.State of l County of b
tvly on expires: _
Personal •nn Or
Produced Identification Y Lt^
�. ,VP/isI I cev 5 Exp.. 7-/r-J7