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625 SAILFISH DR - PERMIT RERF18-0123 , r S's CITY OF ATLANTIC BEACH } 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: RERF18-0123 Description: NEW SHINGLE ROOF Estimated Value: 6900 Issue Date: 5/23/2018 Expiration Date: 11/19/2018 PROPERTY ADDRESS: Address: 625 SAILFISH DR RE Number: 171221 0000 PROPERTY OWNER: Name: CARROLL SUSAN K Address: PO BOX 331391 ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: FLEISCHER BROS INC Address: 1258 FISH HOOK WAY PONTE VEDRA BEACH, FL 32082_ 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$7,500. Building Permit Application Updated 12/8/17 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax: xy(904)247-5845 Job Addressf�,� I7k5 . �J&, l 961,6 ! f` Permit Number: Legal Description 30,- 17 o1S 5K I A711V UIJ 641Re- RE# Valuation of Work(Replacement Cost)$ IMMv., Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addfion 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 (9:)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:3� Florida Product Approval#F4 / 3 r2r for multiple products use product approval form Property Owner Information Name: 52.5!2A ecnYo I Address: C _<q,'I?�Sh A� City aklaa AL L` ryth State_ Zip 3 1.3 3 Phone q©r-/"02q/ 7&11P E-M a I P_C_5-a,'/ /e S J.X_a33 G► Yo hvo,CD M Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Contractor Information Name of Company: �Q[�r�irr /3rak ./C Qualifying Agent: i Crf7�11 i �rP�SC/tB— AddressAG �, s!� /f ocs/C uJys/ CitvAw1_Ve,4w &_!, .estate Zip ,?o7U27�7 Office Phone.S70—6ct - 0'2X_(— Job Site/Contact Number State Certification/Registration#CCG/ Sng 75-3 E-Mail nQ Architect Name&Phone# Engineer's Name&Phone# Workers Compensation 7_')i n 101,z,.j 47 IV& 7/3a/'21Z I ©` 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,et .NOTIGE.In addition to the requirements .1 1 , ermit,there may be additional restrictions applicable#o this property that may be found in the pub is reeocds of this county,an here maybe additional,permits�requiredifrom'otheragovernmentat�entites+sweh as wateimanagement districts state agencies,o ederal 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 RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDIN YOUR NOTICE OF COMMENCEMENT. (Signature of Owner or Agent) (Signature of Contractor) (including contractor) Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this-a day of rA F:kk c MCLAt bol by �ppY PUA•• JENNIFER JOHNSTON MY COMMISSi0N#GGq42984 pt; 2020 EXPIRES:October 27, ( ign ure otary) re o RJOHNSTON Bonded Thru Notary Public Underwriters c?ti 'u ': MY COMMISSION#GG 042984 •,....• [ ]Personally Known OR =*: *E EXPIRES:October27,2020 [\) roduced Identification [� ` [�(oduced Identification .�oFF•o?�_ Bond@dThruNotarypublicUndenrrtiteB Type of Identification: �2_ Cl Type of Identification: "" NOTICE OF COMMENCEMENT State of � x;Ath Tax Folio No. County of Z. i.�. To whom it May Concent: 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 COMIvffi NT Legal Description of property being improved: 20 -110 �Rsjfil (w nisi L k Address of property being improved: '/ - h (-Ys4,2 $fah GL ,T,6Q General description of improvements: n Owner: .SQW07 �'OrJ'y�� Address:"f A J_ Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: Contractor: -74� Address- -6t ddress �lic a L^ f2�oa K Ls2�( oho!° V L 7�aY1 Telephone NO.: 5'917 -�pC2i-D9f(� Fan No: Surety(if any) Address: Amount of Bond S Telephone No: Fax No: Nemo and address of any persom making a loanfor the construction of the impmve sits Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself,designated by mercer upon whom entices 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 Lieoor's Notice as provided in Section 713.06(2)(b),Florida Stahm (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Comorencemem(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 .23rzAl� Dsk i ALYSSA SUTER B.6 s '-yday of�o,,, rode CouayofOuval,State ` CanmisslcoRFF 742349 OCFlocida,hes personalty appeared 0 -�� (` \\ ». Expires July 16,2016 Notary Public at Large,SIR ofFlorde,County of Duval. 'psi;. mmrx.rnv.u...emasm,e Mycoun issione0m.-.�v. \may?dFb Personally Known: or 1'm1240BE RBI(ISM Page sus Daca2078724098,OR aK 788 Page 861, Number Pagesa Recorded 08SSEL E: AM, BONNIE FUSSELL CLERK K CIRCUIT COURT DUVAL COUNTY RECORDING $10.00