1844 OCEAN GROVE DR - ROOF j' 41:
iit sy CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
.ti,f 9 INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0171
Description: RE ROOF SHINGLE
Estimated Value: 10440
Issue Date: 11/8/2017
Expiration Date: 5/7/2018
PROPERTY ADDRESS:
Address: 1844 OCEAN GROVE DR
RE Number: 169627 0000
PROPERTY OWNER:
Name: STEELMAN HARRY
Address: 1932 SUGARTOWN RD
YADKINVILLE, NC 27055-7235
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: EXCEL ROOFING CONTRACTING
Address: 5722 DUNN AVE HENRY SCOTT SORENSEN
MIDDLEBURG, FL 32068
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$7,500.
[.;UILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233 •.
Office (904) 247-5826 Fax(904)247-5845 R E.R F 17_ b 17
Job Address: I/qw a e74 n (rru a /I" .3,, 3 Permit Number:
Legal Description •IO -OG-'09-;1?-"1."-aekmi Ara.143;11,p12. 1-c-hq Parcel# /6,1%/y7 2 - 7O9
Floor Area of Sq.Ft. Sq.kt
Valuation of Work$ 12 ill/AOC) Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door _
Use of existing/proposed structures)(circle one):• Commercial esidential.�
If an existing structure,is a fire prinkler system 'ustalled? (Circle one): Yes No N/A •.
Florida Product Approval# /�' /g�6
For multiple products use product approval form
Describe in detail the type of work to be performed: gs 6.Y 9O7 ii
Property Owner Information:
Name: /`'/ ___ ' - i1Gl,7 Address: )132- 5�//se At:4?) 1d�
City Vag,kik)i/i ne.. State i?'tZip V 7053'P-hone 9", &GI' 72a9.
E-Mail of Fax#(Optional)
Contractor Information:
•
•
Company Name: f �io o d%,�'1�6 Qualifying Agent: bL d4'/. - �t"elan S
Address: 2 :''a De:$nii ,pp/' City o, As an t; //'- State fL Zip :�t!, '
Office Phone lam" ®'-74�,.4 Job Site/Contact Number gt.-_-.3--'5'/i S' Fax# ,11-/-‘94. '
State Certification/Registration# -6(.1,(_. 13 a ff er`
Architect Name&Phone# ,4/4"
Engineer's Name&Phone# .A/;'tl°- -
'Fee Simple Title Holder Name and Address/4-7
Bonding Company Name and Address ,/ ,
Mortgage Lender Name and Address /724- . •
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 o.f a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor•a_perrod of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical{Vork,Plumbing Signs, Wells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Conditioners.etc. •
WARNING T } OWNER: YfSUR FAILURE TS RECORD A NOTICE kI F
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 IF'.
COMMENCEMENT.
I hereby certi&that 1 have read and examined this application and know the same to be true and correct. All provisions of lawsincl� dinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give az ror�" to violate or cancel the
provisions of any other federal,stale,or local law regulating construction or the performance of construction.
,l „ /
Signature of Owner 1: Signature of Contractor . / �—
Print Name __" jgtp� ,64_ Print Name
Sworn to and subscribed before nie Sworn to and subscribed before me.
this '0, Day of ....61,12Y-yin I e,- ,20 / this. Day of
:61"7,,4,:,;1:111.f.,:7
,201- :;1..,
�4jf.- �%'arp,, DENISE LYNN TAIT 4? y � DENISE LYNN TAIT
Public ';_°.--.�a�-_ Notary Public-State of Florida ,, Not Publie4� s _ Notary"Public-State of Florida-
,
Notary i •' Commission#FF980169
{, Commission#FF980169
,,e�op� My Comm.Expires Jul 27,2020�f :i s,, o;� o;.� 2020
„''+'`` Bonded through National Notary Assn. Bonded.through National Notary Ass,:_
NOTICE Or. COMMENCEMENT
. IFFEPARE IN DUPLICATE; : .
Permit No. "� /9 0.6V��'2°
Tax Folio No..
State-of:FLORIDA .. County of
To whom It may concern: .: ..
Theundersigned:hereby informs you'that improvements will bettiade to certain real property.and in
". : :."accordance with Section./.13 of the Florida Statutes,the following information is stated in this NOTICE OF : 1 , ':-
:•COMMENCEMENT.
Legal description of p perty being improved: 0:40 O 09 '' o" ,/�„ : : . "
•
•,
Address of property being imm :roved: g �l ;_ . e..
,
. ". /1704n / / % c- ....' :, :. . ".
General description of improvements:•- :' e...-Pa`81
:o ner , a 1 -.di / •• ."" "
" da � q _e, / •
A . Fes 1s �i j,5 / C 1 j!a'is ,l J�B:: L.. .206. . :
•
- O":/ner's:interest in site:of the impro4ement.OV►I:.NER
Fee Simple Titleholder(if other than owner)N/A
Name N/A.. ". •
Address.. A
I .
SCOTT SORENSEN - EXCEL ROOFING:CONTRACTORS,INC"
Contractor . .
• Address
5722 DUNK AVE JACKSONVILLE FL 32218
Phone No. 904-631"7663 :: No. 904-214-0004
Fax
Surety.(if any) - ." .. """ .. .
Address N/A:. . :. "Amount of bond$N/A:. . . .
N/A
Phone •No... Fax IVo:"
Name and"address of ally:person making'a loan for the"construction of the improvements." : .""
Name N/A . :.
- Address N/A" .
Phone No. N/A:: . - Fax N/A .:::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 N/A
. : : Address N/A : -
I
Phone No. N/A, Fax No.N/A
•
In addition to nimself,o.mer designates the folioiving person to receive a copy of the Lienor s Notice as provided i..�•
Section"713.06(2):(.b).Florida Statutes.(Fill in at Owner's option). •" ". :
:.. Name N/A.. "..
:
..:.Address.N/A .. . .- .. "
•
: . : . Phone No. N/A Fax No.:N/A
.
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. 1 "4 "Q NER .
Doc#2017250215,OR BK 18170..Pa a 944,. : Signed: i '^ �b DATE 1"— "
9 Beton e this /d tlay of e_; O/ in the
NumberPages.1 Coun4.of Duval:`t.e.o Florida;h personally appeared
•
Recorded 11/02/2017:08:18 AM, G ^/, ''-- ,; d , -in bs
RO,NNIE FUSSELL:CLERK CIRCUIT COURT DUVAL : :him t-ft her s that ents deal( i il��;herein-
:
and aYrm zt a statements and `�
COUNTY _ rye
are rile and accuFat= �BER1°VU;f��W6��"J�
:"" RECORDING $10"00
. ".
MY COMMI$3i0 00073737
bru 2021
A 1 ..I / ary"15;
� EXPIRES Fe
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. : ""
` Notary Fu",:ic at L"rge.-�-tet ..County of �m
My commission expires: _
...•.. ... .. ... .. .. .. Produced Identification FL .. ..
Persgnat
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