1128 ROSE ST - ROOF ....
Yj*L`\'y�.j�
/ , ``}„ CITY OF ATLANTIC BEACH
;? 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
�"L0;3 v INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0021
Description: shingle re-roof- FL9792.1 & 16226.2
Estimated Value: 5964.1
Issue Date: 1/18/2018
Expiration Date: 7/17/2018
PROPERTY ADDRESS:
Address: 1128 ROSE ST
RE Number: 171007 0050
PROPERTY OWNER:
Name: CITIZEN CAROLYN S
Address: 1128 ROSE ST
ATLANTIC BEACH, FL 32233-2659
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: The Neill Company LLC
Address: 1412 S Burgandy Trail
St Johns, 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$7,500.
y. <':ti,. Building Permit Application Updated 12/8/17
,r�, City of Atlantic Beach
w.
:,, 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Lie
Job Address: //L ps E. STREET Permit Number: P £ F i 0 —
17-. 3'l 3S- Z$-Z16.,')94
Legal Description A-ch.r/.c ile".. Sec- ti N'oo pr L 41 5" 43/X. ii 2 RE# i 71607-60 S°
Valuation of Work(Replacement Cost)$ Y 5 6 i-f•/V Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial(Residents,
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes NoN/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' ,cv f-
Florida Product Approval#SI\'17 9'z (,(
• I „d..44.y. —4!62,24,2-for multiple products use product approval form
Property Owner Information /?//��
Name: CMCLY/I �_/TJZogAJ Address: // 28' SE 57)W-7--
City
7)7-7City/4-7-ONT I c- gf,icN State FL Zip 32 233 Phone TOL/- 703._ 0 2 Y/
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: /VE/c.( ad.i771vC7-jO,J 64 y Qualifyin y�Agent: I�a ^S ILS /si /r
Address it l Mj,/rd„.. r,A,A 4_,/c._ City ac-4c'n/v,/(c State rt- Zip 7 Z ZS'`'/
Office Phone 1 v Y - 7 t' 5 ~-'7& ( 1 Job Site/Contact Number
State Certification/Registration# C c C t7 Z-15-4 56 E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation $1,-;• S Gr-.14., Ak• W(. (O2 Ok. OCA [, l��j. f tg( (`K
ExempN 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. 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
RECO ING Y UR NOTICE , F COMMENCEMENT.
V ' k _\ )�,� �--
(s-..n.• ure of Owner or Agent) (Signature of Contractor)
eluding contractor)
Signed and sworn • ',r affirmed)before me this 11 day of Signed and sworn to(or affirmed)before me this 13 day of
_.41, , 20/S ,b I --nr)c) C -etVlat,,,,,,-7, 2013 ,by Do:,atn5 /Lr;,r
(46111 Aa. e C/1111--- ---&/-/-1-06C-
SI nature -Nota . IL- • '• .
oow ,"'k%,� DONNA CREWS A .•:�^.`:t:g(•, • 'I V.INMAN
[ ]PersonallyKnown OR _ * MY COMMISSION It FF 114009 [ ]PersonallyKnown OR —•' t.:Commission#GG 125251
* -�..=
It' EXPIRES:April 17,2018 ==,.rw Expires July 17,2021
[]'Produced Identification [...*Produced Identification - F o,.
i r'reoF f\s,q§ Bonded Thru Budget Notary Services „;„.� Bonded Thu Troy Fain Insurance 800-3857019
Type of Identification: 1/� Type of Identification: FL .......... __
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. (\IA U�
State of 4--lc v. c!`h County of 7./
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.
t s'- 3,1 -38-..being2 S _Zn CRY
Legal description of property improved:
A SN-r�c gr.Llt it, H
N if• F{ i.,,,1 5 ail,_ I'fz
Address of property being improved: 1 i ` .iy a�0 if:-- ,)ter g
F TLA-/i 7.1(, RC; t
.> — 3 2,z33
General description of improvements: 4. !i'1fi1
Owner ChM L t°t t in 7..c.-2
/0..) Address t i i/9. r iGr �i' Al-i 'tic , :•4e P"�, .?z S
1
Owner's interest in site of the improvement /6..:
Fee Simple Titleholder(if other than owner)
Name
Address
Air- ('ff Cc Nof
Sirc11L:1 C3-1,-,,,C3-1,-,,,pContractor rirJrJl�P -Z�y
6Address i r q kJ r1(4 r^r firievep- Ade_ /
Phone No. I T�" 7 6 5 V 7 fO 1'T Fax No.
Surety(if any)
Amount of bond$
Address
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name N
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 orit
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): i. \
THIS SPACE FOR RECORDER'S USE ONLY 4j _ ER
(
signed:•. f ,t ' 11 11/44.1 • �lATE 10n17
Before -th- Z-•.yofji�' _., .
Doc#2018013519,OR BK 18255 Page 163,
County of Desai.S r e of F• has•_.;. d.•_red herein by
burse r++�- .elms • •I statements and deciaationsherein
Number Pages:1 jare true- 'accurate o,�".,;u4 DONNA CREWS
Recorded 01/18/2018 12:02 PM, a ' MY COMMISSION#W 114009
BONNIE FUSSELL CLERK CIRCUIT COURT DUVAL * ,?���?
RECORD :,,q . EXPIRES:April 17,2018
RECORDING $10.00 °' n.,?, &Mdidmniaiid9aN micas
i' U)i