1100 LINKSIDE DR - ROOF 0„..,./.4
: _,
', ,=' �t CITY OF ATLANTIC BEACH
g1
.� s 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
'i•t�ss t%' INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0072
Description: RE ROOF SHINGLES
Estimated Value: 10000
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 1100 LINKSIDE DR
RE Number: 172374 5010
PROPERTY OWNER:
Name: GALL ELLEN T
Address: 1156 TUMBLEWEED DR
ORANGE PARK, FL 32065
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: PIMENTEL ROOFING INC
Address: 321 4Th AVE
JACKSONVILLE BEACH, FL 32250
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$7,500.
(.;ft LAN� Building Permit Application Updated 5/S/17
#,
City of Atlantic Beach
l-ir-0.rt
800 Seminole Road, Atlantic Beach, FL 32233
,r Phone: (904)247-5826 Fax: (904)247-5845
Job Address: /100 �,1/,/K-Sfd ht Permit Number:
Legal Description t/9 3 17 2 S--..2 c E Si/rt/,,,),‘k r';44,2,i ,4141#
Valuation of Work(Replacement Cost)$ //91 DDD, 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 detaiill the type of work to be performed:
b°`- 1--.0a t 5 h,..�/i1r2 40 SI ,...)5 le.1 ).--e-11)4;/S�ti7`h►•-11 674;4, 2Q►�la„,,,,�
Florida Product Approval# / d'p- l<v FA /0 6-0) 3 -0044-0 F.:M9-gib for multiple products use product approval form
Property Owner Information
Name: )7l44) X44 Address:
City A-ri,A.,.)-4.::i.- 1j,44- - State rlf Zip 322 3 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: r j r rk 4,4-d 72,r04,7-)s Qualifying Agent: 7?nt /Address �O7 S't': /1K 73iQ �} �,J��C./
Office Phone S City 11�� State �/, Zip 3LL Sp
DC7/ c'S/ l i Job Site/Contact Number 72 r, /_ Sy
State Certification/Registration# CC(../ 3036-- E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation
Exempt nsurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to e 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 Y i, ' NOTICE F CO ENCEMENT.
K 6/4" D ,-:
gnatu e of Owner or Agent) (Signature of ontractor)
(including contractor)
Sig ed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this 7 day of
— 230f-7 , by N4 RA--‘ Di✓NA- �Dy7 , byAi-ifc
(Signa .i - . a
(Si ure of Notary)
'tiK' ANN MARGNA
1 •' ADONMY COMMISSION#FF 161400
= .,��W EXPIRES:September 18,2018
(Personally Known OR ��,,, BondedThruNote
<M�F ersonally Kno, n ¢;;,,.•' ryPuaicUnderwrders
I I Produced Identification ' .s ANNMARGADONNA
a•; ti, •.: MY COMMISSION IFF161400 i ]Produced Idents e
Type of Identification: •'' _ • ;
i
NOTICE OF COMMENCEMENT
State of fit t County ofV et, ( Tax Folio No.
To Whom It May Concern:
_I,:
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: !/.i j2-; /'7— 2 c—a 9 -'j o/rr4x L�,JkS ,
/ ,4 ‘(-2,-7--)- /
1 \Address of property being improved: l l 0 6 4<i✓k5/4%,,e- Di , 4_TAA^/ZJ jl� 7/
a = C
General description of improvements: 51,vdjv5 be„,, --bj ./M) ,/5.24he ',iv I
Owner: C k i Address: /�/>� ��,✓,���,�•��,,.�'�A�4.._4,41q
Owner's interest in site of the improvement: ] 2 t.�r'V.L e,//
Fee Simple Titleholder(if other than owner):
,� Name: `
�t Contractor: �A 2',,77 --/v/a( — /-j�.,N 74( /2 �sei.,5
Address:fop 5.7-', 4,4 , /!/!J( 7-A- )C 1 ? �? �'�p
Telephone No.: , '-q7-.- ,9, &T Fax No:
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 OWNERThr
41::).--711
Si ned: 'Mk ,`
8 Date: 6'— 7--/
Doc#2017184084,OR BK 18079 Page 2215, Before me this fi ay of in tre County of Duval,State
Number Pages:1 Of Florida,has persona ppeared
Recorded 08i07/2017 at 02:24 PM, Personally Known:
or
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Produced Identification:
COUNTY Notary Public: 4j- -ice 7
riln.,„i , r '
e„/ �.
RECORDING$10.00 My commission expires: _
di4ti'R''FP AR
h�;-: ANN M (3ApONNA
-;',4‹.s7-4i
'•', ,i :'' MY COMMISSION it FF 181
_+'''•�. EXPIRES:September 18,2018
R,;s f Bonded Bub Notary Public Underwriters