324 7th re-roof permit •S y�JJ�
CITY OF ATLANTIC BEACH
�r
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0064
Description: replace roof fL 10674-R12, FL17420-R2
Estimated Value: 8614
Issue Date: 3/9/2018
Expiration Date: 9/5/2018
PROPERTY ADDRESS:
Address: 324 7TH ST
RE Number: 169889 0000
PROPERTY OWNER:
Name: RUPERT HENRY T
Address: 324 7TH ST
ATLANTIC BEACH, FL 32233-5434
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$7,500.
Building Permit Application
1 City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: 324 7TH ST Permit Number:
Legal Description 5-69 16-2S-29E ATLANTIC BEACH LOT 11 BLK 8 RE#
Valuation of Work(Replacement Cost)$ 8,514.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Iteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): Commercial IEsidentia
• 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: Replace asphalt shingle roof
Florida Product Approval#FL10674-R12 (shingles) FL17420-R2 (felt) for multiple products use product approval form
Property Owner Information
Name:HENRY RUPERT Address: 324 7TH ST
City ATLANTIC BEACH State FL—Zip 32233 Phone 904-521-5670
E-Mail henrup@comcast.net
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@primeroofingfI.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 904- R
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has E
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.
A4
Signature of Ownerent including .,,tractor) Signature Contractor)
Si ed and sworn to or affirmed before me this t day of S' ed and sworn to(or affir )b fore me this day of
Gvck 201 by it Z0� bmi y
natur (Signature of Notary)
Vdmfl. Davis
COMMISSION#FF160849 %Y1P��'''' Andrew D Davis
EXPIRES: Sept. ' 2018 ?
[-]'15ersonally Known OR OFFi` O` www AARONNO ARY.COM [personally Known OR OlaCOMMISSION#FF160849
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Produced Identification EXPIRES: Sept. 17, 2018
[ ]Produced Identification [ ] ',�r' •••• ;
Type of Identification: Type of Identification: ''� ful%%\� w �RON�IOTARY.COM
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. 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:5-69 16-2S-29E ATLANTIC BEACH LOT 11 BLK 8
Address of property being Improved:324 7TH ST Atlantic Beach FL 32233
General description of improvements.Re-roof
Owner HENRY RUPERT
Address 324 7TH ST Atlantic Beach FL 32233
Owners interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
t Address
l\ Contractor Prime Roof Contracting,LLC
CA/t1x11 Address 13725 Beach Blvd Suite 13,Jacksonville,FL 32224
Phone No.(904)625-1446 Fax No.
v1l 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 — OWNER G y
Signed: DATE 3 /r /��+
Before me thi day of in the
County Duval,St of Flori has personally appeared �+ Q►p'oc#2018056455,OR BK 18309 Page 2301, t�vV Q , °, 'by �I����it►i1 D. Davis�i
9 himself/herself nd atfir that all statements and declarat !,!�
Number Pages: 1 are true and accurate ? COMMISSION if FF160849
Recorded 03/09/2018 02:24 PM, _* "_ EXPIRES: Sept. 17, 2018
COUNTY
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL �o°o` www.AARONNOTARY.COM
RECORDING $10.00 J,
Notary Pu icatLarge.St.
teof County of
My commission
Personally Known ✓� --- or
Produced Identification