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1929 W SEVILLA BLVD - PERMIT RERF18-0113 CITY OF ATLANTIC BEACH 1 800 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: RERF18-0113 Description: INSTALL NEW ROOF F110674-KG, F12569-R5 Estimated Value: 17793 Issue Date: 5/16/2018 Expiration Date: 11/12/2018 PROPERTY ADDRESS: Address: 1929 W SEVILLA BLVD RE Number: 169462 0320 PROPERTY OWNER: Name: BRODEUR THOMAS J Address: 1929 SEVILLA BLVD W ATLANTIC BEACH, FL 32233-4578 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: HANSON ROOFING INC Address: 2765 Leon RD QA JEFFREY DONALD HANSEN JACKSONVILLE, FL 32246 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$7,500. Building Permit Application Updated 12/8/17 City of Atlantic Beach ;,„• 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 Job Address: MCI 5eyi\1a'6\9CX-W - (MDQ 161CIMCin TL Permit Number: Legal Description 4i5-`I Se\Li1\a a(a� U 6+1 1--1 IA _RE# %koCILA(ol-0370 Valuation of Work(Replacement Cost)$ C13 Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alfe'rat30i 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 • 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 beperformed: 7 Florida Product Approval# rl 1 r 7 'LT7 75 Z,4-R5 for multiple products use product approval form Property Owner Information Name: �i�C12Ur,'5,OrruaS Address: ig2G \rel. Se:\17%\\. a -b\SIC\ City P'N\0Ln-t-iC MLLCb State TrL Zip 3Z25-5 Phone g0LA-2u2-911(4 E-Mail Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) ©W- 'nCY Contractor Information Name of Company:X-1Gn56"'\ -.r, ;--\1 Y\['. Qualifying Agent: J2WYfL to Address 7-1Lpb pl-C.on mar, City .\G.ckAbty -,y!\\t State r-L Zip 51-W Co Office Phone 40C\-333—C1()&4 Job Site/Contact Number GG1-1 - State Certification/Registration#MC-bSr1'h\S E-Mail &9922&0 bt1\Sf y*\-- net t Architect Name&Phone# Engineer's Name&Phone# _ Workers Compensation.�r ?: a-. xe /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 maybe 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 oma RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEN °':.,. ' TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE -2. 3 = RECORDING YOUR NOTICE OF COMMENCEMENT. y N m b N j '�2 E I ajl,—I�, G-);'o v° (Signature of Owner or Agent) (Signature of Contractor) No N Cn o 13 v (including contractor) o CD Cy .E � a Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this �� day o o a E E c� ,by` V �-�S `5 �'1C — �by )- �^ E o v u ` zLA ( za Si ature of Notary) (Signature of Notary) ]Personally Known OR [ ]Personally Known OR roduced Identification [ ]Produced Identifica ion "' " Type of Identification: 1=�-��L 'U55 Z-3b� Type of Identification: �I �1 (�5- �� NOTICE OF COMMENCEMENT State of Tax Folio No. County of 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: 45-`7 i' -,25 -OL9r-- S"A\0, uniteL LOA- 03 WR-JA` Ikota'A(0 - ;31c% Address of property being improved: IC12c1 S2\ I\\a 'b\y c1-VI N%retic e00n, -1— s 22z--7, General description of improvements: �� C Owner: ` Myy%pS J. Address: I�2�i 5t:\1 o\\Cr. Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: C t cton \�ay\%fin �C5( j�I11 \nC -` Address: 19V5 �-eo n 1Z& Telephone No.: Fax No: 0(oLk-(s)91- Surety(if any) Address: Amount of Bond$ Telephone No: Fax No: Doc#2018116596,OR SK 18389 Page 991, Name and address of any person making a loan for the construction of the improvements Number Pages:1 Recorded 05/16/2018 11:04 AM, Name: RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Address: RECORDING $10.00 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: Telephone 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 Statues. (Fill in at Owner's option) Name: Address: Telephone 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 Signed: Date: Before me this I}-" day of in the County of Duval,State MONIQUE D EVANS Of Florida,has personally appeared'-1R()1 ` Notary Public at Large,State ofFlorida.Co1}pty of Duval. :^��• .e NotaryPublic-StateofFloridz Commission GG 193217 My commission expires: 3, `• My Comm.Expires Mar 7,2022 ••••• Personally Known: or --- "' Produced Identification: