412 Whiting Ln RERF17-0058 Roof m CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
` 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: RERF17-0058
Description: RE ROOF SHINGLE
Estimated Value: 4900
Issue Date: 7/26/2017
Expiration Date: 1/22/2018
PROPERTY ADDRESS:
Address: 412 WHITING LN
RE Number. 171445 0000
PROPERTY OWNER:
Name: BURNETTBLAKE
Address: 412 WHITING LN
JACKSONVILLE, FL 32233-3913
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: HAMMER TIME ROOFING
Address: 13465 SOLEDAD CT DR 627 AQUATIC DR
JACKSONVILLE, FL 32204
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$7,500.
0800 Building Permit Application
City of Atlantic Beach
Seminole Road,Atlantic Beach, FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: /.l Let Permit Number:
Legal Descripti !?f-& 17-a&Aqc �r/ If &,a/ ?dktc (all 1 C1 /"
Valuation of Work(Replacement Cost)$ /,5t'D Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Clrcle one : New dition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residentia
• If an existing structure,is a fire sprinkler system installed?(Cale 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 performed:
Florida Product Approval R jo 679 I for multiple products use product approval form
Proert "nel,Information 77�
Name Q f (u/'�' Address: y/a j),L
City oil(la I (_State !'� Zip S. Pn e
E MaI OIG— 'f f�
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information pp,,
Name of Company: Qualifying Agent �Je/ ,Llelrrvgycr�
Address /,32!(o.s C's{: CitY ,�.�srn � Sffite_F' -Lp
Office Phone y 7 - Job Site/Contact Number
State Certification/Registration 4 G d'�99 E-Mail
Architect Name&Phone g
Engineers Name&Phone 4
Workers Compensation rn
ExemptIns rer Lease Emes
p /Explratbnpate
Application is hereby made to obtain a permit to do the wor and installations as indicated.l 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 ATTORNE EFORE
CORDING YOUR NOTICE OF COMMENCEMENT.
IS
of Owner or Agent indutling Contractor) ISignat re Contractor)
Signed and sworn to.(or affirmed)before me this 131"day of kgnef and sworn to(or affi ed b this ay of
Zoi,.4 -AA II •by uan, 7 by
c
w KIMBERL
• comnnm.i.rsN fNotary)
IS of b
My Commission
September 24,. 20 2819
TOWINOIESPFF
Personally Known OR I ]Personally Known OR MY r/JMMISSION Y 924951
r'. �'a` EXPIRES:Ootober6,2019
I l Produced Identification I l Produced Identification {rhe, e.�mamN warsp�nucunee�.,irers
Type of Identification: Type of Identification:
NOTICE OF COMMENCEMENT
(PPEPABE IN DUPLICATE)
Permit No. Tax Folio No. 171445-0000
State of Florma County of
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.
Legal descriptkm of property being Improved: 31-16 17-2s-29e
r/p of pt royal palms wit 2 a
M 2 ell,12
Address of property being improved: 412 Whiting Ln
Atlantic Beach Fl,32233
General description of Improvements:Re-Roof
P 1 dr Aske 2 Whitt
Address 412 Whiting the
Ln AUanUc Beach E7,32233
{/-I yQ.•J�[V, Owner's interest in site of tM improvenront
Fee Simple Titleholder(f other than owner)
Name
Address
Contractor Hammer Time Roofing LLC '
Adtlress 134655oledad Cl Jacksonville,F132224
Phone No.(9a)7169149 Fax No.
Surety(if any)
Address Amount of bond$
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 within the State of Florida,other than himself,designated by owner upon when 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 or the Uanor's Notice as provided in
Section 713.06(2)(b),Florida Statutes.(FII in at Owners option).
Name
Address O
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration dale Is one(1)year from the dale of retarding unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ON OWNER
Silrad DATe
IMMnr �h_ Ins»
C my NDuval�,aR°f Fl°T°.n°s pw pxemnlyagweee by
Dot$2017174609.OR BK 18065 Page 1907. Ire'°sr°m°mans Ihm an
Number Pages:l pf°'nia anO ecYfBroK1. I FA aE&LY SIANTIAL
Recorded 0712&2017 at 03:19 PM, C
om
mission# FF 921664
Ronnie Fussell CLERK CIRCUIT COURT DVVALk,r„rnm..sfon Expires
O s'w+�AF?,.i 5 .;..^..n.nef 26. 101V
COUNTY
RECORDING$10.00 9e stere
MY exPlee:
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