838 Cavalla Rd-Roof Non-Shingle - L-tLvf City of Atlantic Beach APPLICATION NUMBER
jk 1 Building Department (To be assigned by the Building Department.)
80a Beac Road p 0C I I — 001q
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2 Atlantic Beach, Florida 32233-5445 ►--tJ r A
Phone(904)247 5826 Fax(904)247 5845
.k; r 013 WE-mail: building-dept@coab.us Date routed: 'a ( �
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 13-. - tom( co Cav q q4 144 " De• - a ., -nt review required Yes No
Building ✓
Applicant: P`\ (2.-0„.) n"WA C-k,i� - - . • ; oning
` ,f Tree Administrator
Project: ( a_ - ( D v}- -S In, n (t d Wl0(cc Z Srt Public Works
C-{ OL.Jf� �tOv __ Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: ❑Approved. ❑Denied. ['Not applicable
(Circle one.) Comments:
BUILDIN
PLANNING & ZONING Reviewed by: Date: ?A/...901k-
TREE ADMIN.
Second Review: nApproved as revised. nDenied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. fNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
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�- \}� CITY OF ATLANTIC BEACH
. �.. .-_ r 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
- r)li Ws- INSPECTION PHONE LINE 247-5814
ROOF NON SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROOF18-0017
Description: shingle & modified re-roof
Estimated Value: 3012
Issue Date: 2/26/2018
Expiration Date: 8/25/2018
PROPERTY ADDRESS:
Address: 838 CAVALLA RD
RE Number: 171717 0280
PROPERTY OWNER:
Name: REEVES SHANNON
Address: 838 CAVALLA RD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: PRIME ROOF CONTRACTING LLC
Address: 13792 HERONS LANDING WAY APT 9 QA MARK ANDREW
YOUNG
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.
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.
* 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$7,500.
OFFICE COPY
Building Permit Application
sa City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: 838 CAVALLA RD Permit Number: g-00[ r p -occo-
Legal Description 31-16 38-2S-29E.03R/P OF PT OF ROYAL PALMS UNIT 2AE 16.40FT OF W 22.54FT OUT 6BLK 26
Valuation of Work(Replacement Cost)$ 3,012 Heated/Cooled SF 1128 Non-Heated/Cooled 64
• Class of Work(Circle one): New AdditionIteration}Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial l e,sidentia]]
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 0
• 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: Replace asphalt shingle roof ' l \=.6.0
Florida Product Approval#FL10674-R12 (shingles) FL17420-R2 (felt) for multiple products use product approval form
Property Owner Information (LtS - C"((. iv.actt6e d
Name: SHANNON REEVES Address: 838 AVALLA RD
City ATLANTIC BEACH State FL Zip 32233 Phone 330-687-0962
E-Mail shannon.reeves@everbank.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Prime Roof Contracting, LLC Qualifying Agent: Mark Young
Address 13725 Beach Blvd Suite 13 City Jacksonville State FL Zip 32224
Office Phone (904) 530-1446 Job Site/Contact Number (904) 860-0230
State Certification/Registration# CCC1329505 E-Mail office@primeroofingfl.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation FRSA Self Insurers Fund Inc. 1/1/18 870-040093/3EE6142 _
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 F COMMENCEMENT.
IV1J-
(Signature of Owner or Agent including Contrafytor) Signature of tractor)
Signed and sworn to(or affirmed)before me this 11,.‘day of Signed and sworn t (or affirmed fore me this j- ay of
11 r .�� by S Annan Re_ , Zdl '' ,by
/� y, n
4, M.,rn.�� !� Dom '
• COMMISSION!FF160849
✓��.' EXPIRES: Sept. 17, 2018 (Signature of Notary) (Signature of Notary)
• .61's.$ WWWAARONNOTARY.COM q01t4tle Andrew D. Davis
.;�"• COMMISSION#FF160849
[ I Personally Known OR Eersonally Known OR S • .'"., EXPIRES: Sept. 17, 2018
[/IProduced Identification [ )Produced Identification '!44df;` WWW.AARONNOTARY.COM
•
Type of Identification: F(. D� Type of Identification: ''`�
NOTICE OF COMMENCEMENT
OFFICE COPY
(PREPARE IN DUPLICATE)
Permit No.facric -19017 Tax Folio No.
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:31-16 38-2S-29E.03 R/P OF PT OF ROYAL PALMS UNIT 2A E 16.40FT OF W
22.54FT OF LOT 6 BLK 26
Address of property being improved:838 CAVALLA RD Atlantic Beach FL 32233
General description of improvements:Re-root
Owner SHANNON REEVES
Address 838 CAVALLA RD Atlantic Beach FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
ontraCtor 117
Prie Roof Contracting,LLC
Address 13725
mBeach Blvd Suite 13,Jacksonville,FL 32224
Phone No.(904)625-1446 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 1 OWNS
Signed: DATE II/lL
11/'1 160
Before me is day of the tit
County i)DuvaState of {. as personal) appeared
Doc#2018043781,OR BK 18292 Page 2276, 11uvOA herein by
p
himself/herself and affirms-that S 5Taements and declarations jye lj(t�, Andrew D. Davis
Number Pages: 1 are true and accurate Q1p' "' S(�.�
Recorded 02/23/2018 03:44 PM, '*, ` , = COMMISSION B FF160849
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL r:� e EXPIRES: Sept. 17, 2018
COUNTY �'��F "�s:" WWW.AARONNOTARY.COM
RECORDING $10.00 ai�"`�
Notary ubli at Large.Slate of County of
My commission expires:.___A`.I.
I
Personally Known or
Produced Identification L. UL