555 Beach Ave re-roof permit 1 f CITY OF ATLANTIC BEACH
y�
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: RERF17-0204
Description: SHINGLE RE ROOF
Estimated Value: 17245
Issue Date: 12/5/2017
Expiration Date: 6/3/2018
PROPERTY ADDRESS:
Address: 555 BEACH AVE
RE Number: 170156 0000
PROPERTY OWNER:
Name: WARNOCK HARRY C
Address: 555 BEACH AVE
ATLANTIC BEACH, FL 32233-5323
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: MY AFFORADABLE ROOF
Address: 1585 KENNESAW DR
CLERMONT, FL 34711
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
Phone: (904) 247-5826 Fax: (904) 247-5845
,/ ,,,, �,/n 2G_k,,x- 17- b Z0 4-
Job Address: 555 1 -M (.XI Permit Numbe
Legal DescriptionR �"lt)ob
Valuation of Work(Replacement Cost) Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): CommerciA Resident'
• 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 detailt
hetypip of work to be performed:
1-it
Florida Product Approval#142677 1100A I — for multiple products use product approval form
Propertv Owner Information
Name: Address: v
City State zip PhoneJeWn-11-M
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information `
Name of Com any: Quali ing Agent: o `l V
Address City State zip
Office Phone Job Site/Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation ffek-Ny C!'bm dliCll I:* tAILQ8116D= CA
Exempt nsurer/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 Age including Contractor) (Signature of Con r)
Signed and sworn
ytt-oo(or affirmed)before me this May of Signed and sworn to(or affirmed before me this��ay of
by by
(Signature of Notary) (Signature of Notary)
Roberta Bennett µ Roberta Bennett
�> NOTARY PUBLIC NOTARY PUBLIC
STATE OF FLORIDA STATE OF FLORIDA
[ ]Personally Known OR : Comm#FF952012 Personally Known OR Comm#FF952012
riroduced Identification 1 1e Expires 1/20/2020 r ]produced Identification tie Expires 1/20/2020
yT pe of Identification: Type of Identification:
Doc # 2017265088, OR BK 18191 Page 753, Number Pages : 1 ,
Recorded 11/17/2017 08 : 53 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
1 L►I
PERMIT NUMIMR:
NOTICE OF COMMENCEMENT
The undersigned hereby gives notice that improvement will be made to certain real Property,and in accordance with Chapter 713.
Ronda Ctamtcx,6c Nin infnrmatim is Tovidcd in this Voticc of Co_ enamor — / �/
I. M"IPTI(A'OF PROPERTY(Iteral description of the rwareny k suref addmu.if aaailahl;)TAX FOLIO NO.:� l/1 �
SU661vtslON /��1k 1Q i (( ^14,(1(j i.et.00KiBLDG IWIT 20,
) -L TRACT , c ,, ----7'— t
' t
' GF,%(�[RALDjE�S(.'RIMON OEE IM OVF.MENf:
3. OWNER INFORMATION OR LESSEE INFORMAflOY IF THE LESSEE,CONTRACTED FOR THE IMPROVEMENT:
a.Name and addrrs;: L� � '
C'%*A'w and addrra<of fec um*cdeM.ldei iii J1ffen:04 Ban Oww bacd abnve)'
i. a.CONTRACTOR'S NAME: My Affordable Roof
ria=, s.►+� 1585 Kennesaw Or Clenr#W FL.34711
' — —
S. SliaF.TY tilappieable,a copy ui Ihr povmpM bum:n1na'ehrdl: -1%.
b.Ph n l—brr
6.a.LENDER'S NAME: —
��<::�:
Phone nun:\T
7. Persons within the State of Florida dcsiynuted by Owner upon whom notice.Or cher documrnts may be sers ed as protiidad b
Seaitxt 713.13(1)(a)T.Florida Statutes: y
a\uxaad addrece' J ,
b.Pf o e numbers of dmigoawd pe .
S.a.In addition to himself or herscl&Owner dtsignates
to rCCttivc a copy of the Lacnor's Notice as provided in Section 713.13(1)(b) Fonda Statutes.
b.P4sonc m,mbs.nfpa.on oz entry dvsornatd by Owoo:
9. Expiration date Wee of commencement(the expiration date will be I year from die date of recording unless a different date is
spocifiedt —,?1D _
WARNING TO OWNER' ANY PAYMENTS MADE-BY THE OWNER A TFR 7HF EXPIRATION OF THE NOTICE OF CO.MI VC'Em.EN-r
ARE CON,511>FREO 1�1PROPER PAYMENTg LNMR CHAPTER
713.PART 1.SECTION 71=!:RESUL7 FRIDTAVR.[-WO M- NTSTOYO R
PROPERTY A 1 T1 F OF C0MMENCD1ENT MUST BE
REMR1)ED ANiD POS7F.D ON TFiE lOB SITE B�FFORE THE FIRST A•SPECTION. fF YO!IIuTEIVn TO f>87AtN F_ tRIANC(IJCi.CONST LT
)LliLli.YOL-R LENDER OR ANA TOatil:Y gEEORE:COMTt1�lCItiG H'ORIi OR err� RDINi,YOLK N TI .OF�4f�Af1vG'F�.1_hT
s
{SiRaature er Lesaeq Or Owner's or[eteee's (Print Vase and Protide Siltnatary9 TiddOlBec)
Authorized OfBeer/DN'ieetor(Partuer/Manader)
State of L
County of tit( y
The fore-oina instr:mmt ssss/ere c ul�ced before^u this
by
(name ofpe rson) (type ofauthority...e&officer,trustee,attorney in fact)
for_
(name of yon behalf of whom iTiStrymenI was execut
Personally Known_or Produced Idcntification pe ut'Identification Ptoduced
otary Public)
�CfaK'a�L, (PrinLTypc, ommissionedName OfNotaryPublic)