1542 W Park Terr re-roof permit CITY OF ATLANTIC BEACH
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: RERF17-0156
Description: SHEATHING, ROTTEN WOOD AND SHINGLES
Estimated Value: 10550
Issue Date: 10/30/2017
Expiration Date: 4/28/2018
PROPERTY ADDRESS:
Address: 1542 W PARK TER
RE Number: 1719400000
PROPERTYOWNER:
Name: COLEMAN CYNTHIA
Address: 1542 PARK TER W
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: G D GRIFFITH ROOFING INC
Address: 5616 RAMONA BLVD
JACKSONVILLE, FL 32205
Phone:
PERMIT INFORMATION:
Please see aftached 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$7,500.
Building Permit Application Updated 5/5/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FIL 32233
0 Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: 145V2- -Tevra-ee OJ, klw7c Permit Number: RERF 1-7 - 01 ,5&
Legal Description zt�i P L) S o 6L_ ao if 2— RE# 1!7/940—00 Dn
�_0 f: 4-,- , 61
Valuation of Work(Replacement Cost)$ 1E) oo Heated/Cooled SIF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existi ng/pro posed structure(s)(Circle one): Commercial 6�a�
• 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:Aa'MVQ- e0d Q 4d 14 11 def'/d�y,"rvjt- r7c,,'/ 5 4 e,�A Pr
A-cc,.re, )6 bld' (-*,,,/e-. c'11
.vt,4-s -_1 S��Ijq)
Florida Product Approval#I—L Z_C�0 9 7 RO for multiple products use product approval form
Propertv Owner Information
N a rn e: 61 /'a— 60" lety)
"4-7% ez_ Address:
City 7-FTO-111-117C L-:ja,0
- C.k) State, r—l__ Zip �32-Z33 Phone 7/&- &q(,,7
E-Mail (17100 M-a h S' 6) t I- e-ZVY)
Owner or,Agent(if Agent, Power of Attoreey or Agency Letter Required)
Contractor Information
Name of Company: —Qualifying Agent: /I/t1t.. 611"g,14
AddressZ J/_ 2- - Led city j7kL X State F1 Zip .3;7-7ar,
Office Phone-NOD Z� - y f/9 Job Site/Contact Number 7— / - f YJ g
State Certification/Registration# 4fc.4—' I_T_;7.o 1,6 E-Mail C,) 23
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation
Exempt/Insurer/Lea'se 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) (SigrA406 oUContr;ctor)
1�')
(including contractor)
S* qpnd sworn to(or affir d)bXefo e me t day of orn to(gr affirme�dd before m jrhirt'� �Sda;y of
by J,140 411 bv -5-
MARCIA SMMi
MY COMMISSION#FF 241003 My CowASSION#FIF 241003
EXPIRES:August 31,2019
nuftns EXPIRES:August 31,2019
Bonded Ttrru Wary Public Undei Bv4ed Thru Notary Pubic Underwilers
wP sonally Known OR [�4ersonally Known OR
rorduced Identification
7,
(;�6LC[ I Produced Identification
Type of Identification: icL .0L,_y Type of Identification:
NOTICE OF COMAWNCEMENT
State of Countyof Tax 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 713 of
the Florida Statutes,the following information is tated in this NOTICE OF CO MAMN YMENT
s IC
Legal Description of property being improved: 60
d47jp _�;
Address of property being improved: 45
General description of improvements: Re- - /?&rp
Owner4b-��io— Cbkfr� Address:
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: A&I e1r1!k&-M 19114"Ae? Oat.
Address: /f— -T;4-v rl
Telephone No.: ax
F' No:
Surety(if any) '7R,3 -/a
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 designates the foRowing person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone 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
-?ed: Q-� Date: /047,o h7
t
Doc#2017244367'OR EIK 18162 Page 1455, in he
day of n the Countj of Duval,State
Number Pages:I Dre me s
Recorded 10/25/2017 01:33 PM, r lorida,has pe7r.sonally appeared
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL �onally Known: or
COUNTY duced Identification: 1"W
RECORDING $10.00
ary Public:
commission expires: .......
MY COMMISSION#FF 241003
—..ez EXPIRES:August 31,2019
Bonded Thu wary Public Uoderwnters