510 ORCHID ST - PERMIT RERF18-0110 ')FCERTIFICATE OF COMPLETION
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Issue Date: 5/9/2018
RE Number: 1709050510
Address: 510 ORCHID ST
Zoning:
Owner: MEWBORN PATRICIA A
Contractor: Triton Roofing& Restoration LLC
480 State Rd 13 Ste 106-348
St Johns, I'L 32259
Permit Number: RERF18-0110
Description of Work: Shingle Re-roof
Approved: _j:)j 6�_,A&K-,b-k
Building Official
VOID UNLESS SIGNED BY BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INS-P t&IdN-ji4b N E-- i IN jit-i-4 7----58,1--4,
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0110
Description: shingle re-roof FL18355-R4 & FL15216-R3
Estimated Value: 14000
Issue Date: 5/9/2018
Expiration Date: 11/5/2018
PROPERTY ADDRESS:
Address: 510 ORCHID ST
RE Number: 1709050510
PROPERTY OWNER:
Name: MEWBORN PATRICIA A
Address: 510 ORCHID ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Triton Roofing & Restoration LLC
Address: 480 State Rd 13 Ste 106-348
St Johns, FL 32259
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$7,500.
Building Permit Application Updated-12/8/17
City of Atlaintic Beach
800 Seminole Road,Atlantic Beach,FIL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: ermitNumber:
Legal Description RE#
Valuation of Werk�(Replacement'Cost)$ -Heated/Cooled ST: 'Norl-H,eated/Cooled
CAass of Work(Circle one): New Additio �Alteralion Repair Move Pool Window/Door
'r
le
C',
Use of existing/proposed structure(s)(Circid e). Commer Residenti
y
Cen Yes
If an existing structure,'is afire sprinkler system installed?(Circ one' No N/A
Submit a Tree Removal Permit Application if any trees are to be removed orAffidavi of No Tree-Removal
Describe in detail'�ke type of work to be pefforme&
Ce__ Y'C)D� shiniqle tod
Florlda?roduct Approval# *P:�I I for multiple products use product approval form
ProverW-0mer.InformadiDn,
Name: ?10 orrh
city n ot4� ��/l 11'h -State )�-L zip 6 Phonec!Q 5/- C/ -72 0 9'
E-Mail -Z ,5"/n J e a)1?t)r n cp) an=I-r 0�r 7 1
Owner or hgent(if Agent,Power of Atto-rn4 or Agency Letter Required)
Contractor Inforrination
Name of Comoanv: Trilbn 07y L(Salifying Agent: J201xvt r2usFif.
Address.lg2 C -<>�w fml; uny 14-L T-
F�tv (Srinf�, stateF--L- zipT_32T09"
Office Phone 10&-V'21 -2-- Job Si'te/Contact Numb r ('CaV - C)q-e;3?a- (04v,�)
# ?1,11'r �2A
State Certification/Registration V-Jle. ('�M
Architect Name&Phone#
Engineer's Name&Phone#
1/of -
Workers Compensation k-' i-0 fr n, M I V)O(Y P D'
Exempt/Insurer flease Employ4esl 6'piratlon.Date
Application is hereby made to obtain a permit to do the work and installations as indicated.I cerl o Arork or gtallatinn 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 ELEICTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,TURNACES,BOILERS,:HEATERS,TANKS,and AIR'CONDITIONERS,etc.�NOTICE:-in additionto 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.
OWNEWS AFFIDAVIT:I certify that all the foregoinginfo,mation is accurate and that.all,work Vill bedone in compliance with all
applicable laws regulating construction and zoning-
WARNING-TO.OWNER: YOUR FAILURE TO:RECORD.A NOTICEOF COMMENCEMENT MAY
RESULT IN YOU R PAYING TWICE FOR IMPROVEMENTS TO YOUR'PROPER I TY. IF YOU INTEND
TO'OBTAINFINANCING,-CO`NSULT WITH YOUR LENDEWOR AN.. RNEY BEFORE
RECORDIN�YOUR NOTICE OF COMMENCEMENT
_,2
.(Signature�of Owner-orAient) 'y(s.nt�re--ofZ; ctor.)
lincluding contractor)
S Ir m d e vrmn�e q
,Rffirmed)before me this_Fd.y of d.and swo!Z f ir h* da f
0 1A_ ot? I - I - z�
__ 1, '0� 1 2 Tby CL
?K-J U- lqEZ-_— M- , - ;;;-,
MISSY K�DNES
my COMMISSION N GG092596 r
MY QMMISSI Neglgp 9 ry)
0
EXPI ry)
OF
EXPIRE7A 2G21
Personally Known.OR er=aaLLtYmoi(01OR
Ica
Produced Identification Produced Identification
Tvoe 0
Type of Identfiffification Type of Identification:
Doc # 20180,96785, OR, BK 18362 Page 1142, Number Paq�s: 1,
Recorded 04/28/2,018 09-.06 AM, RONNIE FUSSELL CLERK'CIRCUIT COURT DUVAL CO
-URTY
RECORD1ING, $L0.00
NOTICE OF CONMENCEMENT
Stateof
TaxFolioNo.
To Whom It May Conoem:
The ztders;i�hereby informs yau,that improvements-will W made to certain-real prapeM,and in-so=dfinoe:W.-ith Se0fion 713,of
,be Florkb Siiarotes,,the-,�tlowiqg m- lbrmfion-as stated Ib.ihis NOTICE.OF� T.
(Yee
AVtt7 C &ZzL6 40-f5 ls�
Address o(propqrty4eing improved:_4M Q1,44'-d <-A
Geaemidescriptiortof�improvemeatv , Q�p =)10-
Owner Address: Z�11)
Owner's interest in.site,of the improvement-. a7eliT. 4
fee Simple Titicholder(if other than owner):
Name.
09,.'ttl Tt
contracton T-AM Mal b'ArIfe"
Addmss: MY
—o'
TelepboneNo.:glt U!2-MM Pax N
SWVty(if Z:ny)
Address: Amount of Bond,$
Telephone NO: Fax No:
Name and address of aay persort nwki;ig loaa fbr-the cous=cdon of the improvemevics
Name:
Address:
Phone No: Fax N(y
Name�of person within,the State of Florida,other than himself,designated by owner uponwhom.notices or other documents-may be
served: Nam:
Address:
Fax No-
In additiom to-limzZlt owner-4esignates,the fdlloWiq&person to--reftiw a copy of tht:Lienor's Nodw zsprovildod in,section
743.,06(2)(b),FloridaStalaes. t(Fill in avOwners option)
Mine:
Address:
Telephone No: Fax No.:
Expiration date.olf Natiee of.Cowmencernew(the expkation date is one(1)year frorm dw.date of rnc&.dh*W"s a,differeat.date is
specified):
THIS SPACE FOR RECORDERIS USE ONLY OWNER
0 o me this 4:
ayof in t ount of Duvalj State
0 Jorida.has personally appewed y- - yn
NoM Public a1,1mgc,1S f unty,of Duval.
MXcommissionexr&-es: I
Pe n wn- or
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