1085 JASMINE ST - ROOF J3 J � CITY OF ATLANTIC BEACH
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,iit
.. s 800 SEMINOLE ROAD
�v ATLANTIC BEACH, FL 32233
'4.40.2 c.-) INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0051
Description: RE ROOF 5 TO 12 PITCH
Estimated Value: 6500
Issue Date: 7/20/2017
Expiration Date: 1/16/2018
PROPERTY ADDRESS:
Address: 1085 JASMINE ST
RE Number: 170990 0500
PROPERTY OWNER:
Name: SIMS ANTHONY F
Address: 1085 JASMINE ST
ATLANTIC BEACH, FL 32233-1816
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.
Doc # 2017167348, OR BK 18056 Page 493, Number Pages: 1 , Recorded 07/18/2017
at 11 :18 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
qPREPARE IN DUPLICATE)
Pemvt No _-- Tax Folio No.
State of r I County or t~7l7 V CLA
To whom It may concern:
The undersigned hereby Informs you that Improvements will be made to certain reel property,and In
accordance with Section 713 of the Florida Statutes,the following Information Is stated In this NOTICE OF
COMMENCEMENT.
(-eve l desc liken w property being irnlxoved:l -3 4 3 8—-2_4-b [�--? -1 1-- - 1 t f1--i 10 r 1t is
1'�e Ca c.'.- ' ..e G r\ SrlD'F T l c)-i 1I L o1 @ Ir. 1$1
Address of property being improved: 0 0 V ,. l.il 1 S 1 1 1 l f e Sl-
General description of Improvements: C e. - r 0 0 £
Owner a n _. ),1,---A-
,t ly Ino
Address ' : , . • ' • , 1 to e.a . - F .
Owner's interest in site of the Improvement
Fee Simple Titleholder(if other than owner) _
Name
Address
Contreetvr Reliant Roofing,Inc.
Address 822.AIA Highway Suite 310 Pottle Vcdra Beach,FL 32082
Phone No.g01-657-0680 Fax No. 9°4-677-7972
Surety('d any)
Address Amount of bond S
Phone No. Fax No.
Name and address of any person making a loan for the construction of the Improvements.
Name
Address
Phone No. Fax No.
Name of person wdMn the Stale of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No_ Fax No.
In addition to himself,owner designates the following person to receive a copy of the Lleno(s Notice as provided In
Section 713.06(2)(b),Florida Statutes.(Fill In at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice Of Commencement(the expiration date Is one(1)year from the date of recording unless e
different date Is specified):
THIS SPACE FOR RECORDER'S USE ONLY I
,_(q—OWNER
signor �lJ OAT!a 71/2770-/Rein, m.Ihh )7 it?),°r h 1114
County• in I.EU%of F... • . appeared
appsed
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dr.A.rolen.her*In aOR_4 tr Jenmi(t' Kraut
arab b Y - 'rte NOTARYP(1BLIC
�, 'STATE OF FLORIDA
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 /,
Job Address: }l )05 -)QS ' f P Permit Number: fw 1E I 7 - v PS I
t8-3tI 38-LS-LIE •t'I mtoettc nse .CM Sec ►t
Legal Description S (.i - Lar It Loq Z 131 k 181 Parcel# 1 7 099 O- ()Soo
Oo
Floor Area of Sq.Ft. Sq.Ft Q
Valuation of Work$GL T.00 Proposed Work heated/cooled l(�17 non-heated/cooled 20-7 I
Class of Work(circle one): New Addition terata Repair Move Demolition pool/spa 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
Florida Product Approval# FL 1(117 4-1215;r L- 152 16,1- r0
For multiple products use product approval form
Describe in detail the type of work to be performed: re"roof_Sh•i n3 i e 5- 5/l a P -I Ct- -
,�5Q -FL- (012 LI - 2..‘S
v
Property Owner informatioon; (7,16'
( p
lir
Name: I Q (J 1 S Address: VS J 1 i1� St
City - I [ Si."e.e. State Zip Phone Cl O' ]-- u7 2 -• ‘4 8 1
E-Mail or Fax#(Optional) .10.1,5 1085 Q be��iti( .nE.---
Contractor information:
Company Name:Reliant Roofing,Inc Qualifying Agent: Cameron Snouppe
Address:822 N.AlA Highway Suite 310 City Ponte Vedra Beach State FL Zip 32082
Office Phone 904-657-0880 Job Site/Contact Number Cameron Shouppe-908-667-0880 Fax# 904-677-7972 _
State Certification/Registration#CCC1330615
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 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 he performed to meet the standards of all laws regulating const,•ue•lion in this jurisdiction. This pet nut becomes
null and void i/work is not commenced within sir(6)months.or if construction or work is suspended or abandoned for a period of six(6)months at any time
alter work i.s commenced /understand that separate permits must be secured for Electrical Work,Plumbing.Signs, Wells,Pools,Furnaces,Boilers,
Heaters,Tanks and Air Conditioners,etc.
. 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.
I hereby certif,•that 1 have read examined this plication and know the same to hetrue and correct. All provisions of laws and ordinances governing this
type of work will be complied a whether specified he ein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of-any other federal. te,or local law'reg 'ti !construction or the performance el-construction.
Z...c. ...''': :.z.,...__
Signature of Owner ALL........r, - Signature of Contractor
Print Name A_mhony__C!...Kr . Cameron Shouppe Print Name __—�. --.---_-----
Sworn to and subscribed before me Swo to and subscribed before me
this : pay of U I 0 thi41111k OW s 1
Day of �,
abgeik
otary P r.lie Air ota u e
71,
Jennifer Kraut ,Is.% Jennifer Kraut
`' NOTARY PUBLIC Revised 01.26.10
' NOTARY PUBLIC
...1,-4 ` STATE OF FLORIDA. tSTATE OF FLORIDA
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