168 MAGNOLIA ST - ROOF ;"' ' �` � CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
15/11
ATLANTIC BEACH, FL 32233
oil INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0170
Description: RE ROOF SHINGLE
Estimated Value: 4891
Issue Date: 1/4/2018
Expiration Date: 7/3/2018
PROPERTY ADDRESS:
Address: 168 MAGNOLIA ST
RE Number: 170616 0000
PROPERTY OWNER:
Name: SULLIVAN KATHY G
Address: 168 MAGNOLIA ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: COMPASS BUILDERS & RENOVATORS INC
Address: 2505 Lane Ave Orange PARK
ORANGE PARK, FL 32073
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$7,500.
4
=` 'a.,., Building Permit Application
Aii
ei City of Atlantic Beach
V800 Seminole Road,Atlantic Beach, FL 32233
A' Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: t(066Pkozikno ick Sr-y'QQ* Permit Number: ' ` C-R P 1 / - V 170
Legal Description (0-(43 - ae-i aqF1{.(��(-- L , 4 Lot- RE#
Valuation of Work(Replacement Cost)$ IA(aQ 1' 54 Heated/Cooled SF (I C,`16 Non-Heated/Cooled 413
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): CommercialResidential
• 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
S"\CI� 4- - Sh (A C.
5
Florida Product Approval# Fi to k 0,4-QNt-k II 15‘)-1 (. for multiple products use product approval form
Property Owner Information
Name: Kaktiy S;,W,vQV\ Address: I GI /agno(i a Stsv.. .+-
City A440.,.-l;<< RQtiC.k State FC zip 3az ;3 Phone (q04) i-{C, 3-(s 56
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: ("QvvTeLSS 'ju'Lk,ts?SS 44- RD n c,Ucs cc SQualifying Agent:
Address '5`3�• f)Qc:takll c sve City ; f l 0th r„(LP State FG Zip 3 Z Z C(C,
Office Phone (1 IP) SO-)-7-7 7 3 Job Site/Contact Number i-o-cv - 1 (7 1d) '36.C,-(1-I q
State Certification/Registration# QC a9 Cal 5 n Q E-Mail kn fl Vu,4) .X( ' c K•CQv \
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation _
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 YOUR NOTICE OF COMMENCEMENT.
.4 4/i ,;:0-14---..-J U.)(1, 45 , C41Re-11/
(Sig' ure of Owner or Agent including Contractor) (Signature frontractor)
Signed and(worn to(or affirmed)before me this-1 day of Signed and sworn to(or affirmed)before me this day of
/Qc.,.;-evAVIIC Cl b 4...A-L.. _ .. vc.. A.A.4.?w� i, abl' , by • . ,..... - / " • • •
" 7�` KRISTA K BURKE-GIRON vt IC l( ��'iltI�
,,,
• +A,r, MY COMMISSION#FF13859gif nature of Notary) (Sienature of Notary)
1 r EXPIRES July 2,2018
• r.+o`,A 4 \ KRISTA K BURKE-GIRON
(ao�)398 0153 FloridallotaryService.com .
I MY COMMISSION#FF138597
%[ j Personally Known OR [ ]Personally Known OR 1,?a ` `� EXPIRES July 2, 2018
[ ]Produced Identification [ ]Produced Identification (407)398-0153 FloridallotaryService.com
Type of Identification: Type of Identification:
Doc # 2017254655, OR BK 18176 Page 1823, Number Pages : 1 ,
Recorded 11/06/2017 03: 17 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of _ T
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.
/ n!,
Legal description of property being improved: 1/ ..' h , 4.1 - ' 01.1 ,
t >� _i 1 a t o4
Address of properly being improve \ .cg V. c 5 "
r titer -`� `� -) • '2�.
General description of imil'
provements: -t0
Owner 1 \ c-] ,t t'Jr\ t
Address 4(0(6 M/t'...\-o Si. L)'.�kar.-}t ' Rent":.' Ft '7ZZ33
owners interest in site of the imp ovement Kn P- r�ncIc
Fee Simple Titleholder(if other than owner)
Name
Address nn
Contractor .. 0;'v\ S (4 f a OuvO j \ R.C; \)Y I;(.1i-CJ,�S
Address 3-3g.(-1 i2,^r ch D^;U•P t .fK I/:Jiir'I La FL
� 37 7.q C.
Phone No. (Ut)L-1.1 F.,07 "7"7:; Fax No. Li u7
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 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 S `� ms's`, .j E
different date is specified): ��
THIS SPACE FOR RECORDER'S USE ONLY i WNE '/ r :' `i%tWilPCf
Signed: IATE /C3/3 fit Myr
eefae Tie this y m C• �j Ir a c ..
Co: '01 at (Fade,.`.as personally appeared o 13 C1 H
y V\ herein by .g 33 t D
himself/herself and trirrns that at statements and declarations herein Z m c
are true and accurate u t7' y to
Z L - C
11
otar:Public at Large, a of ± , County or 0, J.�l g• f� _
Roy ecmmission expires:) 3 p 3?
' Personally Known or
4 Produced Identiflcat:on t� m 7