2257 FAIRWAY VILLAS LN - ROOF • •_``_. CITY OF ATLANTIC BEACH
::� �.r.
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
II S)' INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0018
Description: shingle re-roof- FL10124-R15 & FL18686-R1
Estimated Value: 4500
Issue Date: 1/12/2018
Expiration Date: 7/11/2018
PROPERTY ADDRESS:
Address: 2257 N FAIRWAY VILLAS LN
RE Number: 169398 1086
PROPERTY OWNER:
Name: CORWIN ANDREW M
Address: 701 NEPTUNE LN
NEPTUNE BEACH, FL 32266
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: RELIANT ROOFING INC
Address: 822 N. A1A Highway Suite 310
Ponte Vedra Beach, FL 32082
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$7,500.
' r-, Building Permit Application
k City of Atlantic Beach
....:-..•44800 Seminole Road,Atlantic Beach, FL 32233
,,,•;),:r5• C�7 n ' '1 Phone: (904)247-5826 Fax: (904)247-5845 D o f� G
•
Job Address:MT Fck rWQ� V II III La r' e N . Permit Number: t'E t`'r) `r -Dor b
Legal Description 3q-22 43-23-73E Fairway v i ll m LOt Li 3 G RE# 1 3q 106G
Valuation of Work(Replacement Cost)$ LI 1500,00 Heated/Cooled SF �a 1J Non-Heated/Cooled( 5z C'
• Class of Work(Circle one): New Addition(AlteratiQp)Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial 1kesidential )
• If an existing structure,Is a fire sprinkler system installed?(Circle one): Yes No tN/A 1
• 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: r£-roo c -sviing I es- a l SQ- 5/ I a Fitch
Shingles FL*: FL-Io 124-215 ) under lay ment rLL . FL- Ie686.-as.
Florida Product Approval# EL- IQ 12,L1 - RI5 for multiple products use product approval form
PropertyO neer Information
Name: C,Dr(,1�J i n Address: -Mt Ile�r E) tone
City P� �1��UJ W 'P Be(ICt'1 State FL Zip 3226 (o Phone c'D4-561- ayci
E-MailQ CD+(llb 0Afce 1'YYh.(A(Y1
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information�l�Caq��'
Name of Company: 2- n r 1W'1C,i V ]O
Quail ing Agent: � [ PQe
Addresse22�t4 H1 3117 City State f1. Zip 3Z082
Office Phone ` 1 `3 Job Site/Contact Number Li-7)2 '3/I/
State Certification/Registration# CCC.I 3 61 E-Mall YnrrieT orPt%Grli-t'Otef1 n3.GD r'''
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation P01\C1' 4 WC qp.-ix)-81 r MI ekp lyes i a j 31 1 18
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.
(Signatur'e of Owner or Agent including Contractor) ( nature of Contractor)
igned and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me his SYYday of
j5cth vary , Zo/ by ; ./,,till. • . arwcil ‘242113--,by carrfinn51,7)0 W7
:nature of r a 1' ignature Not
01'r'f,'., JULIANA PANTOJA ,,‘'r"',, JULIANA PANTOJA
„01%11,,,,',,, JULIANA
of Florida-Notary Public Y-State of Florida-Notary Public
Personally Known OR ` r=�•- Commission#GG 151986 t•Personally Known OR y.,• Commission#GG 151986
[ j Produced Identification -;;4,47ai. `' My Commission Expires ( I Produced Identification 'o,,�����':�`� My Commission Expires
10 October 18,2021 October 16,221
Type of Identification: Type of Identification:
Doc # 2018002798, OR BK 18241 Page 1096, Number Pages: 1 ,
Recorded 01/04/2018 02 :48 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of FL 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 bung improved:39-2208-2S-29E FAIRWAY VILLAS LOT 43
Address of property being improved.2257 FAIRWAY VILLAS LN N ATLANTIC BEACH FL 32233
General description of Improvements: RE-ROOF
owner ANDREW CORWIN _
Address 701 NEPTUNE LANE NEPTUNE BEACH FL 32266
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor RELIANT ROOFING
Address 822 N AlA HIGHWAY SUITE 310 PVB FL 32082
Phone No.ea4-657-o88a Fax No.
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
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
(�
Signed. I Acw C+"'- DATE 1/Z/20111Before me ihl .....dapof In the
County of Duval.State of Florida.has personallyrieercd J �� _ _
5IRINE'r CORWIN
himself'narsetf and alarms that ail statements ar.decJea�M)harNd U LI A N A PAN TOJA
■rsI accurate ice` ;;;State of Florida-Notary Public
I _• Commission N GG t 6 i 986
,. re
i:I ._ - h My Commission Expires
U ` October 18,2021 i
Nol ry blit at Large.Slate of county
Mycb-mmissioner es..Jb- tr( _
Parsnne'ly Knnss or
Produced Identification -