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1242 BEACH AVE - ROOF c_r'� r CITY OF ATLANTIC BEACH iso f 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 X0;3 >%' INSPECTION PHONE LINE 247-5814 REROOF SHINGLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RERF17-0218 Description: SHINGLE ROOF Estimated Value: 5978 Issue Date: 12/14/2017 Expiration Date: 6/12/2018 PROPERTY ADDRESS: Address: 1242 BEACH AVE RE Number: 171828 0000 PROPERTY OWNER: Name: KIRKPATRICK ROBERT BOYD TRUST Address: 1242 BEACH AVE ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: , Phone: Name: PRIME ROOF CONTRACTING LLC Address: 13792 HERONS LANDING WAY APT 9 QA MARK ANDREW YOUNG JACKSONVILLE, FL 32224 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. r ` Building Permit Application City of Atlantic Beach utt 800 Seminole Road, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Fax: (904) 247-5845 Job Address: 1242 Beach Ave. Permit Number: R ER 7 — 02- S Legal Description 10-11 16-2S-29E MANDALAY LOT 6 BLK 50 RE# Valuation of Work(Replacement Cost)$5,978 Heated/Cooled SF 1811 Non-Heated/Cooled 200 • Class of Work(Circle one): New Addition Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s) (Circle one): Commercial <ke-sidentia • 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: Replace asphalt shingle roof Florida Product Approval#FL10674-R12 (shingles) FL17420-R2 (felt) for multiple products use product approval form Property Owner Information Name: JOHN AND SUSAN KING Address: 1242 BEACH AVE. City ATLANTIC BEACH State FL Zip 32233 Phone 904-868-6957 E-Mail king9929@bellsouth.net Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company: Prime Roof Contracting, LLC Qualifying Agent: Mark Young Address 13725 Beach Blvd Suite 13 City Jacksonville State FL Zip 32224 Office Phone (904) 530-1446 Job Site/Contact Number (904) 860-0230 State Certification/Registration# CCC1329505 E-Mail office@primeroofingfl.com Architect Name& Phone# Engineer's Name& Phone# Workers Compensation FRSA Self Insurers Fund Inc. 1/1/18 870-040093/3EE6142 _ 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 OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y R NO CE MMENCEMENT. Ay/air /41 4440.00 (Signature of Owner or Age including Contractor) (Sig . ore of'ontractor) Signed and sworn to(or affirmed) b ore me this 1111.day of SignedSi _ a d sworn to(or:f"rm:s before e this/day of Tectr. , ZOIT by SVSvicas ki L01 , by R( (Signature of Notary) (Signature of Notary) „9f.i✓��, „ ' Andrew D. Davis QP�. � ,• P�Y'tf7/1"', Andrew D. Davis " ;�_ - COMMISSION?'FF160849 '2a sa` -= COMMISSION#FF160849 [1ersonally Known OR ° ��'-;• c EXPIRES: Sept. 17, 2018 ['ersonally Known OR = �, ." • EXPIRES: Sept. 17, 2018 Produced Identification ~i it WWW.AARONNOTARY.COM : N [ ] ,,,�������� [ ]Produced Identification WWW.AARONNOTARY.COM Type of Identification: Type of Identification: NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. State of Florida County of Duval 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: 10-11 16-2S-29E MANDALAY LOT 6 BLK 50 Address of property being improved: 1242 Beach Ave.,Atlantic Beach,FL 32233 General description of improvements: Re-roof Owner Susan King Address 1242 Beach Ave.,Atlantic Beach,FL 32233 Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address Contractor Prime Roof Contracting,LLC �b - / Address 13725 Beach Blvd Suite 13,Jacksonville,FL 32224 �J�'f9'�" Phone No. (904)625-i4as 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 //� Signed: dr-i / DATE/2 Before me this day of in th Countof Duval, a of Florida,has personally appeared nv � dein by Andrew D� Davis DCC#2017285192,OR BK 18218 Page N he 2417, himse rself an affirr s that all statements and de dri ltey Number Pages:1 are true and accurate ' ' 11n 'O COMMISSION#FF160849 Recorded 12/13/2017 04:10 PM, ,'�*.:P= EXPIRES: Sept. 17, 2018 RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL �) ,64..!6:•• ° INL4tLN.AARONN07ARY.CQA9 COUNTY t(/ n+unn RECORDING $10.00 Nota Public Public at Large,S ate/of / County of _ My commission expires: '/1-J• Personally Known ✓ or Produced Identification