311 17TH ST - ROOF CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
P v ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0008
Description:
Estimated Value: 12895
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 311 17TH ST
RE Number: 172020 0244
PROPERTY OWNER:
Name: RUDEN ANN V
Address: 311 17TH ST
ATLANTIC BEACH, FL 32233-5811
GENERAL CONTRACTOR INFORMATION:
Name: JOHN GILMORE
Address: 10950-60 SAN JOSE BLVD #196
JACKSONVILLE, FL32223
Phone: 9048808044
Name: JOHN GILMORE ROOFING, INC.
Address: 11647 GWYNFORD LN QA JOHN CHARLES GILMORE
JACKSONVILLE, FL 32223
Phone: 9048808044
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
1 exceeds and estimated value of$7,500.
rj14J.N,. BUILDING PERMIT APPLICATION
\sY CITY OF ATLANTIC BEACH DATE
800 Seminole Road,Atlantic Beach FL 32233 C
ffice:O (904)247-5826 • Fax: (904)247-5845 J/1 1. I 1
\4L-)T11914
Job Address: 3 1 1 r 4-h eJ Mj t1 c 8€iLCh Permit Number: R CR F 17'0
Legal Description<-5/-715/ - 6 q -as d,9I Slut 0/.1/lun,f-(p RE# /' 7Ao - Q Z
LO l 8/ 12 895
Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled
• 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 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: Fe-Rio F nv,�e,q `ReS�cl.enc-e Per' na-adi&r- Spec:
-L� ) l w rCL 3 tJc.krsbi elob dm' sn Or, y/12 P, ch Rcof, al so i nsl-e 1 l't13 -Mott,Fret(
&tf'men to PU f(OO4 per SpecS.
Florida Product Approval# FL. 10 b 1 4- R 8 FL 2633. for multiple products use product approval form
Property Owner Information
Name: Pc n q U e(/1 Address: 11 1r/ S �—
City a Ka-rtlIC Reaeh State r--LZip 32233 Phone 72-S- - Lf9 9
E-Mail
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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.
Contractor Information:
Name of Company:&hn GAIY1Oc. � 3 toe Qualifying Agent: S1941Q�kmo -c
Address: IO SO' b ZanJoie Ql udt lflq(oJ City 6OICk.sbnUi IIS State(Zip 322-2
Office Phone 96U- no -8-044 Job Site/Contact Number 9e'- 9 S S-1 7
State Certification/Registration# Ca-657(079 E-Mail Rz1e oa h o113,4 0 l 1.CO N1 -
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation F'lzSPr SrF. &u i 1 2-0 13
Exempt / Insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. I certiji 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 if work is not commenced within six(6) months, or if construction or work is suspended or abandoned fqr a
period of six(6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,
Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc.
Signature of Property Owner: 1Z',t40 p,t Signature of Contractor: rd, `. /'
Before me
this I Day of I /, c Q Before me this 9 Day of Y ale//7
CLEO LANGWE a IE C.RICHARDSON
Notary Public. ``ifsi4� , r e uNotar Public: �3�-��''" =` Y
/� of Florida �. PUBLIC
Commissiortp FF149302 STATE OF FLORIDA
My comm.expires Aug. 10 g01B !.v FF
I hereby cert that I have read and examine t is is t-• < ne to be true and correct. Al.',' . -K' nr o a« i
ordinances governing this type of work will be complied with whether spec' ted herein or not. The granting u a p. I8 18
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.
Rev. 5/2/16
NOTICE OF COMMENCEMENT
•
State of Fr/!'14k County of Jk!t/et Tax Folio No.
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. t
Legal Description of property being improved: 34/5/ 6 41 -:S Lci E St I(la Tqr/net vni/ 1p Lc /
6l oct /5
Address of property being improved: 1 J 1 7 S�y-- Q.rc_ .
General description of improvements: RP-(ZCOT-
Owner: ny7 Ruder) Ale/ etteLn Address: 3/) 1 r716 /IJu -tC &alfa re__ 3 223
Owner's interest in site of the improvement: Re s I ck'YLC_�
Fee Simple Titleholder(if other than owner):
Name:p /t p,�`
Contr ctor: \i0(rwL G�1 trot) r t -U- , •
Address: I Qq 50-(PO S �'lQ . B‘vo( 1 Q cp SGRSO ny i 1 le, P' ,2,zz3
Telephone No.: 1Oq- 8".8"0 0 4-1(4 Fax No: g g O`(0 1
Surety(if any)
Address: Amount of Bond$
•
Telephone No: Fax No:
Name and address of any person making 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:
Telephone No: • • Fax No:
In addition to himself, owner designates the following person to receive a copy of the.Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address: •
Telephone 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 Alf/
�Q� �/Signed: A �{�" Date: D 1al j I
Doc#2017110299,OR BK 17979 Page 72, ore me this ` day of int e Co my of Dul,State
Number Pages:1 Florida,has personally appeared nN . len
Recorded 05/11/2017 at 01:28 PM, zonally Known: or
Ronnie Fussell CLERK CIRCUIT COURT DUVAL iuced Identific:j n: 1,_ ��� r ca—
Ali
COUNTY ary Public: , = _ �- �-Zigniiiii11111
RECORDING$10.00 commission expor: d,47:rZr=W EO LANs ,
,�� '" 'U.IC,State of Florlda
,..; Commission t FF149302
My comm.expires Aug. 10,2078