728 Cavalla Rd re-roof permit f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
rom 9' INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0128
Description: RE ROOF
Estimated Value: 0
Issue Date: 10/13/2017
Expiration Date: 4/11/2018
PROPERTY ADDRESS:
Address: 728 CAVALLA RD
RE Number: 171365 0200
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$7,500.
Building Permit Application 70-0 _ PF-9,pdat d�5 (3�
City of Atlantic Beach -71 8 —RCR ::-17_ b I Z`7
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904) 247-5845 -7 2-S - ll� ( Z�
I 7�er f� G�Fl7 - C� tZ �
Job Address: �� E� l Permit Number:
Legal Description RE#
Valuation of Work(Replacement Cost)$ g� ►. Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool 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
• 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:.I-cA, p ffF Yt,r,.J -Dd f, to j,cv, rv', t-
c%lalc..-)li,,,��r Pe-cl a J IL str,,,.A, l.,� Nu
Florida Product Approval#vq�fvl.yf �,rf -19S' FJ-R 2ti A."alai Q.1 Zti-41br multiple products use product approval form
Property Owner Information // D
Name: q!\ Address: Co l �QWooa
City State l Zip 3 ZZ5 Q Phone_
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Psis Qualifying Agent:
Address L 9z'' p/G_,w►,,/ (S)• City Gr • [ , • 1 State FL Zip 7 2-01y,>Office Phone(qo t_j 71 - I,f-r*) Job Site/Contact Number 1'U 2.2-b I��
State Certification/Registration# E-Mail r"'v %h, GE`C7(2-1412r.ne 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) Nig-nature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this Lji&day of Signed and sworn to(or affir )before me this 1-]5day of
Oc-fadt&-f , orb( 7 ,by A L,4 A) 624,✓ 0 2-01�]by o_ V s Q
CLARENCE E. HILL f 2/-/,/ Q, . C—L.
MyCOlvMISSION#FF948715 (Signature of Notary) (Signatu[ec�J_ a
a EXPIRES:February 23,2020 --
TONI GINDLESPERGER
MY COMMISSION#FF 924951
EXPIRES:[ Notary
PutOctober 6]Personally Known OR "IFS{ BondedThruNotaryP�h!i�J
[ ] Personally Known OR P.-.--'•• .'��
DQ Produced Identification L}-Produced Identification c�
Type of Identification: G-�S3'ol 6 'SS - Yv/ -o Type of Identification: I_ C Z k S- S (;::2-� 1 - 7-25- 0
NOTICE OF COMMENCEMENT Uv-t% � �7o'g
(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.
Legal description of property being improved: �/ 1 - �S 5 N t)
Roti) P� ►,.-,i ✓M.�t � •4 w 16 ti t�� �� r 2�. ��'�- lot. �
BIK t1
Address of properly being improved: 7L-,?
(�,✓;.I 1 rCp� r7��. 5 �. 3 Z 7
General description of improvements: re Ta a
Owner Gn 7'lrc.. C
Address J T 1 f 1/t vJ AJ- Jtax 17,4 .1 Z'7.
Owners interest in site of the improvement
Fee Simple Titleholder(If other than owner)
Name
Address
Contractor 1^-),;,r Ag L—Il c
Address_ z 2-k Ply; ►✓�r:/ P/" J �[. 7 z U13
Phone No. Fax No.
Surety(f any)
Address Amotmt 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 Lienor'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 a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER Cy(0 53"0110—91 401 r
Signed: _
DATE/
Be(ore This iR o!' m the
CaurN of of Florida,has personal appeared
Doc#2017235549,OR BK 18151 Patry
ge 16 ~ N! �
hirrrselU fusrzeN and affirm twat ori smtemerrts ubnorAere
Number Pages: 1 are true and accurate �D""r"1n CLARENCE E. HILL
Recorded 10/13/2017 11:56 AM _ j MY COMMISSION#FF948715
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL !, /�� '�TiP� EXPIRES:February 23,2020
COUNTY _/ arm
RECORDING $10.00
Notary Pubic at Large.State -c o r J . County of J VA j-
My coundssion expaes_27 2 3
Personally Known or
Produced IderrWkation t-4 (, 1 •U/LD/-c�