RERF18-0139 m CITY OF ATLANTIC BEACH
si 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 41PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0139
Description: shingle re-roof FL10124 & FL15487
Estimated value: 5200
Issue Date: 6/20/2018
Expiration Date: 12/17/2018
PROPERTY ADDRESS:
Address: 340 SAILFISH DR
RE Number: 171362 0000
PROPERTY OWNER:
Name: FOSS DOUGLAS C
Address: 1818 COUNTY RD 2098
GREEN COVE SPRINGS, FL 32043
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Best Roof Jax LLC
Address: 3352 Shelley Drive
Green Cove Springs, FL 32043
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$7,500.
Building Permit Application Updated 12/8/17
City of Atlantic Beach
„ 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax
(904�)247-5845
(( D p _
Job Address: D �.� s� Dr F (1( e'^x` mit Number: FI pp O
Legal Description!(•1 11 QS a9 f &q� 1 QIrS `1 mi ZA Lot oX• 0 R 1-113(01--a-ro
Valuation of Work(Replacement Cost($,!� 2QOHeated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition AlterationRepai 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 N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit o 0Tree Removal
Describe in detail the type of work to be performed:
Re400d - zo S.Q 24124*0r,
Florida Product Approval If L 7for multiple products use product approval form
Pro a Owner Inform on p p
Name 1(1 Ptiss Address: lRlD )InLp i�1/!,R
City 3'y ksi NP arse-i I State TI_ Zip x,2(42 Phone
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Nameof Company: k U Qualifying Agent:
Address Qs(7Qkh E S ttP- Ilft� City Stale_,y_Zip X2 0
Office Phone 9174,$7J}7 a. Job Site/Contact Number L fJ/(p
State Certification/Registration N 1� 33- b E-Mail 1.)- kj AX �G L Q.c l
Architect Name&Phone a
Engineer's Name&Phone 11
VNorkers Compensation Exe or
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,etc.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,of
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
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND Qac,•
WGm
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE "3
RE,E •NG•YOUR OTICE OF COMMENCEMENT. � mel
NG Y 4 1.A 1
1 E,
»Er
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this 3J day of Signed and sworn to(or affirmed)before me this JL day ofa ;N u
Aon'f. 2 Aby 411MCf6. EUS3 � hk -Ich by n�•`,'��—Fb`n°.r.yW,d1
r
(Signature of Notary) 4lgnatme of Notary) ,
I 1yersonally Known OR ( Personally Known OR ---- ,1LET a_
( Produced Identification h I I Produced Identifioan. , CHARISMA f or
Type of Identification:VL VL Type of Identifications i Ov Btata of Fl°” 'p
g u1 nnY Lonu• E""m 2
DOC 8 2018134143, OR BK 18413 Page 512, Number Pages: 1,
Recorded 06/06/2018 02 :23 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE. OF COMMENCEMENT
tax Polio No. _17_I3_Lu —0000
CounR of fltJVgl
F.Whom It Ma)Concern: - - -
The undersigned hereby Informs you that impruvonents will be made to cenaln real propn), and in acxurdance with Semon 713 of
the Florida Statates,the following information is SuIled in this NOTIC F OIC'OMMEW LNIFNI
Legal Descriptionufpnspeny Ming improved: 3` • ,• !7_25 yQ-E A"kl Py tad 0nlf.,2-._e_.__
•lddressofpropeny Mingimpn„+,t 3�iU .S0.H'�ls� (�� . . A4LW'1hC 5el4jr-c.._. ��3—S
Gcncraldxxripiionofimpmv¢ntuJr.
Owner: Q(y ffjp� ,[QSS._. . _.__... 4�.Id;<., IB/B (0 Rd ?D4 6 IiCC�!-/12P'f. 2fDf_ �in43
Ownar'x imcrcsl in silt of the Improvement: _aWne—✓
I cc Simple i itleholdu til other than ownxv)'.
Name
Address J0157- De&UAID
felephone Nn: fa.No
(it 311))
Nddrl,, ,lmoum ofHard$
'felephnnc Nn. Fav Nu:
Name and addr olny"ll"In m'tt tc o loan fill Ihr umxtrucli r l of file impmvcasents
Name
j Address. . .
Phone No: fax No:
Name of pennn within the State of Fka Ida.ether than himself designated b) owner upon whom notices or other documents may be
Telephone No: Gm Nn.
In addition n. himselt: owner dcsignntn Ibc h4howing pram in recei.c a enp) of the I,ienar's Notice as provided in Section
713-Oaf2'0).Florida Statues'_ (NII m at Owners option) - ---
Name
4JJress:
felephom ho . _ Fax No
I'sura ntn date of Notice of Commencement Ithe expiration date is one it)yxmr from tlw date of recording unless a diffemtn data is
.Pecifivel).
THIS SPACE FOR RECORDER'S USE ONLY OWN4if
�S gned, "_' "iceW _ itIkf rrc Oa t d�in rM1e Count)of ural.Sate
(It1wiFuN1c iI e,Nt,acM red 4won firundl _
o tw+ Publ t l a.♦we pl I IwWa t rwnp f Iluval.
Veuwnlh t.nown
I•:•J ••P doltr", 11
� Will Niwa/a.dN