1359 BEACH AVE - ROOF s� CITY OF ATLANTIC BEACH
c) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0148
Description: RE ROOF SHINGLE
Estimated Value: 17871
Issue Date: 10/19/2017
Expiration Date: 4/17/2018
PROPERTY ADDRESS:
Address: 1359 BEACH AVE
RE Number: 170299 0000
PROPERTY OWNER:
Name: GOELZ JOHN H
Address: 1359 BEACH AVE
ATLANTIC BEACH, FL 32233-5731
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: SOUTHERN COAST ROOFING & CONS
Address: 4557 EAST SENECA DR QA MEHMET ORS
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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 t\ ERE ( 7 - b (4
Job Address: 1351 SePe-e-XVE•glAirIC,(c41CW32233 Permit Number:
Legal Description 147L'P4.)rtC DSPC* 1-OT713, [34X---5 2 Parcel# I '9"D 2 'tel qI 00V0
Floor Area of Sq.Ft. Sq.':t
Valuation of Work$1 `:3 'I•?7 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration epair.„, Move Demolition pool/spa window/door
Use of existing/proposed structures) circle one): Commercial l/ Aal
If an existing structure,is a fire sprinkler vslem installed?(Circle one): Yes No
Florida Product Approval 4 f' Dl 24/FL—186$6
For multiple products use product approval form
Describe in detail the type of work to be performed: TENS CIF- ' 'Re 12-00E- i &fi., --tv ,}1-1 1,$
Property Ow ner Information:
Name: JO4 ,5J Q0‘12- Address: 1 g69 .W4C-14 71-1./�• •
City 1eTt.Anrn(- > A CA-t Statet=G Zip Jzz 3 3 Phone q'p 9-4 51-6 S)4-
E-Mail or Fax 4(Optional)
Contractor Information:
Company Name: 0 I ..' NI r-441ga0 h'•1- Qual.iking Agent: H l T,e7S,
Address: 3b22.- G A 1.-1.-1 PA/ 'R.D• City 4ACK`3GYV V t t-La State t- Ail) 2-2 O -
Office Phone Plc-354-'bhQ .lobSite!Contact Number 0Ay gb439S8$S7-Faxf C?'t (
State Certification/Reaistration 4 CCC 13 2$-9'9.(
Architect Name&Phone 4
Engineer's Name&Phone 4
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated l certify that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet the stmulards of all laws regulating construction in thrs jtiri sdictron This permit becomes null
and void If work is not commenced within six flit months or if construction or work is su.cpended or abandoned forariad of six i6t mom In at ant time after
work is commenced. I understand that separate permits must he secured for Electrical N ork,Plumbing.Signs, Mels,Pools,Furnaces.Boilers,Heaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOIJ INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
/hereb•certify that/have read and examined this plication and know the same to he true mut correct. All provisions of laws and ordinances governing this
opt,of work will he complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel The
provisions of any other federal,stare,or local law regulating construction or the performance of construction.
(..."-----
/
Signature of Owner i • (T--
/— � i Signature ofContra /�
Am
Print Name fQ get 6-0c.1-7.__ Print Name { Ar, ,
Swornto and subscribed before me Sworn to and subscribed befor me
this tI Day of r .2011 this AltDay ofGL '�[ �% 201
`i b lB2 tot (1gAjw *I<<t!/ •4a 414 - c1- /
Notary Public otar u,rc
Revised 01.26.10
4
a9 Notary Public State of Florida
Mona G Carter
My Commission FF 203242 !•P.", PAMELA SOMPHONPHAKDY
.'or Expires 04/03/2019 tri,
MY COMMISSION A FF221913
•/oomftf. EXPIRES April 19.2019
,41;t,s5it:.c•5:t ft nal lora'Zlary atmr
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No,
State of r.OtDA 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 descnpton of property being Improved: REQ l 70299 DODO
LEGAL DESC.6-IATLANTIC BEACHLOTS 7,8 BLK 52
Address of property being improved: 1359 BEACH AVE Atlantic Beach FL 32233
General description of improvements: RE ROOFING
Owner GOELZ JOHN
Address 1359 BEACH AVE Atlantic Beach FL 32233
Owner's interest in site of the improvement 100%
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor SOL-11[ERN COAST ROOFING&CONSTRUCTION INC.
Address 3622 GALLION RD.JACKSONVILLE.FL 32207
Phone No.904-356-7663 Fax No. 904-330-0836
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 tie 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 NE
Signed:_� / DATE AP//0//7
his_y� day of i, u i�
_�(� Y' i . in the
County of D v. State of q.i;t, as personally appeared_ __ .
himself/hersett and anima that all statamen-and d ations srein
Doc#2017237963,OR BK 18154 Page 1949, are true and accurate , Notary Public State of Florida
Number Pages:1 . Mona G Carter
•
Recorded 10/17/2017 01:23 PM, / My Commission FF 203242
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY /, )j 4(✓ orn Expires 04/03/20ts
6
RECORDING $10.00 Notary PubiicatLarge.SW.eof t%foricounty of
My commission expires:.!.4 3 J t n+_.._...
Personally Known
or
Produced Identification