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1390 ROSE ST - ROOF '01:0110 CITY OF ATLANTIC BEACH s) 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 , v INSPECTION PHONE LINE 247-5814 REROOF SHINGLE - II MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RERF17-0095 Description: RE ROOF SHINGLES Estimated Value: 5200 Issue Date: 9/19/2017 Expiration Date: 3/18/2018 PROPERTY ADDRESS: Address: 1309 ROSE ST RE Number: 171064 0130 PROPERTY OWNER: Name: WIETESKA MICHAEL J ET AL Address: 1309 ROSE ST ATLANTIC BEACH, FL 32233-2639 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: GREAT WHITE CONSTRUCTION INC Address: 4320 DEERWOOD TRAVIS SLAUGHTER JACKSONVILLE, FL 32216 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 ' Phone: (904)247-5826 Fax: (904) 247-5845 / Permit Number:`?Zz� 309 ERF 1, 7- 000i5 Job Address: / i1"--ELS e �• �T�C��j j/��.- r. Legal Description/7-44.1=079e.See N ifrottniceaci, .S: i`T ZITS A'/2•G�S�T6 RE# �/�D6O &/30 • Bac Valuation of Work(Replacement Cost)$6720O.Oo Heated/Cooled SF /3e4 Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration epair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial esidenti' • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No • 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: 7641-or-F2c-/ F /3s;1 ern 4c i4i -(lHs/mss Florida Product Approval# llo 43e / 19qy -6 for multiple products use product approval form Property Owner Information ,e se y idi•' fSIEl4 Address: /3o? Se £f City AytA•,i/77 State Zip 32a..33 Phone 9 "aa3-•,S7L7l E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information E Name of Company: Yom-'' ` - Contr1Tua Qualifying Agent: rav►3 vl c^ ' t + Address 14320 e L_o.�r.G Pu-41 (An City �,X_ State cL Zip Office Phone 0104) ( r-I 1——r0-5 Job Site/Contact Number State Certification/Registration# (' C.C_v-37.10 R1 E-Mail Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Lp I O c1coo 1(A tC)k C- \-1 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 YOUR NOTICE OF COMMENCEMENT. (Sig re of Owner or Agent including Contractor) (Signature of Contractor) Si ned and sworn to(or affirmed)bqfore a 6sac. rn./ day f Signed and swoto(or affirmed)before me this IS day of by U11�'1gy 2011 MATTHEW D ,ignature of Notary) /ignature of F'ary) / 43114= Notary Public,State of Florida Commission#FF 931789 "A'' My comm.expires Oct.28,2019 ;,�;;,Y P, •. ASHLEY RIDGEWAY "�•t• Notary Public-State of Florida i.•• Commission 1 GG 077166 ( 1 Per nally Known OR [Personally Known OR ;;..a ` My Comm.Expires Jun 20,2021 [ roduced Identification 1. f [ ]Produced Identification -� *. ` BoidedthrgyhNational Notary Assn. Type of Identification: �(. �1""� W"" Type of Identification: cyo n 3 p n (-) = C') _ ° to 'b ``; 5. ' 3 q a g a N �. Z A N o 5' �' �. C • y o Y r* a 0 0 C , 0 ^ o Cz7 z z a. � 0 ry c 0 Si = � by Crn .� � � � Q- a- � o• � O o lJ - 5v~oo � o a cA C t. < ccA _ 5 'cs c 0 a✓ o ,_ fi �. / ¢' Co r' Q < M 0 S su . a5gg -, i) Ca a p A No • ~� -, acr PD 0 o g ° C% O� 0 0 ..4. �o o0. � C a AvCr7 / " - � n '3 , '+Ck Ca o co yga z C ,rt co p • o io p' C s to tn G. 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I . 4 1 1 C sz t•; -i t - I ..-, 4. • t O 0 C n .:r n n r7 'C C I 7 r- y 0 0 ' C cm 0 i 'n 0 It It Doc # 2017169129, OR BK 18058 Page 1239, Number Pages: 1, Recorded 07/19/2017 at 02:55 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 en:■p. cOROIN -RETURN TO PERMIT NUMUER JVOTIClF OF 4'Qrkthf EINCENIFNT The undersigned hereby gives notice that Improvement will be made to certain realproperty.and m accordance with Chapttx 713, Florida Statutes,the following information is provided in this Notice of C'cmimcnccmcnt 1 DESCRIPTION OF PROPERTY(Legal description of the property&street address.if available)eriA FOLIO NO.: -71064-0130 SUBDIVISION BLOCA TRACT IAT SLOG 1'Nrf 17-25-29E SEC H ATLANTIC BEACH S 25FT LOT 5,N 12.65FT,LOT 6 3LH 235 0/R BRC 6964-1248 1309 Rose Street Atlantic Bch, FL 32233 2.GENERAL DESCRIPTION OF IMPROVEMENT: Iear:Mtf BeBo4f OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR TIIr.IMrROvr.Nr:NT, a Name andadd•c,t Wendy tnieteska :309 Rose Street Atlantic Bch, FL 32233 _ — b Interco inpopeny SOP% _.—.— e Name and address of fee ample titleholder pf ditterent front Oona lilted above) •— ---- — 4. a.CONTRACTOR'S NAME: RMX Construction,Jeanne Gazlay -- Contractor's sm. — Contractoralddresa 10752 Deerwood Park Blvd.#100 Jacksonville,FL 322561,phoaesumber 855-769-6262 S SURETY(if applicable.a copy of the payment bold is attached) a Name and address -- b Phone number _C Amount of bond S ----- 6.a LENDER'S NAME: --- Lesdes's address _ b Phone mamba- .... 7 Persons within the Stair of Florida designated by Owner upon whom notices or other documents may be served as provided b) Section 713.13(1)(a)7.,Florida Statutes: a Name and address' - b Phone numbers of designated persons .-_. -_--- --- - a.In addition to himself or herself,Owner designates of to receive a copy of the Laenor's Notice as provided in Section 713.13(1)(b).Florida Statutes b Phone number of pawn or entity dei gnaw'by Owner 9. Expiration date of notice of commencement(the expiration date will be I year from the date of recording unless adifferent date is specified). .20_ WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 7 13.PART LSECTION 713 13.FLORIDA STATUTES.AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY A NOTICE OF COMMENCEMENT MUST BE TAIN FINANCENG_CONSULT WITH YOUR LENDER ORACORDED AND POSTEDON COMMENCING THE JOB SITE BEFORE THE FIRST IO N ATTORNEY BEFORE W O N ECORDING YOUYOU INTEND R NOTICEO OF COMMENCEMENT, ,/ fi � en (Sigaaturc of Owne • ssee,a n r7 or Legse s riot Name and Pr e Signatory's Tide/Office) Authorized Offae ar,tor/Partaer/Manager) State of Florida '/ / County of �V I `✓ WW1 The foregoing instrument was acknowledged before mc this day of ,20 / es n (type of authority, e.g officer.trustee,attorney in fact) (name of party en behalf of whom Instrument was execut ) 9 Per all gahgyT_or uce ern Ica ion Type of Ide ifica • Produced 2, ?R-co X`r.. .''gym° ''.1 LryPubENA i WOJNAROSKI /,// �, ' ' Notar •Public•State or Florida I s ,. My Comm.Expires Feb 17,2018 l _ a 1.LI .� /� car.• Commission N FF 64656 Signatur.�t' • ' (Print Type. StampCannnssi.• a eof oma Public) x Rev io.is•I±