800 JASMINE ST - ROOF I.
„,„
' CITY OF ATLANTIC BEACH
at
\\N _
;�> 800 SEMINOLE ROAD
-1 ATLANTIC BEACH, FL 32233
ft f.);f» INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0043
Description: shingle re-roof FL16305-R4, FL21350-R1
Estimated Value: 4800
Issue Date: 2/8/2018
Expiration Date: 8/7/2018
PROPERTY ADDRESS:
Address: 800 JASMINE ST
RE Number: 170927 2030
PROPERTY OWNER:
Name: DIAMOND LIFE REAL ESTATE INC
Address: 554 JACKSONVILLE DR
JACKSONVILLE BEACH, FL 32250
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: AMERICAN CONSTRUCTION PROS INC
Address: 695 HAWBERRY PLACE
DELAND, FL 32724
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$7,500.
. L'`,. Building Permit Application Updated 12/8/17
Jrt
%' City of Atlantic Beach
•'QJ;;.y.,/ 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 �/ �W�L( ?�
�J
Job Address: 8 00 J 4Srvl,ne Sf r e e' 4+/4AIL L B 0 aell Permit Number: �t F Q -
Legal Description I 9 -311 3$'2 S--21 E .iyt Stt k ,A-7L4,V!it Wit H)S NOR LAT 3 RE# 17 0127— 22 03 0
II)
J 4/ 20 FT LOT II 13e,1C 1q1; `LQ
Valuation of Work(Replacement Cost)$ 1) g 00 Heated /Cooled SF 11.52 SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration 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 e N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal q
Describe in detail the type of work to be performed:Mir r o-f f a,4 re roof 3 i(Si 6( a S rhQ 1¢ Shi til e) (,/4± 4.0
Florida Product Approval# FL 16 3 0 5 -12 ,-/ P F L 2.13 50 — R -I for multiple products use product approval form
Property Owner Information
Name: bi a OnA I:4e 'eqj S*LI+Q 1.nl. Address: S5i Te/cs7nv!//P five
City .i GtGKS•on I ' :r / , State FL Zip 322 50 Phone L' 't ) `-177 ';S- 13 8'
E-Mail Mat W 8 Ai6Iirnou,[i fl es4-0i 6 011n
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) ow/le('
Contractor Information n -7�
Name of Company:Arneric4n `ORS'-►'N1+ipll PrUS . 1G. Qualifying Agent: T"n&t]i t t livers
Address $ 10 5'014 Fd3ew000 Atte *' 221 city.acksoiU;l(e State F L. Zip'3 2105
Office Phone 9 0 y- 1.O p -6 7 b Job Site/Contact N�umber
State Certification/Registration# t2.4027c q7 E-Mail FL R 0 0 I-PRO e friotil. c OM
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation eo�/t C (. A 2017_ 10tH— '0. , Jl 0 fg
e 14Exempt/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 ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
N
ik,rilickV7itcyc a, 1
(Signature of Owner or Agent) ( ignature of Contractor) o o N g
(including contractor) s *' J.
112
LI,gned and swo to(or affirmed before me this day of Signed and sw to(or affirmebefore me thisp7q $ :y IA a
J p
,�C7 Y 11141 _.h fie, . .. by 6 <.li%. 4. . _ :.
,, ,••':.; .'.. AMBERD.H•' - ininsPifirA� // ,LL Wil!/ I XZWa;
1;i MY COMMISSION#GG 145949(51( ature of Notary) (Signature of Notary)
;;4„$;,.-4,Q EXPIRES:September 25,2021 �• _
�er�x1 T14o 8b Underwrfters Personally Known OR 111,•r_
r..u -. .• . • [ ]Produced Identification 9. " i.
Type of Identification: `/%1_ Type of Identification: ....1.-,=
Doc # 2018024151 , OR BK 18268 Page 1439 , Number Pages : 1 ,
Recorded 01/31/2018 12 : 11 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT I7_ 2 7-2L230
Permit
No,�t C 2_J- Dao Tax Folio No.
State of Florida,County of
TUE UNDERSIGNED hereby give notice that the improvement will be mode to certain real propertY to accordance with
Chapter 713,Florida Statutes,.the following information is provided in this Notice of Commencement. �/
1 Description of property(legal description of prom and address if available): �/n Lo T [y 20 FT L 0 r ,
Is- 318-t4 - E ' : / :- :, R -A , / J -- 13ik /I/6
2. Tal DDee�t of improvements: 800 T45Aril){' 5-f� tat/ar(-f7 c 13Q4tI , FL.j 3 22 33
L--_-
3. Owner Information: Lift Rr ' ¢ I�1�. S3 Jacks�l�lr 1�/ JR�ksoNl/�/1P l,J�/t��
al Name and Address.di AM c44 t11 I- Q.1(
b)Interest inO
property: >:rF Sis;r�((..�. lei d -- Fz,, 122
c)Name and address of simple titleholder(if other than owner):
4. Contractor Information:
a)Name and Address: ti, a. A, ,_ • 6,„ • .. ►• +. A` . .
b)Phone Number: ct04 yaj.L4- mei 5w-a4a `a22455. Surety Information: "3 -1LSLa'w1, F
a)Name and Address:
—
b)Phone Number
u)Amount of Bond:S
6. Lender Information-
a)Name and Address: -
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documeots may be served as
provided by 713.13(I)(a)7.Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
d. In addition to himself/herself,Owner designates of to receive a
copy of the Lienors Notice as provided in Section 713.13(1)(b),Florida Statutes.
a)Name and Address:
b)Phone Number of person or entity designated by owner:
9 Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year fiom the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY TRE OWNER ATTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,
SECTION 713,13, FLORIDA STATUTES, AND CAN RESULT IN YOUR 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 COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true to the best of m knowledge and belief. ` `,,
Signet o •ner or Owne Authorized Officer.'Dnector Panner/Manager Sigrrtory's Printed Name&Tit160ffice
Si—
The foregoing instrument was acknowledged before me this ' 1 day of J ICU( ,20_1B
by/22 e Z11 r<iogA7 as for
(Name of Person) f lType of Authori V t e ORicenA�nion•.ey) (Name of Parry Insuument was Execuud fon
/5, „1/./
...e*,... AMBER 0,HORDOS OTARY PURL .STA.yE OF FLOR) A
;„: :.; MY COMMISSION#GG 145949 Print Name: ✓e
,, Pa•; EXPIRES:September 25,2021
� %Y ��V
%
:f`P,!,!;°'' Bonded 7/rt Notary Public Underwriters
❑Personally Known
enfi-fi catiorfType:
(Affix Notary Seal Above)
Revised 3/15/12