42 3rd St - Reroof j Ai,]
CITY OF ATLANTIC BEACH
s3 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: RERF17-0114
Description: re-roof- FL10674-R10 & FL15216
Estimated Value: 10000
Issue Date: 10/10/2017
Expiration Date: 4/8/2018
PROPERTY ADDRESS:
Address: 42 3RD ST
RE Number: 170193 0000
PROPERTY OWNER:
Name: ANTON ROBERT C
Address: 42 3RD ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: J. ROGERO CONSTRUCTION INC
Address: 8620 RANCHWOOD LANE
ST AUGUSTINE, FL 32086
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$7,500.
Building Permit Application
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233 OCT 1 0 2017 ii
,,""Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: �Z 3Q,Q�7 farth( h Permit Number:
Legal Description 5} 01� F, .a�� q�-la,rH-i c RRa )n ook U a J?C RE# 'L 6 V-F - n( 1
b,���9
Valuation of Work(Replac ent st)$toy ,OC)o 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 Residenti
• If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No /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:
N,-Tai NY\ -�6� .
Florida Product Approval#_ew olP7y-g.1 cii FLWA.l u for multiple products use product approval form
Property Owner Information
Name: Robegk fti-OY1 Address: L-V- SP4 %Cckzy
City �(�(il�Y1 Lei V.-Otk `b State (AZ Zip `aaa. Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information J
Name of Company: salifying Agent:
Address a1 1 f`e— U City h Q.�( State P(, Zip Sd.2.5 I
Office Phone 0((24 !;lot ^9LCJ 0 Job Site/Contact Number Or!q !!c J -y3 I t o
State Certification/Registration ion# CCCV63 kV10 E-Mail -�Qs�10R.�GUti1 L�l0.GK-� O 'IOo1C- CoY►'L
Architect Name& Phone#
Engineer's Name& Phone#
Workers Compensation GING /-// /07-?
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 NOTIC OF COMMENCEMENT.
x
(Signature of Owner or Agent including Contrac or (Sighigiture of Contractor)
Signyd and sworn to (or affirmed) before met day of Signed and sworn to(or affirmed) before me is I-C__day of
by bydift
iAYtOR KAY BlAd4r re of Notary)
m�",:'
y) ,. "�c, TAYLOR KA ��tare f Notary)
j s commibsion N GG 101 ' - Commission GG 10%
My Commission Ex es '*®"
My Commission Expires
May 04, 2021 May 04, 2021
[ ] Personally Known OR ersona y Known OR
oduced identificationy [ ] Produced Identification
ype of Identification: Type of Identification:
NOTICE OF COMMENCEMENT
IPREPARE IN DUPLICATE) (�
Permit No. Tax Folio No. �I --60 00
State of Q County ofaV
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. .nolo.
Legal description of property bei improved: (�—a, d- 1
Address of property being improved:
r� .v `G C - 3 -a-a 3
General description of improvements:r mrd
OWner
Address O&Ar 2�
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contracto & 0 'D n .�
ftpL
Address Vi e
53
Phone No.gN Inh-41-.l�b 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 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):
THIS SPACE FOR RECORDER'S USE ONLY ER
Vl?,Signed: DATE p �� /Before dayof i
*?Or'
County of Duval.So Florida.h r o appeare
Doc#2017231674,OR BK 18146 Page 806, himself herself and arnrms that all statements and ca �(erein TAYLOR KAY BLACK
Pa
Number Pages:1
are true and accurate 3*' "i Commission#GG 101742
'�,�;Recorded 10/09/2017 04:11 PM, ? My Commission Expires
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00 N ublic at Large.state of County of
commission expires:
Personally Kno,.:m OF
Produced Identification