RERF18-0141 '+ 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: RERF18-0141
Description: SINGLE ROOF
Estimated Value: 7980
Issue Date: 6/21/2018
Expiration Date: 12/18/2018
PROPERTY ADDRESS:
Address: 750 REDFIN DR
RE Number: 171311 0000
PROPERTY OWNER:
Name: ROSE BRIAN JOSEPH
Address: 750 REDFIN DR
ATLANTIC BEACH, FL 32233-3902
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: B. SMITH ROOFING, INC.
Address: 13525 SAWPIT RD QA SMITH, BRIAN EUGENE
JACKSONVILLE, FL 32226
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 12/6/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
n Phone:(904)247-5826 Fax:(904)247-5845
f� 2 c Q CI
Job Address: —150 �AN �a (�i(ael.� (�r F(. 7I;I Permit Number: ' ` v r\r `U �otz4
Legal Description 30-q LI 1.1-1S-1.9 G R y t FJ e,, t , i 1 L i I L &Vq RE# 1-11311-0000
Valuation of Work(Replacement Cost)09S10.H0 Heated/Cooled SF 19(1 Non-Heated/Cooled aOu3
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door Ik.-i
• Use of existing/proposed structure(s)(Circle one): Commercial esidentia
• If an existing structure,is afire sprinkler system installed?(Circle one): Yes No 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: Rc�Roof 30 ,,,aonxi5) $4i• ks
Florida Product Approval It RI S S.1 for multiple products use product approval form
Pro a pOwner Information r1
Name: Pi m.w • V.OS): Address: —150 Rcx1{•il-+ (X'vc
city Ail ; earrc4+ state A. zip 37x33 Phone 9o4-451-A593
E-Mail rilA
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information ¢
Nameof Company: QI•�imit. �.1Y'>FtNd) ' .t•K qualifying Agent: 1JP+n SfNIL
Address 135AA 45AL,q'iA R.1 City Sax State FL zip
Office Phone Chow 7`6- C Job Site/Contact Number Qo(+ 4`45.1'328 Liles )
State Certification/Registration# 137•(919. E-Mail bC •iC 8 'ctP) �4• 1"
Architect Name&Phone lf
Engineers Name&Phone#
Workers Compensation \NC• 11444
Exempt/Insurer/Lease Employees/Expiation 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,or
federal agencies.
OWNER'S AFFIDAVIT:1 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.
it -hi z=
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to or affirmedl before me this 10 cl yof Signed and sworn to(or affirmedr51 before me this 10 day of
t/nE ')OL by , n cl'i - d6g by CXR.on E N41
; .,("Signature of Notary) (Signature of Notary)
(�sonalty Known OR '•�'Fy�THLEEN R BEAR EY rwnalty Known 0 i i CATHLEEN R BEARDSLEY
I ]Produced ldentifwtio ; Commation#GG 034251 I ]Produced ldentiFlcation �,a' "1'2
°':Expiaa Nowmbar 78,2020 ?a Commbebn#G0034261
Type of Identification; Type of Identification- �yjloy-Mp�g_2B20
ft ,, „t� Bar4kllwl'rw EshweaotppNS)41t
NOTICE OF COMMENCEMENT
State of '�(..n0.1�� Tax Folio No.
County of �t vroL
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: r�
Address ofproperty being improved: 150
General description of improvements: O ooF 30 C LA"I nli <<v• 4J
Owner: QA;,A :5. RoSL Address: —1$0 (Zvb�•N Da Pyla •� &�dr,F+- 3�as3
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
0
Name: n rc
Contractor: ti` Q^.,'F t«t tea+ 0
11pY� ,Add.: 135a.5 SPw6- R1 -Ya FU 3a}al
Y Telepbone No.: T8•$(OS Fax No: �7S'•$686 E�
4V
Surety(if MY) m 8 x
Address: Amomt of Bond$ o .-0
Telephone No: Fax No: w
f N
Name and address of any person making a loan for the construction ofthe improvements m LL
w_
Name: u
z
zD
Address: o z W W O
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: Feet 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: Daze: (p115/I�
Before me this�ppmred
of in the Comty of Duval,State
Of Florida,hes
%> CATHLEEN R BEARDSLEV taff of{l'onde,Com a vol. /
l�A.•XCommissionRGG 034251 Notary Public az Large,SMy commission expires://�'^'�9/M
E;. Expires November 16,2020 Personally Known: m
Bor4ktbruimt rNn�muramra14rS1a19 Produced Identification: