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842 Cavalla Rd- Roof non-shingle sy�Air City of Atlantic Beach APPLICATION NUMBER �s�ipir „ Building Department (To be assigned by the Building Department.) •- 800 Seminole Road p� 1 J Atlantic Beach, Florida 32233-5445 �—(.J OF I 0 014O Phone(904)247-5826 • Fax(904)247-5845 "tJ,tis. E-mail: building-dept@coab.us Date routed: 'a' l-3 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: lic3 .- - t'`-{ Ca-t/4114 'P - Department review required Yes No Building V. Applicant: 6 trite (Loo - C1311ANC6CC.'‘A/1Jc. oning Tree Administrator Project: (2— (Dv —S�k(\ (-Q d MOCU CC Public Works C� ()WA, VLO S Public Utilities Public Safety Fire Services 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: M4/.26i r TREE ADMIN. Second Review: Approved as revised. nDenied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. I INot applicable Comments: Reviewed by: Date: Revised 05/19/2017 :,,,,,,, r SSL CITY OF ATLANTIC BEACH ' - .. ? 800 SEMINOLE ROAD �\N;-.. ATLANTIC BEACH, FL 32233 �. 110/ INSPECTION PHONE LINE 247-5814 ROOF NON SHINGLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: ROOF18-0019 Description: shingle & modified re-roof Estimated Value: 3012 Issue Date: 2/26/2018 Expiration Date: 8/25/2018 PROPERTY ADDRESS: Address: 842 CAVALLA RD RE Number: 171717 0300 PROPERTY OWNER: Name: MYERS STEPHANIE Address: 842 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$7,500. OFFICE COPY b-,, Building Permit Application ,!:... City of Atlantic Beach 800 Seminole Road, Atlantic Beach, FL 32233 ` >f' Phone: (904) 247-5826 Fax: (904) 247-5845 Job Address: 842 CAVALLA RD. Permit Number: ( !' 0O I Legal Description 31-16 38-2S-29E.0R/P OF PT OF ROYAL PALMS UNIT 2AW 16.4FT OF E 26.66FT LOTI x K 26 Valuation of Work(Replacement Cost)$ 3,012 Heated/Cooled SF 1152 Non-Heated/Cooled 16 • Class of Work(Circle one): New AdditionIteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial lesidentia • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No del • 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 �Ud�.1� .0 L Florida Product Approval#FL10674-R12 (shingles) FL17420-R2 (felt) for multiple products use product approval form Property Owner Information r:=1„2,5 33 _V_fj(_p (11'64' ``19 Name: STEPHANIE MYERS Address:842 CAVALA RD. City ATLANTIC BEACH State Fl Zip 32233 Phone E-Mail smmpeach@aol.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 OF COMMENCEMENT. I�� j (Signature o Owner or A nt inc uding Contractor) (Signa ure of Co ctor) Si ned and sworn to(or affirme befere me this ay of Sigestt--ci ned and sworn to(or of irmed be or- me thisZday of , act's, , by ] n�IL Ay__L _� 241/( ,by OrUV1F ,I — .. . • a� • QP ftture of�I�tt D. Davis (Signature of Notar '?' �a� 4,1:. D. COMMISSION#FF160849 ,�`��e•••��e''% Andrew D. Davis -4`• .:�_i.= EXPIRES: Sept 17, 2018 i� "` •�'= COMMISSION#FF160849 [ ]Personally Known OR S% •$ WWW.AARONNOTARY.COM [ sonally Known OR =,�.✓��; EXPIRES: Sept. 17, 2018 [Produced Identificati � „�`�;'�� [ ]Produced Identification '�., WO:` WWW.AARONNOTARY.COM Type of Identification: V(i Type of Identification: �� NOTICE OF COMMENCEMENT OFFICE COPY t-� / (PREPARE IN DUPLICATE) Permit No.�O I / O q 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 W 16.4FT OF E 26.66FT LOT 7 BLI<26 Address of property being improved:842 CAVALLA RD Atlantic Beach FL 32233 General description of improvements:Re-roof Owner STEPHANIE MYERS Address842 CAVALLA RD Atlantic Beach FL 32233 Owners interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address Co tractor Prime Roof Contracting, Address 13725 Beach Blvd SuiteLLC 13,Jacksonville,FL 32224 Phone No,(904)625-1446 Fax No. urety(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 ' OWNER Signe.', 11DATE��118 Before me this a(2 day of W TT.r. in the CopofDovaei.►;ate of FIic 11a.has Pers*:Ily ppeared him ;hFrse't and affirms that-Li iafements and deciaraii �� Andrew D. Davis Doc#2018043777,OR BK 18292 Page 2272, are true and accurate COMMISSION#FF160849 Number Pages: 1 :# —, a►_ Recorded 02/23/2018 03:44 PM, .�� r EXPIRES: Sept. 17, 2018 RONNIE FUSSELL CLERK CIRCUIT COURT DUVALkof WWW.AAR0NN0TARY.COM COUNTY RECORDING $10.00 No ry Public at Large. , County of — My commission expires: __._.._.- Personally Known or Produced Identification •f` PL.