1907 Creekside Cir re-roof permit S yL
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
.3 J INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0047
Description: 4/12 PITCH SHINGLES
Estimated value: 7900
Issue Date: 7/14/2017
Expiration Date: 1/10/2018
PROPERTY ADDRESS:
Address: 1907 CREEKSIDE CIR
RE Number: 172020 1212
PROPERTY OWNER:
Name: GOODRICH THOMAS W IV
Address: 1907 CREEKSIDE CIR
ATLANTIC BEACH, FL 32233-4505
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: RELIANT ROOFING INC RYAN SHOUPPE
Address: 528 Millhouse Lane Orange PARK
ORANGE PARK, FL 32065
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$7,500.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH -
800 Seminole Road,Atlantic Beach,FL 32233 �
l� 7
(p]
Office(W)247-5826 Fax(904)247-5845 RGRP1 7 'f
Job Address: 1 �I �7 CI�.I SIM Clr Permit Number:
—S6-43 vq j2.S-29 E SQI74� fl'IQ.rina to I-79(77 h- 17.12
Legal Description I lot t i2 Faroe.# ' 2- --'- - - -
��1r Floor Area of Sq'fit --ffes(�,` Sq.Ft
Valuation of Work$y91)O Proposed W]Io�orr�k heated/cooled�,,,L'rJ non-heated/cooled 22999
Class of Work(circle one): New Addition A7teNsion Repair Move Demolition Wol/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Resident
Iran existing structure,is a Bre sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval# Shen 1e5-FL-IOI2.4-1215/unClerlaymer-4 —FL 152-i 6.1-Y0
For multiple products use product approval form
Describe in detail the type of work to be performed: Ye- VOCT- ' y) 34 5Q
41IR PItC10
Proreary Owner reformation: -
Nome: ddress: Y
City C Stam[4Zip Pb mISZ S43
E-Mail or Pax#(Optional)
Contractor].formation;
Company Name:ammm star"e.ire Qualifying Agora' con-asaose
Address:saax..uRxpm.s s gra City amwveneawn Stater Zip seats
office Phone w'a's° Job Sire/Conrad Number wm.mnsromr.-nnaraaso Fmsq sawn-»r -
Stam Ccrtfication/Regisnarion#Farms
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 ie bnx,T dem about, ,r,mi to do lM nnA and inntatian--ta-od! lees M1ouronvhorau lblion bat rommencedpnwrolM1e
a/ onsaf a"that all-4 rill Gepey rmed m meet me standards of all tont rep annY mMimm in ebvla+itdiclion. Thitpe^ni(beromer
!I and wid fwvrkanal commenced wi(ontal6)meper;orJron+lr eessnrwdllawfiralW ora1wdaRSJIRRymod Jt6(61 monthat onetime
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A[ettm,PubaMAir CnRlltlanrrs,eh.
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO
YOUR LE DER OR AN ATTORNEY BEFORE RECTAIN FINANCING
RDING YOUR NOTICE WITH
COMMENCEMENT.
fA b cetHw.ihotl6avz rmdondaamined eM1u aod"onanand Mre, ^�s f n. All�w au bead i, volare mmrae tlbhrte
t owrk 11 M canpliN xilb whether s 71 d Ferein rpt a]be d a"s to B, ry ro
peav darywberfedmd.tmre.wmmt�:rme,sidlorivaar—t hon mem Rre lea„
nscator
Signature of Owner 'aa""�'✓'� Signanue of Contrac[or �
Print Name
`(}�'_l� d41 G Print Name Cameron Shouppe
Swore or and subscribed before me Swore to and subscribed before me
201-7
this y of I this Day of
assay, b m
Nomry is J �« great atlrilB! 1
OTARY PUBLIC NOTARY BLIC Revised01.26.10
+STATE OF FLORIDA STATE OF FLORIDA
Comrllf FF951584 Comn*FF951584
' t Expires 1119/2020 Expires 1/19/2020
Doc ii 2017163222, OR BK 18050 Page 1976, Number Pages: 1, Recorded
07/13/2017 at 08:05 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
IPREPARE IN mx Llx n)
Palmi[No. Tax FUIa No.
Slabat FL CO"MYat 1
To wfamn II may corlarn:
Th.Om1 reldned hebhy Informs you that Imprm amen,WIII b made to mardon.1 property,and In
accordance With Section 713 of ma FIOWD SNNWea,ma fo,PWIV InI mbdon b atebd In this NOTICE OF
COMMMCENEM. I
Legal dow,whIn W property bang improved: ��� O"/'�I '? S C Set V(3..
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Addmaof mopMybele irMoved: �' -
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owner s iMeraal x alb ohne AnpmvelneM
fee Simpk TOehNlder(IIoOSIMnawpeN
Name
Addbae
conb.ab Kellar& Rooflr)a
Address i h 5UIie 11QP 82
Pholle R. 161040-712.-31111 c.x Nn_(Q O4 ^ �77 ^7872
amly(If any) _
Addrosa __ _ -. AntouMof bmld 3
Prom No. Fax NN.
Now are edmab 0M Param made a Mn Ior Me-handa3INn at the mad"W"mmta.
Name
Addbb _
Pho.No. Fax No.
NAM a Mham w1dYn the 8isb MFWMa,odWrmrl himcaa,dwiprlabd by owner"Fonw O,n notices Or~
datlaMnb mer Ib ebved:
Name
Amirms
Plane No. Fax No
In add0bn b NmsalL owner desgmen,the fol WI para",b receive a Nd,,W Ma Llopers NNbcs as phnided In
Sedan 713.06(2)(b),Findde SbNbs.(Fad In at 0~6 opiOnb
Name
Address
phpne No Fax No.
Expyatbn data of Noche W Conroe nand,(me eapislon data bane(1)YOU 11011%the date d amMmO"nada:e
dF W*m d d.Id apedfied):
TNM SPACE FOR RECORDER'S USE ONLY
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nme.W nana3'a ronin errawmx mi num, NOTARY FUDLIO
Dolma Nxnannla -STATE OF FLORIDA
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