45 Donner Rd roof repair permit A
CITY OF ATLANTIC BEACH
SO 800 SEMINOLE ROAD
`) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0263
Description: ROOF REPAIR (2 SQ) & DRYWALL
Estimated Value: 1450
Issue Date: 11/15/2017
Expiration Date: 5/14/2018
PROPERTY ADDRESS:
Address: 45 DONNER RD
RE Number: 172067 0000
PROPERTY OWNER:
Name: HILL JOHN W
Address: 45 DONNER RD
ATLANTIC BEACH, FL 32233-4208
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: DAJIS CONSTRUCTION INC
Address: 9951 ATLANTIC BLVD SUITE 316
JACKSONVILLE, FL 32225
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$7,500.
Building Permit Application Updated 5/5/17
r� City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
`A yr Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: Apt, Ind uf' hl Permit Number: RE —.;)1'7-
Legal
)' /Legal Description RE#
Valuation of Work(Replacement Cost)$�j 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: k0OF dyw,_(( Qocz(tfS
Florida Product Approval# �(, �� — for multiple products use product approval form
Pro ert wner Information n Jf
Name: 6 / Address: ��f D � O
1-2
CityState rIL a Zip,% � Phone S (p D
E-Mail
Owner or Agent(If Agent, Power of Attorney pr Agency Letter Required)
Contractor Information Q-3 is
� Lu4Name of Company: Qualifying ent:
Address City cS State Zips
Office Phone — — Job Site/Co act Number
State Certification/Registration# P rte,E-Mail 9D c w_
Architect Name& Phone#
Engineer's Name& Phone#
Workers Compensation �g J
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 O:ATTORNEY BEFORE
RECORDINqVOUR NOTICE OF COMMENCEMENT.
0
(Signature of Owner or Agent) ignat re of Contractor)
(including contractor) ,ryt
Sigpfd and swot to(or affirm )before me this a of Signed and sworn to or affirmed)before me this day of
Al Q bI b I U1`e. �
Y n IrnV r
2C
ignature of Nt64 V,
4�q+ ., CLEOLANGWELL
,g�°� Notary Public,State of Florida
Commission#FF149302 State of Notary tAft
My comm.expires Aug. 10,2018
[ ] loft
Personally Know [ ] Personally Known OR My Commission Expires 08Rf7PM
Produced Identification f"� t [ roduced Identification CoimYnion- QG 11
Type of Identification: �l�fGtGt U// G(GL' Q. Type of Identification:TL SZy
Nov 1417 03:23p DAjis Construction 904-757-2208 p.5
NOTICE OF COMMENCEMENT
State of County of avoTax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 71.3 of
the.Florida Statutes,the following information is stated in this 1\tOTICE OF COMNMNCEIVL-NT.
Legal Description of property being improved:
Address of property being improved:. L(s, ~LI
General description of improvements:
ov
OKrner: 6 /'ice -- y Address: li .� Zoe 7jI eJ"
Owner's interest in site of the improvement:_
Fee Simple Titleholder(if other than owner):
Name:
` -
Contractor: c oQ V-- jj
Address: q '
Telephone No.:.__ ��� �� (�(� Fax No: �n"t Z T !$
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 State of Florida, other than himself; designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner ees grates the following person to receive a copy of the Lieuor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Te3eplion.e 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):
TWS SPACE FOR RECORDER'S USE ONLY OW ER * ^fes
Sig —1�� Date:
.Be ore m s day of County of Duval,State
Of a,has personally appeared
Personally Known: z or
Produced Identificati CP
Notary Public:
My commission e,(Ais: a