342 7TH ST - ROOF ,..\.„.,..or, � CITY OF ATLANTIC BEACH
-� - 3.:-,. s> 800 SEMINOLE ROAD
1511 z: ATLANTIC BEACH, FL 32233
at
!0;3 9? INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0023
Description: SHINGLE ROOF
Estimated Value: 4500
Issue Date: 2/7/2018
Expiration Date: 8/6/2018
PROPERTY ADDRESS:
Address: 342 7TH ST
RE Number: 169896 0000
PROPERTY OWNER:
Name: GHELERTER RICHARD
Address: 342 7TH ST
ATLANTIC BEACH, FL 32233-5434
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.
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$7,500.
•'jn, ,rte Building Permit Application
ii iiitA City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
"t'•! A Phone: (904)247-5826 Fax: (904)247-5845
Job Address: 341 S\--• Permit Number: R ER F( g "- 00? -3
Legal Description 5`tLoct T 1" A Y1ii C. 'BP ac-Vl LE* (C1 V--K-- g RE#
Valuation of Work(Replacement Cost)$ OD. u0 P ated/Cooled SF CX-1 Non-Heated/Cooled 03(42r
• Class of Work(Circle one): New Addition Iteratio Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): Commercial esidential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No IA
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
DAscribe i detai�� the type of work to be performed:
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SV.tar-pS FL--RAD-1— 2t5 UYtdlo.r1C4 vys v - EL- 1oRCD- 1Z-1-
Florida
- LFlorida Product Approval# � for multiple products use product approval form
Properly Owner Information"
Name:A Star t(&� Vt1'1e.` ue-i- .Y Address: 342 -701s� .
City it-i-tpon,fit, 5e,a.C.1/1 State (>L- Zip 3227;3 773 Phone at)L1- 6t I -a c3Lp7
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information>
Name of Company:l Lt(,tc k 1e-uo r Qualifyin Agent: Carr' 12JY1 Sh
Address 221.1, AIA- HIGIy( alt 310 J CityD V 17 State r L Zip gZ.
Office Phone��- 'lit- ,I 11 Job Site/Contact Number ( 04 -112--b I t I
State Certification/Registration#CU,.1.72)-b()l o f E-Mail S iarlyuuYlf• Yr-LlCt-vi f'YLJttl( 13, LQ3y (Th
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation -
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
RECOO,. ING YOUR NOTICE OF COMMENCEMENT.
• �QNt�,
(ii.,.(_, , '�-
(Signature of Owner or Agent including Contrac r) gnature of Contractor)
Signed and sworn to( affirmed) before me this /66 day of Signed and sworn • •r affirmed)before me this e day of
J CAnijA,9, 2DI ,by Q CV,C(rd G kiei ' - J-ar- iQ t 8 by (Da siw p pe_,
Signature of Notary) Signatur o otary
�"" ULIANA PANTOJA
,!,1 t;; JULIANA PANTOJA y i '�r State of Florida-Notary Public
...,,,,!,1=t;,,,
Q r:State of Florida-Notar Publi �'= Commission#GG 151986
[l•rPersonally Known OR 1�'": /_ Commission#GG 151988 q personally Known OR n�;, ,r
•�'� Produced Identification '�,,�,,0," My Commission Expires
OI I `
[ ]Produced Identification �;;ow,'���,.�' My Commission Expires I October 18,2021
Type of Identification:
'___' October 16,2021 "'pe of Identification: •
Recorded 01/17/2018 12 : 01 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. l
State of �� County of Civl\I C
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. /- \ �`---7�
Leff description of propertyeing improved:t- l0CA. N 1 C 1 /��-i/Y 1
Lot- \/vf1 1 f.
Address of property being improved: }3 LI -r\ 1" 1
i CA
,E, eilC,V)vl, 37:7:3
General description of improvements: t .(2.-- r't,/
Owner12 (Ai-� � r 1L�(�`-r r { I,
Address a 1.11/1 b P 1 Ian-Ft i .4 eC C ? Ft_ - .3
Owners interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Reliant Roofing,Inc
Address 822 A:A H.ghway Su is 310 Pontc Vedia Hench,Fl.32082
Phone No.9o4-657-oeeo Fax No. 904.677-7972
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 Lienors 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
Sinod, L� i�” "
9 _ DATE 1/9/t018
Before me this —L clay of In the
Co o//r �( I t f Flom, as Pers%�:I•: •• ed
V1\� 5.e
himself(heisatt and a nms That.IIs erne 1S, n (.1eclaid s
are -and accurate '( ':• J��1.���1 P�•�NTOJA�
"'. - State of Florida-Notary Public
�Jj ; - iCommission NGG 151986
!///(� ---s"..-'--',;`1. My Commission Expires
October 10. 2021
`ter
Notary Nuwic al Large.Lti e t
' Lourey et �Y�I ! A
My commission y /
Personally KnO:•.TiVs. „
_ Or
Produced Identifcotion