722 CAVALLA RD - ROOF �. > '' ` � CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
J� ~ ATLANTIC BEACH, FL 32233
"!O;i 9%' INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0142
Description: re-roof FL5259-R24 & FL10129-R9
Estimated Value: 2800
Issue Date: 10/16/2017
Expiration Date: 4/14/2018
PROPERTY ADDRESS:
Address: 722 CAVALLA RD
RE Number: 171365 0170
PROPERTY OWNER:
Name: ASHLEY LINDA J
Address: 13903 SAWPIT RD
JACKSONVILLE, FL 32226-1633
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: Thigpen Roofing, Inc
Address: 2928 Plainwood Place
Green Cove Springs, Fl 32043
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$7,500.
4,-, ►� Building Permit Application Updated 5/5/17
.41 City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
"��" Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: ---)-7--1- c.1/e,IG fid. pp. I3t L ,h_. .7 i L3) Permit Number: 1`--E(t—P ly—D 14a"
Legal Description '/ ' /- 36 Z .5 - 2`t I R0, /P4,,,-s vn:+-1_,4L7
,q (y3 RE#
Valuation of Work(Replacement Cost)$ ).--4700,01) 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: '1-ear o FG ropf f o/ki e- (✓r'I^
GL CJS-P A "d e-d .c•i 4 '1/6) L, -Ala). /„Yc/
Florida Product Approval#14,4 ii. '1'zti 4,4e, Z
, fl )O) 't-Rtifor multiple products use product approval form
Pro ert Ow er Information
Name: L//V wL Address: ( ,214;tjP't Rd ...)60,-., F-1 ))-2 14
City Sc a ate £&, Zip 3 i-2k)( Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information _
Name of Company: )h, pen &' ^f �L Qualifying Agent: ,.G7lb.i/o._
Address 2' t f f]�;,,,.,a,,1 PI_ City 6-( ) State-T-C. Zip 3 Z.0)J
Office Phone 4,q 7-7i,- ) If) Job Site/Contact Number f lj h t) 2 L6.,1'Z;p�
State Certification/Registration# ell L /'ro E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation )--Gr-yr f/4/2.•41
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 OBTAI FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORD YOUR NOTICE OF CO 1 EN EM -NT.
OI. ir /x-
, _
/ (Signature of Owner or Agent) �/ (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this /tTada of Signed and sworn to(or affirmed)before me this 140 dy of
Dci-Disi(t , Lo/ 7 , by L.1,43A S', fi-SNc,oi,y 001 , x011" ,by uCUL Q-a11.1k4.1k . t
5,`r`�P`� CLARENCE E. HILL
L� �211 `!_I .� ��Rr�� -
�I MY COMMISSION#FF948715 (Signature of Notary) ' (Signa re .fi ota
"7c EXPIRES:February 23,2020
`n.;".r,;9-., JENNIFER JOHNSTON
, ,•, ' ; MY COMMISSION#GG 042984
[ ]Personally Known OR [ ]Personally Known OR %-j,,,,„,, ;° EXPIRES:October 27,2020
or rIl° Bonded Thru Notary Public Underwriters
k]Produced Identification .fig Produced Identification ' "'''.' _
Type of Identification: i""..1.-- D L . if ór:2 V -%3,1 3'I cf 2-1P0 Type of Identification: r , ' t 111-1
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
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:
Pl )- I ' O - Z-.) — 2S!-'
rk 3,,,i CA 11.-.4 LJ,• r- — I 1St. .1%11 of1,!_ 3 d' ? J 2,41±Z
Address of property being improved: -7 Z i C.ci t Jam,1 c. A,,/ 4.4)G nt+� 4.I,. 7'r✓.
71.2 ?2
General description of improvements: re- ( F
Owner Y•-ir11ti '/•1), lef► �.>/ 36.A- .1 .-1. 2 2 2 2 6
Address I2i0? .)/c.....fr't- R
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
n Jo Contractor N) c ) h r'Cy/
)t Address , Z?� f 1e.,,,'�;rv, / G'e.4 r;U:�.� 1�C�nl i 1 7 Z�j�!
/ Phone No. 7�N.. Z -1 7�� 1 Fax No.
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 ��' `If l�R f/4 �j , ,, /� /�
B -.ems+'"n �'_ 11 /
C ny of .-lr
himself/herself and affirms that I statements and'--V�'7lv='' -41
Doc#2017237153,OR BK 18153 Page 2002, are true and accurate '
Number Pages: 1 yD CLARENCE E. HILL
` MY COMMISSION#FF9413715
%
Recorded 10/16/2017 04:38 PM, `� EXPIRES:February 23,2020
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL )40
COUNTY ,
RECORDING $10.00 Notary Pubic atLarge,State.of_r/-00./OA, County of D v&'A4
My commission s: 24/
4 fez D 2 v �f y /rsonally Known
/I�,
Produced Identification 65•/► / 5�.3 4q3 /l0