RERF18-0143 �f.:JPI
CITY OF ATLANTIC BEACH
n 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-8814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0143
Description: Reroof Shingle
Estimated Value: 7489
Issue Date: 6/21/2018
Expiration Date: 12/18/2018
PROPERTY ADDRESS:
Address: 249 S NAUTICAL BLVD
RE Number: 170703 0378
PROPERTY OW NER:
Name: PUNDAMIERA BEN
Address: 249 NAUTICAL BLVD S
ATLANTIC BEACH, FL 322334120
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: PRIME ROOF CONTRACTING LLC
Address: 13725 BEACH BLVD SUITE 13
JACKSONVILLE, FL 32224
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$7,500.
Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax: (904)247-5845
Job Address: 249 Nautical Blvd S Permit Number: '6'
43
Legal Description 35-64 17-2S-29E SEASPRAY LOT 6 BILK 4 REN 170703-0378
Valuation of Work(Replacement Cost)$ 7489 Heated/Cooled SF 1626 Non-Heated/Cooled 1634
• Class of Work(Circle one): New Addition qgEion Repair Move Demo Pool Window/Door
• Use of existing/proposed structures)(Circle one): Commercial <15esidentia
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if anytrees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: Replace asphaltshingle roof
Florida Product Approval NFLI0674-Rl2(shingles) FL17420-R2 (felt) for multiple products use product approval form
Property Owner Information II
Name: Rosito Pundamiera n puAAAmin'[�r Address: 249NaWcal Bil
City ATLANTIC BEACH State FL_ Zip 32233 Phone ex,b2wn620
E-Mail
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Prime Root Contracting, LLC Qualifying Agent: Mark Young
Address 13725 Beach Blvd guite 13 CityJacksonville State FL zip 32224
Office Phone (904)530-1446 Job Site/Contact Number (904)860-0230
State Cenification/Registration N CCC1329505 E-Mail officeQprimerootingfl.com
Architect Name&Phone N
Engineer's Name&Phone N
Workers Compensation FRSA Self Insurers Fund Inc. 1/1/19 870-040093/3EE6142 _
Exempt//Insurer/Lease Employees/Expiration Date R
Application is hereby made to obtain a permit to do the work and installations as indicated.)certify that no work or installation has E
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 or Agent including Contra or ( nature of Co actor) 16y
Si ego demand sworn to(or affirmed)before me this I�tl.dey of S,fad and sworn to(or affirmedi6�I re me this LOWY of
M Plc p YyA, - by
e�&�q F,ofl IJ (Signature of Notary)
34 `` COMMISSION tFF160849
=`c C a` EXPIRES: Sept 17, 2018 �gplp, . Andrew D. Davis
,Fo7 WWW.AAR INNOTARY.COM --// COMMISSION Y FF1fi0849
I )Personally Known OR .. I TPersonally Known OR ac aV
I-I'Produced ldentificati9n ii�a I I Produced Identification - - EXPIRES. Sept 17, 2018
Type of Identification: i�-r. VL. Type of ldentifica[lon: -"'rr)„afi,�o`� WWW.AARONNOTARY.COM
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of FkxWa County Of Ouve
To wham It may concern:
The undersigned hereby Informs you that improvements will ids made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following information is staled In this NOTICE OF
COMMENCEMENT.
Legal description of properly being Improved:3o-a"17-2S-29E SEASPRAY LOT 6 BLK4
Addre55 O(properly being Improved:249 NouOol BNE S.Pllentic Bn@.FL 3M3
General desorption of improvements:R—f
Owner abuts Punaem i T U
Address 249 Fusion food B.basic Exxon,FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder of author Man owner)
Name
Address
Contractor Roof Conlrefim.LLC
Address 137M Be h Blvd SW 13,Jedso odre,FL 32224
Phone No.(got)825-14ae Fax No.
Surety if any)
Address ".tofbaid$
Phone No. Fax No.
Name and address of arty person making a ban for the construction of Sa Improvements.
Name
Address
Phone No. Fax No.
Name of person within to State of Florida,other Nan Mmself,designated by comer upon wham dolma a other
documents may be served:
Name
Md..
Phone No. Fax No.
In addition to himself,owner designates to folbwing parson to receive a Copy of the Lienors Notice as previded in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone No. Fax No.
Expulsion date of Notice of Commencement(the expiration data is we(1)year"in the date of recording unless a
different data Is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
yer'eaa..i Dore �"r9 .)rBefear....,. ��jg no.
couIN W OHVL orFWNa PeamrH 91n8
If y Andrew D.Dauis
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&BPI. 17,2018
ONNIE FUSSELL CLERK CIRCUIT COURT DUVAL _x
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