239 BEACH AVE - GARAGE ROOF r,\J,
�� CITY OF ATLANTIC BEACH
tS
11
'"` s' 800 SEMINOLE ROAD
Kv„_______
ATLANTIC BEACH, FL 32233
Ao,3i� INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0150
Description: Garage Apartment Shingle Reroof
Estimated Value: 6258
Issue Date: 10/19/2017
Expiration Date: 4/17/2018
PROPERTY ADDRESS:
Address: 239 BEACH AVE
RE Number: 170190 0000
PROPERTY OWNER:
Name: HYMAN CHARLES D
Address: 239 BEACH AVE
ATLANTIC BEACH, FL 32233-5214
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: FORD ROOFING SYSTEMS INC
Address: 1216 N Burgandy Trail ST
JACKSONVILLE, FL 32259
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$7,500.
7-rf",,i,„ BuildingPermit Application
. _
,,, , City of Atlantic Beach
;� 800 Seminole Road,Atlantic Beach, FL 32233
71;iiklf%
Phone: (904) 247-5826 Fax: (904) 247-5845 p
Job Address: 239 Beach Ave, Atlantic Beach, FL 32223 Permit Number: .-. ei r1-060
Legal Description 5-64 16-2S-29E Atlantic Beach Lot 3 BLK 27 RE# 170190-00
Valuation of Work(Replacement Cost)$ 6258 Heated/Cooled SF 1700 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: remove shingle roof, install new shingle roof I
Florida Product Approval# Shingle FL 10124.1,underlayment FL 17401.1 for multiple products use product approval form
Property Owner Information
Name: Charles and Janet Hyman Address: 239 Beach Ave.
City Atlantic Beach State FL Zip 32233 Phone 904-343-3366
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor information
Name of Company: Ford Roofing Systems Inc. Qualifying Agent: Robert Maust
Address 1216 N. Burgandy Trail City St Johns State FL Zip 32259
Office Phone 904-471-2819 Job Site/Contact Number 904-699-8688
State Certification/Registration# ccc1327698 E-Mail fordroofing@gmail.com
Architect Name&Phone#
Engineer's Name&Phone It
Workers Compensation Lease Employee/Bouchard Insurance for WBS/WC 90-00-818-06/exp: 12/31/17
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 , ATTORNEY : - ORE
RECORDING YOUR NOTICE OF COMMENCEMENT. /
/ /
i._ r J`...ro"
(Si:n. . sf ner or Agent including Contracto (Si: ature of Contractor)
:ned and sworn to(or affirmed)before me this/fir/day of Sig ed a • orn to(or affirmed)before me thisy/fi iy of
tii � .24/7— ,• �/7 , by c c�
A,.,�✓ CCT2ett)/ f4? , by , 8c2T ,j
•
Nj 777.1;; EXPIRES aWi 2 (Potary) _ = PAYC�BJ y)
o'
-74€OF 4:-. Bcoded Thu Budget Notary Services T. .', Ex - . . . 6„2.020
1>eOF Food Bondec'hru Budget Notary Services
'(Personally Known OR [ •PA-sonally Known OR
[ ]Produced Identification [ ]Produced Identification
Type of Identification: Type of Identification:
NOTICE OF COMMENCEMENT
PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 170190-0000
State of FL 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: 5-64 16-2S-29E ATLANTIC BEACH LOT 3 BLK 27
Address of property being improved: 239 BEACH AVE Atlantic Beach FL 32233
General description of improvements: re-roof
Owner Charles and Janet Hyman
Address 239 REACH AVE.Atlantic Reach F1.32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Ford Roofing Systems Inc
pct Address 1216 N Burgandy Trail,St Johns FL 32259
Phone No. 904-471-2819 Fax No. 904-461-8453
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 / OWNER
Signed: _ ,r/� DAT
Before me is F. C �
ay o ��l iM' in the
Coup of ival tate of Fl r da.has pery appeared
Doc#2017240326,OR BK 18157 Page 1517, LQ /}?/son herein by
Number Pages:1 htmse erseif and affir I all statements and declarations herein
Recorded 10/19/2017 02:56 PM, are true and accurate
ear ptiee, GREGORY J.BARTHOLOMEW
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL i
COUNTY __�� `ex � % 48753
RECORDING $10.00 ` -- :Feb-uary 6,2020
Notary Pubic at Large..," irek
My commission expires: ,, Avgi'
Personally Known or
Produced Identification ft 0 Z