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361 SHERRY DR - ROOF :'S�A'yi , ��,` , CITY OF ATLANTIC BEACH 1'-, s) 800 SEMINOLE ROAD uv v~ ATLANTIC BEACH, FL 32233 "LO;t r-.) INSPECTION INSPECTION PHONE LINE 247-5814 REROOF SHINGLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RERF17-0155 Description: re-roof FL18355-1, 15487.1, 37923, 16160.1 Estimated Value: 5937.5 Issue Date: 11/3/2017 Expiration Date: 5/2/2018 PROPERTY ADDRESS: Address: 361 SHERRY DR RE Number: 169825 0260 PROPERTY OWNER: Name: HARDMAN GARY N Address: 8244 OLD PORT CIR N JACKSONVILLE, FL 32216-6335 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: JACK C. WILSON ROOFING CO. Address: 4522 ST AUGUSTINE RD 4522 ST. AUGUSTINE RD. JACKSONVILLE, FL 32207 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$7,500. icy ��+i "" �� :::li'ld:ng 4 '1 I OCT26 Permit Application Wed lZ Q jj i City of Atlantic Beach li -800 Seminole Road,Atlantic Beach, FL 32233 JtitJr _...___ Phone:(904)247-5826 Fax: (904)247-5845 Job Address: '�`'3tca t � C ck-'���rt;� .)4 . t 01141( ,)'1 r I Permit Number: f/-6 f---F (9-^O J S 'S - 1.901 1V"C.32_,' X1(1 .ti�`1 1-vc.- Z' '�-1 rkf`, ►c1 . gCA Legal Description kr,'t.L''A.e, Vs_ (ria-k a'$t 3� 'A1K S RE# 1 V-i C.icsAs" ":::Il ic 0 Valuation of Work(Replacement Cost)$.`J Cit 1,S rd Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Doo r.)c • Use of existing/proposed structure(s)(Circle one): Commercial Residential-1 • 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: '"?-41...0 1 Florida Product Approval# (6x.55- -`. '6 1•, '•511)..3 1bt.‘.d-` for multiple products use product approval form Property Owner Information 1111......1-("4-Name:C--nt.,7 A {\;.tCt rrlc_.n Address:'?) ) \ 1'7 C 1 t City Yt41,c:i< -tc. "&i'.c\eN State I .L Zip?.,iia l Phone ' G '3 2.-,l`a E-Mail Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Contractor Information _ Name of Company: e 731;`....) p y: C� L w :�. T�-[ (C"au Qualifying Agent: Crc� Y Address L\`4 E ` . 4 ,, 4\k,, " ai't+-,.s.. 1\ i City .c'C . ><7+t At Stater-t Zip-.?..,:...4a.`�� '1 Office Phone�0,0'...!."? `�C:ILL. .t 4.'" Job Site/Contact Number State Certification/Registration#C.t_L 0 "l'i S 1)t E-Mail J'VJ i"-Z.,:-/A.i SC Lvf'c� C(--,rn Architect Name&Phone# Engineer's Name&Phone Workers Compensation IA 1S.,A.". • l >^Z g' 41. ',-'• 3 - 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 OBT' FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECO:A,G YO ' OTI OF COMMENCEMENT. .� II c... zos.f....__........" (Signature c finer or Agent including Contras r) (Signature of Contractor) i y j"��S�iig ed and sworn • •, affirm/fid)before a t}hiso� day of Sig ed and sworn to(or affirmed)befoor�me this-\day of `�,v ,a by 1 51CV-� CCI MC(11 OC c › c7.r\,by '‘ACT eild \LIS �,I,L- — .:,,e-o1/4. atA Jt-2 (Signature of Notary) JESSICA SOULE .ez MY COMMISSION#GG083767 JESSICA SOULE EXPIRES:MAR 15,2021 %fir r\ � MY COMMISSION#5G083767 [ ]Personally Known OR o"0" Bonded through 1st State Insurance Personally Known OR EXPIRES:MAR 15,2021 [(�toduced Identifica jun ( ]Produced Identification a^ Bonded through 1st State Insurance Type of Identification:' ' ITOS L.iCILOSe Type of Identification: NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) (c�, Permit No. Tax Folio No. Y1/,� `�+ ©a C State of 1(.4- County of IVO,, 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 stated in this NOTICE OF COMMENCEMENT. �} Legal description of property being improved:S --bet "L `�`"\ k 0 S - �% \as, '�3 i31 5,Q n r,,, nbcr-tt 44.4c--,0 \ ►r t,� 4A-Nkit., 04:: Address of property bein,g improved:��I r- General description of improvements 'c c c Owner `�flC CVS GCC\M&,A Address''b\ SYK1 f�+'�(' - t 0.(Or 1 C L t,t:.h Owner's interest in site of the improvement .1 CY0'D Fee Simple Titleholder(if other than owner) Name Address,. ,/ _ Contractor X+�(,�.. C \' \0317 .. � - L 1 Address a a Jam. v:��,11 1AL_` ( 3 • •1"14 1�k+ I Qa()-1. Phone No.��O�').C "1 Fax No. • 4 . - l • Surety(if 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 within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: 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 different date is specified): THIS SPACE FOR RECORDER'S USE ONLY II OWNER A Signed: � 1 � D T I Z1! / N Before me this I _'et,•_f *1402r1'I'P .. I the ,� V Doc#2017237868,OR BK 18154 Page 1651, :ounty of Duval. of orida.has persona y appeared o 4k v, ma�yy[[ rr��.//�� herein by a Number Pages:1 ilmself/herself and ms all s eMiit and declari�tions herein v y Recorded 10/17/2017 12:22 PM, u, u, ire true and accurate RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL u o ,s ac e COUNTY RECORDING $10.00 -�� ����� g VotaryPublicaLarge.Std - �County of f\-)L)/C.\\ _ , • My commission expires: j Personally Known or Produced Identification