1887 BEACHSIDE CT - ROOF ''" CITY OF ATLANTIC BEACH
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_'`1 r) 800 SEMINOLE ROAD
4�
ATLANTIC BEACH, FL 32233
;3 �' INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0106
Description: shingle reroof
Estimated Value: 11500
Issue Date: 9/25/2017
Expiration Date: 3/24/2018
PROPERTY ADDRESS:
Address: 1887 BEACHSIDE CT
RE Number: 169542 0568
PROPERTY OWNER:
Name: BENNETT DAVID C
Address: 1887 BEACHSIDE CT
ATLANTIC BEACH, FL 32233-5954
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: A CROWN ROOFING INC
Address: 6504 Beach BLVD
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$7,500.
rS—L'r�-. Building Permit Application
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
F�Di2t�r Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: ) g S) tSL'`cA S4eC c8„401—, ,, (36,GL Permit Number: ,KE[`�(7—C�`C, ”
Legal Description Lia- /1 O q — a S — a 9 E 3j sl�e 1-.-o�' 1 L� i�E#f f )(09 Sy.4` D 568
Valuation of Work(Replacement Cost)$ /ISO 0 ' Heated/Cooled SF ✓/&,r Non-Heated/Cooled4 '//9
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial R enti
• 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:
Ke - roc.
Florida Product Approval# FL 101 .211. 1 for multiple products use product approval form
Property Ownjer Information /�
Name: Na vi A 13-JM L f-/- Address: IV? f 157 t C I—
City 44-I t,c /3c“,L, State Fc- Zip 3a.23-7 Phone YdN-5%25- Y8-bl
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information �/�,' � //JJ
Name of Company: /✓ W //
�/Co�/ OD /Illl'j `LNC Qualifying Agent: i .,�, /'�� Z.:)1.4,_
Address /.�C/ r t1�� 1J �� City 1]1 State f t` Zip39/(v
Office Phoned 6/1%4?/4ff Job Site/Conta Number / ,.2 — - . I
State Certification/Registration# C t/J�2yS�/ E-Mail 16/ 7Itivl 6P 2GlJN R60 c,1 1 ,v(--
Architect Name& Phone# • )))4
Engineer's Name&Phone# /(1)
Workers Compensation , ,46-• „„ ��-3 / _
Exempt/Insurer/ •. e Emplo •• /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 Ye - ' ENDER OR
N ATTORNEY BEFORE
RECORDING YOU •,; 'TICE OF Cs • f ENCEMENT.
6--- ___._.___---------------.____ 0x
(S.... . e of Owner or Agent including Contractor) (Sign.ture of'ontractor)
Signed and sworn to(or affirmed)before me this Ilo day of Signed and sworn to(or affi •-. •efore me this ), day of
,, a�fl by- p„...3...,----€:.>„4„,-1,...td S�'r, 2•iJi 7 , by 4• ill n \ _ . :+1, .5:�
,,�, ���'�1 -�Karen Willis
i*' IA1 'r' f;rr1S2AArfi ' +�� '��`� ::A,•. GRACE MACK L./431U;Commission# :�••• "°�•. ftna
�i '�= E I (Signature of Notary) . * MYCOMMISSION# Gre of y)
xp res: March 16 2021 %!:;...".•:<;,.i• EXPIRES:October .2
' ����`s Bonded thru Aaron Notary %F•o:f°^ Bonded Thr,Notary Pubic Underwriters
I [ ]Personally Known OR
'[ [ ]Personally Known OR
Produced Identification [ Produced Identification (t
Type of Identification: �:v�.�1 1, - 11
\' - , type of Identification: rt ur1 A Mk?' L-';-(Nr .‹.
Doc # 2017213776, OR BK 18121 Page 1723, Number Pages: 1 , Recorded
09/20/2017 at 09:37 AM, Ronnie Fussell CLERK CIRCUIT COURT DWAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
State of °R1e.w
County of -3
Tax Folio No. IO tcgZ
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: L Z - l - 6 9 - 25 -2 E
13PF.3A-CN-S)ob2 LOT-
Address
OTAddress of property being improved: 19 'a-1 g R...pc - of C.r. 6}rr-ozr4 rye geJ 41, 3 2-2..33
General description of improvements: R bo r- 2GP«.L4»14+1y
Owner: iAv' R 5 o?rwua�
Address: l eel/ >3 c 1be_ CT
Owner's interest in site of the improvement: SELF
Fee Simple Titleholder(if other than owner):
Name:
Contractor: A Grow Rooftop, dam,
Address: gat;Beach Blvd. Jacksonville, FL 32216
Telephone No.: ' 4)61 V6g7K Fax No:.__J : -•1125
Surety(if any)
Address:
Amount of Bond$
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 Stato of Florida,other than himself,designated by owner upon whom notices or other documents may be
served: Name: A Cettm Rootng, Inc,
Address: Same
Telephone No: Fax No:
Arlt.;;
In addition to himself, owner designates the followingperson to receive a co
713.06(2)(b),Florida Statues. (Fill in at Owner's option) PY of the Licnor's Notice as provided in Section
Name:
Address:
Telephone No: Fax No: •
Expiration date of Notice of Commencement(the expiration date is one(1)year from thc•datc of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: 1 /� Date: {o �
Before mo this l=»day of-3 in the County of Duval,State
Of Florida,has personally appeared
` Karen Willis Notary Public at Large,State of Florida,County of Duval.
` � Commission GG08440My commission expires: - a
,,�, 4,�� CXplres: March 16, 202' PersonallyKnown:����,�,�
--c4cr•- : � Bonded thru Aaron Notary Produced Identification: -J or
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