762 Cavalla Rd re-roof permit rj 1.11��Ji
�Ss f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
�r
ATLANTIC BEACH, FL 32233
131119, INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0130
Description: RE ROOF
Estimated Value: 0
Issue Date: 10/13/2017
Expiration Date: 4/11/2018
PROPERTY ADDRESS:
Address: 762 CAVALLA RD
RE Number: 171365 0380
PROPERTY OWNER:
Name: GRANT ALAN R
Address: 61 TALLWOOD RD
JACKSONVILLE BEACH, FL 32250-2924
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Thigpen Roofing, Inc
Address: 2928 Plainwood Place
Green Cove Springs, FI 32043
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$7,500.
Building Permit Application Updated5/5/17
CZCity of Atlantic Beach -764 - R EK[,!=��� (z`�
J '2- 800 Seminole Road,Atlantic Beach, FL 32233 7(o Z - REP,F-7- v 15 o
J �d Phone: (904) 247-5826 Fax: (904) 247-5845 `J Cj Z -(�ERFI -
U 13
� d 7s4 - REP-P17_ C) ( 3Z
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Job Address: u a V� 1 \ Permit Number:
Legal Description RE#,759, -RQRF�l 7- p 13
Valuation of Work(Replacement Cost)$ y 7-S u� Heated/Cooled SF Non�t�d/Coolele 17 " 135
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Dt0000r
• 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 detail the type of work to be performed:.teti,. 0.�C V1*.f `oaf, fc p/ei'- tw';r3, ,IC-W c,c..
U.�der)Uy.��fi Pe-cJ XJFE'-IZ S11e1. Z; � .>. "4)
Florida Product Approval -FUlfl-Al t A j le) -1 /91 %f r multiple products use product approval form
Property Owner Ior ation -- _
Name: CL rQ Address: l� 1 4 ' l LA-)nn
City c State P Zip 3 ZZ:V Phone
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Qualifying Agent:
Address 2-92,y P G_tiw ,,,l 1• City G*c t I State FL Zip 3 2_0'f,>Office Phone(qv tl ) 3 71 - lf�� Job Site/Contact Number d-U 2 7-ii-J-101
State Certification/Registration# E-Mail rkg-= 2,416E` Cd--c-It.nQ r
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation
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.
(Signature of Owner or Agent) ignature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this l3i,4 day of Signed and sworn to(or affir ) before me this day of
beio3iK 20t 7 , by Al 4.1 6,44�,JI Q���, I byM c1 u
RCLARENCE E. HIMY COMMISSION#FF948715 (Signature of Notary)EXPUkES$ February23,2020j(�11 GiPU1LESPERGER
°,: MY COMMISSION t FF 9249'
EXPIRES October 6 1�
[ ]Personally Known ORGondedThruNotayPubk
[ ]Personally Known OR '
M Produced Identification L441roduced Identification_ q
Type of Identification: 6653 ' D/b's8"10/—D Type of Identification:
NOTICE OF COMMENCEMENT V h T 76o?,
o2,
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of 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. 1
Legal description of property being improved:
Address of property being improved: -7 6 Z ���v� 1 la '7 z ;-3
General description of improvements: 1-C C
Owner -11c—
Address
11G—Address 4
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address �r-
Contractor P,% r-r G rtn �;f�'e v� y L •,
Address )-15"1 t 9 FJ r_ w :�i� P T. L r t a.� Cr— 0'j.Cf CL. 3 -Z&4_7
Phone No. Fax No.
1 Surety(if arty)
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 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 Lienors 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 a
different date is specified): II
THIS SPACE FOR RECORDER'S USE ONLY OWNER
SWWd�Du �FWvda
DATE�'�
�4WW
o in the
Doc#2017235555,OR BK 18151 Page 1629, Herein by
t:reseW herself and affirrm Mrat all sratenw is
Number Pages: 1 are true and accurate ,,Y
Recorded 10/13/2017 11:56 AM, y° CLARENCE E. HILL
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL two MV COMMISSION aFF949715
a0.
COUNTY d IREXPES:Fdnuary 23,2020
RECORDING $10.00
Notary Pubic at Large,Stft of County of 4–
My ca—ftsim expires:
Perwwft known or
Produced IdenM6cadon_J''- D L 4J 0/ - -yo/-O