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367 19TH ST - ROOF CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 \\Q011 >`' INSPECTION PHONE LINE 247-5814 REROOF SHINGLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RERF18-0014 Description: Estimated Value: 15280 Issue Date: 1/11/2018 Expiration Date: 7/10/2018 PROPERTY ADDRESS: Address: 367 19TH ST RE Number: 172020 1308 PROPERTY OWNER: Name: ISABEL R JOHNSON REVOCABLE TRUST Address: 367 19TH ST ATLANTIC BEACH, FL 32233-4541 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: HAGERTY CONSTRUCTION AND ROOFING INC Address: 12850 WINTHROP COVE DR QA QUIN J HAGERTY JACKSONVILLE, FL 32224 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$7,500. Building Permit Application J . t 11 City of Atlantic Beach `l 800 Seminole Road, Atlantic Beach, FL 32233 = ,_ ,,,y Phone: (904) 247-5826 Fax: (904) 247-5845 Job Address: 367 19th. Street Permit Number: ii'N �r (:12--'00141 Legal Description Lot#3, Unit#12-B, Selva Marina RE# 172020 - 1308 Valuation of Work(Replacement Cost)$ 15,280.00 Heated/Cooled SF 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: new asphalt shingled roof(re-roof) Florida Product Approval# Shingles FL10124.1 Underlayment FL10626.1 for multiple products use product approval form Property Owner Information Name: (sable Johnson Address: 367 19th.Street City Atlantic Beach State FL. Zip 32233 Phone 1-904-910-2650 E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company: Hagerty Construction& Roofing, Inc. Qualifying Agent: Quin J. Hagerty Address 12850 Winthrop Cove Drive City Jacksonville State FL. Zip 32224 Office Phone 1-904-992-9960 Job Site/Contact Number 1-904-591-4354 State Certification/Registration# CGC 019551 E-Mail hagertyinc©yahoo.com Architect Name& Phone# N/A Engineer's Name&Phone# N/A Workers Compensation Bridgefield Employers Insurance Company 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. I i ___________ ALW-4ae (Signature of Owner or Agent in uding Contractor) ( gnature of Contractor) Signed and sworn to(or affirmed) before me this q day of Sigr e_d a d . n to or affirmed) before me this q day of 2018 , by 1-.S.„, L...,1 k AL• _ ,' 2018 , by Q j J. Ha•e SPayAs um J.Hagerty o l`',,: soo NOTARY PUBLIC �''�,� —i o ? � 7.;STATE OF FLORID Mr Ca re . Notary) ( i. •ture of Notary) ex, i Comrrd#GG119052 .s> 1.910 Expires 6/26/2021 4�0„'�}.�e JAKE MILI.ENDER [ ]Personally Known OR [)d Personally Known OR * A� * MY COMMISSION#FF 940637 [x]Produced Identification [ ] Produced Identification •rey EXPIRES:December 2,2019 Type of Identification: Florida Drivers License Type of Identification: 1.o,+rFo„ve>° gond21irTgot?!m;u ;rYx NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. 172020- 1308 State of FLORIDA 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: Lot#3, Unit#12-B, Selva Marina Address of property being improved: 367 19th.Street,Atlantic Beach, Florida,32233 General description of improvements: new asphalt shingled roof(re-roof) Owner Isabel Johnson Address 367 19th.Street,Atlantic Beach,Florida,32233 Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address Contractor Hagerty Construction&Roofing,Inc. Address 12850 Winthrop Cove Drive,Jacksonville,Florida,32224 Phone No. 904-992-9960 Fax No. 904-992-9961 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 Adoress 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 ocv N different date is specified): U o >. o8iN THIS SPACE FOR RECORDER'S USE ONLY R f dri Lt N Signed: des DATE 1 !9/1? re me this � {day o' V` Z � OC7 CouBefonty of Duval,Stare of Florida,nas personally appeared in the c Q < ISABEL JOHNSON herein by ': Q x Doc it 2018007951,OR BK 18248 Page 250, himsel7 herself and affirms .t all statements ane declarations herein o Z :..) r., LU Number Pages: 1 are true and accurate Se • Recorded 01/11/2018 09:32 AM, . I Se % RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL / / ix Mi; COUNTY D ��./ �.� RECORDING $10.00 ��' y Notary-Mr at L- IDA , County of DUVAL d�fZi��• My commission ex. Personally Known I&- o" Produced Identification •RII!i1r RS LICENSE