1753 E PARK TERR - PERMIT RERF18-0112 �'� R.• CITY OF ATLANTIC BEACH
` ? 800 SEMINOLE ROAD
'•r _A_TLANTIC BEACH, FL 32233
9 INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0112
Description: shingle re-roof- FL10674.1, 17188.1, 6267
Estimated Value: 10290
Issue Date: 5/17/2018
Expiration Date: 11/13/2018
PROPERTY ADDRESS:
Address: 1753 E PARK TER
RE Number: 172020 0410
PROPERTY OWNER:
Name: HEFLIN MICHAEL B
Address: 1753 PARK TER E
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: JACK C. WILSON ROOFING CO.
Address: 4522 ST AUGUSTINE RD
JACKSONVILLE, FL 32207
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$7,500.
Building Permit Application
r= M City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 h
Job Address: ` K,,eU( &Q' E ' Permit Number: 1— I v —y
Legal Description 3`Z �,�S'd IG �a',�t"'�4 V� 1��t��� RE#
Valuation of Work(Replacement Cost)$ l`� J O Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Mov o Pool Window/Door-;44_�_04—_
• Use of existing/proposed structure(s)(Circle one): CommercialRee Iden
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No /A
• Submit a Tree Removal Permit Application if any trees pre to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: h x
Florida Product Approval# ( for multiple products use product approval form
Property Owner Information
Name: 2.. Address:
City State ip 3 Phone
E-Mail v t
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Informal ion '} \ c�
Name of Compan 4l v`1 W Qua Iifyin Agent: V6CU
Address City State zip
Office Phone Jo ite/Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation �
Exempt/Insurer/Lease Employees/Expiration Date t
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.
` (Signature of Owner Agent including Contractor) ( ignature of Contractor) _
Signed and sworn to or of Irmed b f re melthti_s day of Si ped and swoornn to(or affirmed)be fo e m .this).day of
by `l"3�F'11(ls� by L>5
(Signature of Notary) J (Signature of Notary)
C;0C
JESSICASOULE. I JESSICA SOULE
MY COMMISSION#GG083767 / 04141!
MY COMMISSION#GG083767
ersonally Known OR E(PIRES:MAR 15,2021 Personally Known OR EXPIRES:MAR 15,2021
VProduced IdentificatioBonded through 1stSlale Insuranc [ ]Produced IdentificationBonded through 1st State Insurance
Type of Identification• Type of Identification:
NOTICE- OF-COMMENCEMENT
(PREPARE IN DUPLICATE) L
Permit No. Tax Folio-No. 6%0
:State of County of ATI W h
To whom It may concern:
The undersigned hereby informs you thafimprovements will be made to certain real-property,and In
accordance with Section 713:of the Florida Statutes,the following Information Is stated,ln this,NOTICE OF ;
COMMENCEMENT:
:Legal description of.property being improved:
MAY 1 2018
Address of:property being improved: �(Ac I L --- �
General description of Improvements:
Owner \>.
Address �u ` ,Q�
Owner's interest in site of the improvement Q� �V
Fee Simple Titleholder(if other.than owner)
Name
Address
Contractor ter, rang
Addressfkj]eu0L11%. d,
Phone No. ril Fax-No.
Surety(if.any)
ac g-
r .J'
Address- Amount of bond$
Phone.No. Fax No.
Nameand.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):
ThIIS:SPACE-FOR RECORDER'S USE ONLY / WNER: �.r
SIgned:2ez,, DATE ( w .N
afar m a of In the
County of a of FI da," s p r§o I appeared
- hereln by v 52 � Iz
.
---- himself/herself and ffirms tha all statements and declarations herein — w —
are true.and accurate w SQ 66
Doc#2018115766;OR BK 18388 Page 1040; ;;�W -
Number
Pages:1 o
Recorded 05/1512018 02:32 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL m
COUNTY Notary Public at Large,St a of County of nod`-+
RECORDING $10.00 -My commission expires: tet,.. .
Personally Known or � $
Produced Identification oy �F