1275 SEMINOLE RD - ROOF r„J.,J,,,
,..._ ,-,
r e a.- CITY OF ATLANTIC BEACH
.
','”" y- 800 SEMINOLE ROAD
!iv yr ATLANTIC BEACH, FL 32233
"!osiisf? INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0049
Description: shingle re-roof- FL10124.1 & FL10626.1
Estimated Value: 12620
Issue Date: 2/14/2018
Expiration Date: 8/13/2018
PROPERTY ADDRESS:
Address: 1275 SEMINOLE RD
RE Number: 171895 0000
PROPERTY OWNER:
Name: TODD WILLIAM T
Address: 1275 SEMINOLE RD
ATLANTIC BEACH, FL 32233-5506
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: HAGERTY CONSTRUCTION AND ROOFING INC
Address: 12850 WINTHROP COVE DR QA QUIN J HAGERTY
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$7,500.
- �S -e Building Permit Application
iI City of Atlantic Beach
V410"
800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904)247-5845
Job Address: 1275 Seminole Road Permit Number: f C.- fZ.PI -00 ti
Legal Description Lot#8, Unit#1, Selva Marina RE# 171895 - 0000
Valuation of Work(Replacement Cost)$ 12,620.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
• 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:
new asphalt shingled roof(re-roof)
Florida Product Approval# Shingles FL10124.1 Underlayment FL10626.1 for multiple products use product approval form
Property Owner Information
Name: William&Theresa Todd Address: 1275 Seminole Road 704/—
q pp
City Atlantic Beach State FL. Zip 32233 Phone 1� � lU /- 7pp�—q!( 0
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Hagerty Construction&Roofing, Inc. Qualifying Agent: Quin J. Hagerty
Address 12850 Winthrop Cove Drive City Jacksonville State FL. Zip 32224
Office Phone 1-904-992-9960 Job Site/Contact Number 1-904-591-4354
State Certification/Registration# CCC 057779 E-Mail hagertyinc@yahoo.com
Architect Name&Phone# N/A
Engineer's Name&Phone# N/A
Workers Compensation Bridgefield Employers Insurance Company
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. 1 l
--/-44AAA-4_ 4-67(c_k. ......aLi adi
(Signature of Owner or Agent including Contractor) VW i :ign:ture of Contractor)
Signed and sworn to(or affirmed) b-fore me this 10 day of Signed and s .r to or a irmed)before me this I'Z. day of
February , 2018 , . h; esa Todd c-I-ANYZ}(, 20 8 .y rS in J. Haile
.tl/_,fir WAR
' y try F(S frieture of Not�a�ry)' '�" NJ° art JAKE MINDER
A.
t• OTARY PUBLIC �� ��/� MY COMMISSION i FF 910637
TATE OF FLORIDA * '`,n/- * EXPIRES:December 2,2019
31 Camm#GG119052 44 " , em�xa 1tw Qudget Netary Sikhs
[)()Personally Known OR ;pj jet0 [)]Personally Known OR eorrsl'
[ ]Produced Identification Expires 6/26/2021 [ ]Produced Identification
Type of Identification: Type of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 171895-0000
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: Lot#8, Unit#1,Selva Marina
Address of property being improved: 1275 Seminole Road,Atlantic Beach, Florida,32233
General description of improvements: new asphalt shingled roof(re-roof)
Owner William&Theresa Todd
Address 1275 Seminole Road,Atlantic Beach,Florida,32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
„'n Contractor Hagerty Construction&Roofing,Inc.
I„`(T)( Address 12850 Winthrop Cove Drive,Jacksonville, Florida,32224
Phone No. soa ss2-ssso Fax No. 904-992-9961
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 r
different date is specified): CJ N N(c),'
THIS SPACE FOR RECORDER'S USE ONLY OWNER CO
Signed*" . 4 ATE Z'Iti 'IC. _ } O G! CO
Before me this day of U U in the
County of Duval,State of Florida,has personally a'peared ' <
Doc#2018035854, OR BK 18283 Page 729, THERESA TODD ereln by Fa- g x
Number Pages: 1 himself/herself and affirms th• II statements and declarations herein C1 2 CO U W
Recorded 02/14/2018 09:36 AM, are true and accurate AT104/
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL • 'I
COUNTY >
RECORDING $10.00
5
Notary Pu"'at Large, iii -IDA , County of DUVAL 'mat
My commission expires:
Personally Known xxxxx or
Produced Identification 11111111F