1065 LITTLE CYPRESS KEY - ROOF CITY OF ATLANTIC BEACH
1.5V S? 800 SEMINOLE ROAD
•r 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: RERF17-0065
Description: Tear-off& Re-roof Shingle
Estimated Value: 8129.69
Issue Date: 8/1/2017
Expiration Date: 1/28/2018
PROPERTY ADDRESS:
Address: 1065 LITTLE CYPRESS KEY
RE Number: 172027 5828
PROPERTY OWNER:
Name: WHITE NANCY
Address: 3780 VALLEY PARK WAY
LAKE WORTH, FL 33467
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ROGERO &WILLIAMS ROOFING CONTRACTORS IN
Address: 883 Lawhon Dr ST
JACKSONVILLE, FL 32259
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$7,500.
o Building Permit Application Updated 5/5/17
il 9 City of Atlantic Beach
'Wtr
800 Seminole Road,Atlantic Beach, FL 32233
` n 0- Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: /d6 c...- G6)'f/t Cy i(SS 417 y Permit Number: RE(F-1 7 -ed‘
Legal Description c/60 1726-21 E S aC VA1 /,4I - (II f'r 3 Li07 // RE# 172-0 2-7 --c-82A7
Valuation of Work(Replacement Cost)$ T/a9,0 Heated/Cooled SF 16,06 Non-Heated/Cooled <,76
• Class of Work(Circle one): New Addition Alteration -epair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial R-sidentia
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No al
• 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:
,fit-4nr
Florida Product Approval# /:16-/06 74- /2/O for multiple products use product approval form
Property Owner Information /
Name: /✓,4itel Gt//% l/moi Address: 3371 I/ V d¢I S4IJ�/
City i- wan/ State P- Zip 33'-ib 1- Phone Sl, / - Z-S't —v7 34
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information /4V-ii.
/� / /�
Name of Company: �i;yt) it t-/i //�A S /"c{,6 Qualifying Agent: .knee- '1 ry /tea CI)
Address 3(i is- �( if-40-6 JJJJ City JA- State /C1 Zip 327 S---7-
Office
Office Phone 074 <7 r S 1 4,3 Job Site/Contact Number 77/✓r1 A/a7Z.t5 90'/ 607-gw I
State Certification/Registration# r,['r/33631 E-Mail
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation
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 UR O E OF COMMENCEMENT. /
atu o O Owner or Ager-- ---
7
t
) diiiiiw-11111L7).'4")
(Signature of Contractor)
(includi : ontractor) l
Aned and sworn to(or affir -e)bef• - m• this day of •Si d\and sw9j to or affir 0%) before r'- this (. day of
?o [ 7, by_ - I `��' 2b17 , .
1WAll"" . II ' WilkiNEkb.
„.,..... .
(Si: . re o ota (Signature of Notary)
7."ar.:y TONT GINOLESPERGER
il MY COMMISSION#Fr 924951
,s• �• = EXPIRES:October 6,2019 y.
[ ]Personally Know
Bonded ThruNotayPublic urderwriters [ ]personally Known OR�` ' \YY"rl� TONIGINDLESPERGER
ki . . = MY COMMISSION 0 FF 924951
[ ]Produced Identifl i•n [ ]Produced Identificati ;. EXPIRES:October 6,2019
Type of Identification: Type of Identification: fI ."4 cF........ 6cndedThroNc:ayPubtcUndenvriterS
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
C'S Office (904) 247-5826 Fax (904) 247-5845
Job Address:IR,�!L_. _ .Ljthed_-..0 pres_*. Permit Number: ._-h 1F17" (X)(aS
Legal l)escri )tNUN'+ C-241 01 _ ' .1.9 ' W arcei # O — J� �� ,,,_._
oor rea o" ,q. •t. q. 't
Valuation of Work$2)t 2..Q,0'1 Proposed Work heated/cooled 1(p D(p non-heated/cooled, __
D.(0
('t rb of Work(circle one): New Addition Alteration Rcpai MoveDemolition pool/spa window/door
r
Use of existing/proposed structure(s) (circle one): Commercial . Residenn`
If an existing structure, is a fire sprinkler s stem installed? (Circle one): Yes No �
Florida Product Approval # 1LJ1 f'1 t e, 4116jO
For multiple products use product approval form p
Describe in detail the type of work to be performed:+tate t7 F 1(ZP r&DF — F/fl. Ch1--. 4✓(UrVikritillN
. .v1,nk$, OL t j-f j _ VOtikr tnaa.0- -.._ ..4.2_►a.ol_ARP ..dam lit
ri(20:Jir..(y�4�r,;��et: Iulorinixtifon: �p 1�/���p i
• A)tt l Whitt) Addres4 '110 1!Ol_lL 111�1LV ------------_--_-_•
.;.
1r'TJ/2 OrzZ�'l-L StateEtzip 33.9.0 Phone--. _�--2. -$' 3- ..___..._....• -__.--_________._..
Contractor information: 4
�- • ++ till ► li dua i yin Agent:\_�QX' 1 ro r1z3
Company Name O {' s V, If L_. g g t.J
Address:_. Sill Kbp_), City C. Y State f L _ ZipVZ5r)
Office Phone909 5' 3 Job Site/Contact Numberfl Q QS Fax#
State Certification/Registration #Mal�� r7 L')0 100o- iSS
Architect Name & Phone #
I,ngineer's Name & Phone If
Fee Simple litre Holder Name and Address
Bonding Company Name and Address
Mort ;ago I.cruic r Name and Address
application is hereby made to obtain a permit to do the work and installations as indicated. /certify that no work or installation has commenced prior to
issuance of a permit and that all work will he performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes.
and void j work is not commenced within six(6j months, or if construction or work is suspended or abandoned for a period ofsix 6)months at any time o
work is commenced 1 understand that separate permits must be secured for ElectricalpWork, Plumbing,Sins, Wells, Pols, Furnaces , Boilers, Heat
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
/0 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
:u' 'br certify that I have read and examined this application and know the sante to be tow and correct. All provisions allows.0 q ordinances o0. ,ur..y
work will be c•, iplied with whether specflied here or not. The granting ol o permit does not pretreme .ire aro•ort'to violate oe ,.cur,r:
.,ri, „(env.'l,u'r lydc'ncl wig• cn l., t'
r•ul law renlan ;construction or the pe'rJiirmcu uu• o/construe/tun. -
��
it /
Signature of Owner A Signature of Contracto S
/ ff ( e
Print Name � t�i Mt, 4 Print Name --t w 1N e�'�+ r...S
Sworn to and subscribed b=f•te me � Sworn and subscribed befo e me 20��
this ', Day of_ 6,4. . . . , 20) this Day of
Tina.Nettles- - - -:.d:'t. �Nettles - - --- - ._. .
Public is - {, NOTARY PUBLiC No c:,)-i'l'NOTARY PUBLIC
41' c ` STATE OF FLORIDA Revised 01.26.10
• �. STATE OF FLORIDA `, ,,
�,�t.,r'-Comm#FF235532 -`r4..,'. Comm#FF235532
,.�'r,. • w i..
�' WIb Expires 5/2812019 i% Expires 5/28/2019
Doc # 2017177246, OR BK 18069 Page 1010, Number Pages: 1, Recorded
07/31/2017 at 09:51 AM, Ronnie Fussell CLERK CIRCUIT COURT DWAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
IMRI!PFJte I'I otit.r...A,TI"I t•'►�J /� �) }� ,(�J�(
Stats of ermit 0. it;rbloy Carny of
olb No. 1 C�Lr� ( r�.7(J li C�To whom It may concent:
The tnlderstgned huroby informs yoU that hnprovomonts will be mode to cortaln rent property,and In
accordance with Section 713 of the Florida Statutes,iho toliowin_q Information Is stated Ili thio NOTICE or
COMMENCEMENT.
Legal description of property being Inn rovwi: '1D 1') 2 S- 2q t _
LI A + I- 3 LGT_.1LL _.
Address of aroperty r I proved' / , r . _ -
General description of improvements: (2,4?-P.01117
Jwner , `.. a
Owners Interest In eke of the Improvement 6 39 CO
e7
Fee Simple Titleholder Mother than owner)
Nonce Ky!een and wkkiem ae&Mrnand aen+emx ru•mnw.: -.. - '...
Address 3411S Korl Rnnn,J ackcorvge Finnda 372S7
conMlctorJeterney S.Regevn
Address 3415 Kan Road.1 arkconvilte Flexida 32257
PIonP No..1)A-Ss*-.5A63 prix Ne.404.0e)-2400
Se n ety(if any)
Address - Amrnmt Ohm'$
Phone No. Fey.No.
Nnme and address of any(anion making a Inert for the eons:ruclon of the Improvements.
Nome__
Address_ --
phare No. `.. _ror.No. ----
Name of person within the State of Florida,other than himself,designated by owner gym wlpxn notices or ether
documents may he served•
Name imm"S.peer'"
Addte453415 Kori Road,J acksonviLe Florida 32257
Phone No.nIM-SMS4G.T rax No.904-619-2400
In addition to himself,owner designates the folk-wing person to receive a ropy of the Uerot Nota,err nmvIcle-1 k'
Gooden 713.06(21 Ib1.ratan Statutes.(rill In et Owrie•.os endo❑1.
Name
AddressM•
ontt NO. _ —ray No.
c%Pastor date of Notice of Cornn oncoment(the expiration date le one ti)year from tiro data of recording tnuk-syr,
different date is specified;: _
THIS SPACE FOR RECORDER'S USE ONLY 1 • . �..ac..+ h
:.bore.: 'sI •
Evan 21/r.1
a.nxenorIII 1 Myer �x- air
County nr /'1.11,0f'rex .I-a wTT 11 I
Ateldes
h nWWY I • r uw.ra. e!aWuarrae. a NOTARY PUBLIC
Im nix ens ester,,. V STATE OF FLORIDA
-
Corinth FF235532
Exp'Se 5/28/2019
KOr..eY
11,1)k el Lemur.Sialw _-..Olyy
my<urmution urpras,_,
�+ axlM
*Kn -..