300 BELVEDERE ST - ROOF ,rj r�J�-Jcs.
11 cs. 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: RERF17-0189
Description: shingle re-roof FL10674-R10 & FL15216
Estimated Value: 9800
Issue Date: 11/21/2017
Expiration Date: 5/20/2018
PROPERTY ADDRESS:
Address: 300 BELVEDERE ST
RE Number: 170703 0314
PROPERTY OWNER:
Name: WARNER CAROLYN ELLIS
Address: 300 BELVEDERE ST
ATLANTIC BEACH, FL 32233-4174
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Rogero Roofing & Construction
Address: 2980 Hartley Road
Jacksonville, FL 32257
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$7,500.
•
-'._Y l�� Building Permit.Application
•
..moi •r
. J
City of Atlantic Beach
fi oras>> 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845.
Job Address: 3O ue-c't¢.►Y,k-i- 4' FiC.A1."►i-r5.2a3g Permit Number:. P—C- F(4 0 1 Vci
Legal Description 3$(o'-f )-7 5- l Secvccoi I^-1 2 J "PCY.sg RE# I l67c)3-6 31(1
Valuation;of Work(Replacement Cost)$ 9(O n Heated/Cooled SF 1`j"3 8 Non-Heated/Cooled /3"1-17V-fl rCs S 3
• Class of Work(Circle one): New Addition Alteration Repair. Move II-sio 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 N•
• Submit a TreeRemoval 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: /
re.-rrb`t•. rt,,,,1 re.p\ .e�, ,251.53.1 5i,c r .e_.5. c,,a2.l"{ w.e.„ 1rC-"4-1:J 64 de(t-kZn
Florida Product Approval# F/ -1 o(pi c:4 --12Ic). F'/ .1 5 I Co for multiple products use product approval form
Property Owner.Information '
Name: C-Ckgs 1r" lA�f,,l^n4...�
�{'�. Address: Z3OC+ �-Ali`Ps: 4 rL 5 4
City -�-\ctirAc r+ 'Pp! C\ State ( Zip 3vg: '3 Phone clot/-(a$(e)-Zoi(
E-Mail tJ A
Owner or.Agent(If Agent,Power of Attorney or Agency Letter Required)SL.)t-eT-
Contractor Information ,
Name of Company: E ' \
P v: ���l�r �o�•t��1t,n QualifyingAgent: J �j ,
Address ,_2 %(7) r•Ale t ni City '3 u;ll� State ‘JR-- p "3 �---1
Office Phone Qoc(- C/1 .. 40.56 Job Site/Contact Number .ti. i . ,a A
State Certification/Registration# CSC 13 31a.t b E-Mail 'bl,kar, "('o ,erg("b,ri e cry�n„c ,C�rv`
Architect Name&Phone-# C}
Engineer's:Name&Phone#
Workers Compensation LAD c., 61r1 0000 Q 2 st_p ‘ I % I t 8
/Qat
Insurer/tease Employees/Expiration Date
Application is hereby made.to obtain a permit to do e work and installationsas 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 foregoinginformation is accurate and that all work will be:done.in"compliance with all
applicable lawsregulatingconstruction and toning.
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.
C _OD /
ve
(Signature of Owner or Agent Including Con ct ig
p�' (Signatg e o o 'tor)
Signed and sworn to(or affirmed)before me this--day of Signed and sworn to_(oi affirm•d)befotre me this/ 0 day of
6.0'J C1M.'t,..,c , 02017,by r-0/ iir..VSA Nove..+ti\e--a-,as t 1 ,by c.^.l Cc,.s S edl-ct
�► ' Al Cam
i JARYD M:. - ...41111111r. t► ", °••...6v PAUL ROBERT CASSETTA i
tkil
NOTARY PUB (Signature of Notary) , fr;'`�;`' Notary Public-State ofFlori•a {Signature of Notary)
'" -STATE.OF FLORIDA — ;�? My Comm:Expires Ju124 2021
S' �• Cbmm#FF1 X6189 •''FE`F: • Handed through National Notaryassn.
eEr2/10.18 a -
["[Personally. n, [ ]:Personally Known OR
4 roduced Identiflcatio j [ )Produced Identification
TL
ype of Identification: W%�''�S .c (,$v-- 5 f Type of Identification:
.rr rvcwc, vx tsx ltsltti Page 1467, Number Pages: 1,
Recorded 11/14,/2017 03:34 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RE.CORD'ING $10. 00
NOTICE:OF COMMENCEMENT
(PREPARS IN oUPLICATE)
Permit No. e-i -at or 7•Z,t.ca.j Tax Folio No. nbnV�1 z,.-oA14.
State.ot -YI[�r►. County of, 11p
To whom It may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and In
accordance with Section 713 of tho Florida Statutes,the"following Information Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:
5- 1-. aQ nlL0.1- 1 t311L
Address of property being improved: ROO .FVedGYG S4.--
General description of improvements:
r -7o
Owner_C•41. 0:241 r. 1 66 y va
Address TR . p
-
Owner's interest;in site of the improvement Ov41.0 fQ
Fee Simple-Titleholder(if other than owner)
Name
Address
Contractor
Address; '.P. S r.A_ D S 1
Phone No. a O •. .. n'q- .1; '; .7'7)' Fax No.
Surety(it any)
Address. Amount of bond$
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 withintthe.tate of Florida;other"than himself.:designeted by owner upon wftom•notices or other.
documents may be:seNed:
.Name
Address
Phone No.. Fax No. .
In addition to himself,owner designates the following person to receive a copy of the Lienor's 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 a:I"o,
different date is specified):
THIS SPACE fOR RECORDERS USE'ONLY,j NEIR } u' Lt. ch
0O a
_ I Icy • .• E
Signed:- DATE r i f-I t 7 }�
&Lore me this 't ,ay of?_ Q"1��1M r.7�sc 644yyy tr1 2p Q ag
1 County of CIA].Stale of fl`orriidda,Itas porsonell appeared ,(i t�
. • 4/`el.hit.y— _.Ci c..r P herein by
,himself/runnel,and ottirma t al.stat:. ants and declaratons nereln ,�1)P
'are true an.accurate )••I&.!: _. r�,
1 " / 77 q 41
./.0
J.
Not. intro at targe,S .County of .
My nrssran nnpl•es,7f j
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Par aU1.Knorin." _. _ _ _,_.Or._
, P.c. eed rle?ntlieation;p