387 BELVEDERE ST - ROOF 6' rt.
lit ITY OF ATLANTIC BEACH
`- si 800 SEMINOLE ROAD
yr ATLANTIC BEACH, FL 32233
"4o;3 >% INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0031
Description: shingle re-roof FL16568.1 IK07006.1
Estimated Value: 8500
Issue Date: 1/25/2018
Expiration Date: 7/24/2018
PROPERTY ADDRESS:
Address: 387 BELVEDERE ST
RE Number: 170703 0274
PROPERTY OWNER:
Name: WILLOW FALLS LLC
Address: 2221 ALICIA LN
ATLANTIC BEACH, FL 32233-4219
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: Sky High Roofing LLC
Address: 7424 Scarlet Ibis Lane
Jacksonville, FL 32256
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$7,500.
Building Permit Application Updated 12/8/17
City of Atlantic Beach
wzs 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 P-6—
2'
Job Address: 3l eet � c�nticth'lpr, �Permi Number: f�
Legal Description 35 i ''3J-kiEZANcti
L1)1 RE# '�"
r-t '�t
Valuation of Work(Replacement Cost)$ cl( t 1 Q Heated/Cooled SF ',;417 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:
Florida Product Approval# 11(0 1 M►, I i l 147�e I V?'Ytts for multiple products use product approval form
Property Owner Information
Name: �W Address: 't �1�K,kli •.
City At'd\k1.C, ger.%_ State 1F),._ Zip 'Sr 3i Phone CIC�-133 ( Z I ti
E-Mail
Owner or Agent(TfAgent, Power of Attorney or Agency Letter Required)
Contractor Information r
Name of Com any: k 1C' , r 1, Qualifying Agent: ��1 _
,� ��1�rtSr lti�
Address 1�lgc 1 � � ..h., City jr)(:K`,.^Y1V:iW State Fl._ Zip ''��v 5 )
Office Phone CtCt1(I''AC+ .V1%;-% Job Site/Contact Number Cie-l0, e..7Z
State Certification/Registration# 1�1 d'b I E-Mail S 1`i\V;p irGr L1(�(�'' "(11'19
C1k cowl
Architect Name& Phone# •/ �- 'J
Engineer's Name& Phone# _
Workers Compensation (1ZL'YdV)Ct,C(, A/NI ( ujc, 1)c\U9 T Cvl )O) lane(
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. 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 ORNEY ORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
( ignature o caner or Agent) (Signature of Contractor)
(including contractor)
Signed end sworn to(or affirmed) before me this 2y day of Signed and sworn to(or affirmed) before me this ZY day of
• Y LUZE409R2P,46rSANTAMVIike /arc,3r �c,, - , 200 , by Murc6•
'c MY COMMISSI N#GG0941 9
EXPIRESnil(08A021 // !� r �+_ . Adm..natllL€ Notary) ;• •- ''6 MY 16tSMi�NS316 'ta�
of C,L;�1019
.' ; • EXPIRES April 06,2021
[ ] Personally Known OR [ ] Personally Known OR
['Produced Identification [ roduced Identification rs,�
Type of Identification: L 'D L Type of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of FicarA County of i,Aal
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: K+/-1 t k,7----9 \,--:a9..t_ dam•
Address of property being improved: . '"1IV l.V C ,�k* tal m EWA
General description of improvements: P-& G
Owner 10 ii gal 1/----fDA,( UC
Address d‘:1:-.,)a 1 \'C.►(LA. Pit WM-. r� FL- ,2sc
Owners interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name •
Address
Contractor .. 'ie 4 - - .
Address L1 3 _ � _� _ e. .- - l� 0 '4, �'-
Phone No. CLIM ,� _ 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 fL OWNER j/a5�)�
Signed: `/ DATE
Before me this 2 S day of --T. -Z..-Z.. r. In the
County of Duval State of Florida his person'�liy appeared
Wy(e r3P'-,A1 herein by
Doc#2018020022,OR BK 18263 Page 437, himself;herself and affirms that all statements and declarations herein
Number Pages:1 are true and accurate
Recorded 01/25/2018 04:26 PM, '•+6U . ADRIAN; f TAMARIA
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL �, .�; 18 •N#GG0910:
COUNTY �t/� w; t
RECORDING $10.00 Notary Public at Larg . -, r,�` --anz a''t : A • "��-
My commission expir s: '0 ja _Z '
Personally Known or
Produced Identification 7—L (1 L.