201 PINE ST - ROOF L`I
• s' CITY OF ATLANTIC BEACH
" te a:-
15 . e} 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
"'Lost S) INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0159
Description: re-roof FL10674.1-R4 & FL15216.1-RO
Estimated Value: 7550
Issue Date: 10/30/2017
Expiration Date: 4/28/2018
PROPERTY ADDRESS:
Address: 201 PINE ST
RE Number: 170565 0000
PROPERTY OWNER:
Name: CASAS MARGARITA MANALO ET AL
Address: 837 F TAYUMAN ST
MANILA PHILIPPINES 1012,
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: HAMMER TIME ROOFING
Address: 13465 SOLEDAD CT DR
JACKSONVILLE, FL 32204
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$7,500.
,.s.JJ BUILDING PERMIT APPLICATION
,
P CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
,-_,= .---!/;!..---/•- Office:(904)247-5826 • Fax: (904)247-5845
Job Address: _o f )),,e_ S4 AH., „ L Permit Number: 1?-61�-t" (--4-- 01,s-c,
Legal Description / - RS e 1 ,r S e_3 ez4 S3 7 RE# / 7G co--ox )
Valuation of Work(Replacement Cost)$.4'j 573 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo 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 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: ��_ i,•
Florida Product Approval#1)JAG 7 1-Q./ //ç D /62_ )-20 for multiple products use product approval form
Property Owner Informati nh •�ff ��'" C'
Name: l— c?ggak Address: 265 Pine st
City May -( £ 1-' Stater Zip 22 33 Phone d'St.f-LjD1 - 1O6
E-Mail Lel,U( el. t- 3c5a --� 9mtaiI ( ,Qyr)
Own: or AgeI1t (If Agent,Power of Attomey'6r Agency Letter Requited)
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.
Contractor Information:
Name of Company:/-4,,./m1.1.-.*t ) LLC Qualifyin Agent: 4.,l ty�y fe.to,coLA,-7
Address: /:3//( j '64. City,V-..., kle,.,,,.//e_ State Zip R. 3 Z 11 t'(
Office Phone 09011) 7/6 <%y'' Job Site/Contact Number rui) <)NCi- a ,y S-4
State Certification/Registration# (:_c_crt319s 3 E-Mail t'1Ararte- .,..,e ,-iLc 4' S sem, I , .,�
Architect Name &Phone# ��ttilillitt
Engineer's Name &Phone# �0% 0AVIL..4
� r
Worker's Compensation 13(",clsCie c (' n �`�Q- oTARy••:•v�
)ate • .
mlit nsurer Lease Employees / Expiration Date =Q:: ;
m xpires; —
Application is hereby made to obtain a permit to do the work and insta laiions as indicated. I certify that no work or instal/atioie is=d�ln l 2o2o
pnor to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction i.this•uiI 14439 J
This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended o/,<tba,f4: . Q
period of six(6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical , Jd1 u ergg,, G Q
Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. lf j; U61;�• •• %�
B
Signature Property Owner:r`-,, 4a� 0 Signature of Contractor: I4E! "1 t t ‘�`
this Day of 0 c " k 1 Before me this / ' Day of ,��/2
(1J(t/1144/inac
Notary Public:
V l C b2JF?' Notary Pu. d ��f .
411
I herd
application and know the same to be true an.
. rivet. Al/provisions of laws and
ordina r.�, y .y��in t/ 1M.th4E ANN,ANOENSON)r 4niplied with whether.specified herein or not. he granting of a permit does not
presun ' p ft{JxNt �p
grUpli�susivi plOYl'dit% `/n'ovisiatis of any other fe eral, state, or local law regulating construction or the
pe>.fn0(a; •.: IV'wetd ission#GG 012344 •
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Doc # 2017246908, OR BK 18166 Page 536, Number Pages: 1 ,
Recorded 10/30/2017 10 : 23 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
(PREPARE IN OU-LICATM1
Permit No, Tax Folio No.d7C$G S�' °Cloy
State of ;in.�;d, County of ,a,C i
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 statedlri this NOTICE-OF
COMMENCEMENT.
Legal description of property being Improved: 16-
/-
-/- S 7
Address of property being improved: 00 I 19:0? S 4 •
btu r & , fC �.��. 33
General description of Improvements: RC—
Owner J.Z Q- - 1 qq qqoW
Address �,55 •P'rhe c-f-, y9 tia✓I11tc. eeaCil , FL 32-133
Owner's Interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor 12n�y+p , Ke•-t pia Mgr - tMe r—ZaCl,14 u�
Address /3 Y6 0 rt-„ C ar Y...,.11e 1:C Ya a L1
U
Phone No( b') 7/a,-`I'/y? Fax No.
Surety(if any)
Address Amount of bond S
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 Llenor'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 I / r*‘-- f0
°lQnsd: 1�aA,%Y.t DATE )f�ji
Pi r•m•his �'pay of in the
Co;:nVu�V+�y�j��1!, red
WW1 by
hirr.se U hs. if and e'a Ilanaspus appea
t al statements and da4arat,sns haroh
ars We and accurate .. — y
,,,,,;,':' CAMILLE ANN ANDERSON i.. p
est�(���, (�/�-,, `1h e Notary Public•State of Florida
it &44 4 • y{w '1* •' Commission+#GG 012344
1 Notary Public at Lerc•,SIe; p /_ ^�OL!1' •• Comm.Expires Aa 4,2020
by ccmmsslcn expires: I: I; 1I/_�l 7 ♦J'�.'.: .,'. I_ 7
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Perin hely Known
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Produced Idsntificeton
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