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1121 HIBISCUS ST - ROOF i, . , ,,„.,,J.,,,,, , ,.„it �� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD jr ATLANTIC BEACH, FL 32233 r n !.) INSPECTION PHONE LINE 247-5814 REROOF SHINGLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RERF18-0006 Description: reroof shingle Estimated Value: 5985 Issue Date: 1/5/2018 Expiration Date: 7/4/2018 PROPERTY ADDRESS: Address: 1121 HIBISCUS ST RE Number: 171011 0010 PROPERTY OWNER: Name: WARD SHELLEY Address: 4360 TRADEWINDS DR JACKSONVILLE, FL 32250-1813 GENERAL CONTRACTOR INFORMATION: Name: Address: , Phone: Name: Jacksonville Roofing USA LLC Address: , 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$7,500. #I; Building Permit Application Updated 12/8/17 , City of Atlantic Beach -%,,;,, • 800 Seminole Road,Atlantic Beach,FL 32233 PP:hone:(904)247-5826 Fax:(904)247-5845 Job Address: i � �'I 14 i bI glks _L 1�11- igentr)-- 3123.. Perm it Number: R -'- C?-©bC3 ) Legal Description /Pig -c ",9-J , 041,3 t414AvhiC 11 S'L'RE#/1710 Ck�101 1$ Valuation of Work(Replacement Cost)$ 5'1 '2 , C Heated/Cooled SF II 9o.. Non-Heated/Cooled /.3,5E) • Class of Work(Circle one): ( Addition Alteration Repair Moe De o 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 Q 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: Re_--C'G p. -- 0r\ q (0 11 T1. 1914-t, w,'4\ ') 511i!es_ rGl kn 3—`r,,\ *n ihvfiL waleclaympn-t Florida Product Approval# 1i S,S5, 1 1 I$1. / for multiple products use product approval form Property Owner/ Information Name: a�p//ct/ wGLS4 Address: i ),1) It'b1�Cf•(3 �f City ANn)gC.(S'8GLC� State FL, Zip 39.„9,3 3 Phone 9oY-03-4(f-- E-Mail _Si r it,'&fd ®CerrlCcOt Vet" Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Ota c't2 Contractor Information • r Name of Company:U� We OVI 1'f br i n �J k1 qualifying Agent: Jt»'vmy--(armAddress lO7 �9. `bb d, '4S City ` I/ill_ Stale pi,.. Zip 3 ,AS7 Office Phone f f-3 74-v i le/ Job Site/Contact Number gt4/-759- 1037 State Certification/Registration CCC j 31bgq,9_ E-Mail c t c2ct7'"/O c;ir 1 C l, 6 hl ' Architect Name&Phone# I/ Pr J J Engineer's Name& Phone# 74- Workers Compensation ? / time_rt 7 d1ch To f,re), /64./,8S r„ Jrksostvrlle �Ctrty-L(sf ;a/,3//t,'' Exempt/Insurer/Lease Employees/Expiratiob/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. NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and there may be additional permits required from other governmental entities such as water management districts,state agencies,or federal agencies. 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. wc,4 Signature of Owner or Agent) (Signature of Contractor) (including contractor) Signed and sworn tojor affirm-.)before me this 1/� day of Signed and sworn to(or affirmed) before me this '`'/ day of + k al) by t -3-6,nti\gi (l b Tmmvt COctC?-4, ,►11.7: R-ERT SCOTT RAW INS 4; G, !' ,j%, ., "t- ,. 1 tionbrii%GG058242 I'�,n a STT RAWLINS • ..;r` EXPIRES December 27,2020 'c MY COMMISSION#GG058242 [ j Personally Known OR [ Personally Known OR EXPIRES December 27,2020 [1.1157oduced Identification [ ]Produced Identification Type of Identification: I- 0 L. Type of Identification: Doc # 2018003075 , OR BK 18241 Page 1969, Number Pages : 1 , Recorded 01/05/2018 08 : 11 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10 . 00 NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. State of noctda County of Duvall To whom It may concern: The undersigned hereby Informs you that Improvements will be made to certain real property,and In accordance with Section 713 of the Florida Statutes,the following information Is stated In this NOTICE OF COMMENCEMENT, Legal descrtptlon of property being improved: 18-34 38-2S-29E.093 ATLANTIC BEACH SEC H S 25FT LOT 2,N 1 5FT LOT 3 BLK 195 Address of property being improved: 1121 Hibiscus St.Atlantic Beach,FL 32233 General description of improvements:Re-roof Owner Shelly Ward Address 1121 Hibiscus St.Atlantic Beach FL 32233 Owner's interest in site of the improvement Homestead Fee Simple Titleholder(If other then owner) Name Address Contractor Jacksonville Roofing USA LLC Address 10702 Hood Rd.t 5 Jacksonville FL 32257 Phone No.904769-1037 Fax No. Surety(If any) Address Amount of bond$ 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 S�r wCJ�"V HER sig • ...JE► D; 1 . !S Betm n this day of •,-1CalFrallriCIOSSY, County of Duval.state el Ponds,- personal,/a., ad WELLY WARP WW1 by himself!tursatf and a at rota . ,.cs harsh are fruit and occurs * * CammkiSion A 88157432 Expires November 4,21121 40/1607 a°ae.d iAry weyst tblrfy«Mus olis 1k atof fl.cRl , county of DomMy commission enamor I:m,oao Psnomown or ProducedBy IdKnenllOcailon R.CPOAPL