805 Plaza RERF18-0150 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
- _ ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5514
REROOF SHINGLE -
MUSf CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERFIM150
Description: Reroof
Estimated value: 6900
Issue Date: 6/28/2018
Expiration Date: 12/25/2018
PROPERTY ADDRESS:
Address: 805 PLAZA
RE Number: 171115 0000
PROPERTY OWNER:
Name: AUGUSTINE MI YOUNG LEE
Address: 805 PLAZA
ATLANTIC BEACH, FL 32233-3809
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$7,500.
Building Permit Application
City of Atlantic Beach }
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax: (904)247-5845 v 1--})
Job Address: 805 Plaza Permit Numbert�FY i VQ
-o15o
Legal Description 30-60 17-2S-29E ROYAL PALMS UNIT 1 LOT 25 BLK 1 RE# 171115-0000
Valuation of Work(Replacement Cost)$ 6,900 Heated/Cooled SF 975 Non-Heated/Cooled 270
• Class of Work(Circle one): New Addition IEEonoRepair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial <sidentia
• If an existing structure,is afire sprinkler system installed?(Cirde one): Yes No• N/A
Submit a Tree Removal Permit Application if any trees are to be removed of Affidavit of No Tree Removal
Describe in detail the type of work to be performed: Replace asphalt shingle roo
Includes rolled roofing section
Florida Product Approval#FLI0674-R12(shingles)FL17420-R2 (felt) for multiple products use product approval form
Property Owner Information
Name: James Augustine Address: 805PIaze
City ATLANTIC BEACH State FI Zip 32233 phone 1,04-716-5774
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Prime Roof Contracting, LLC Qualifying Agent: Mark Young
Address 13725 Beach Blvd Suite 13 City Jacksonville State FL Zip 32224
Office Phone (904)530-1446 Job Site/ContactNumber (904)860-0230
State Certification/Registration# CCC1329505 E-Mail officeftimeroofnaticom
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation FRSA Self Insurers Fund Inc. 1/1/19 870-040093/3EE6142 _
Exempt/Insurer/Lease Employees/Expinnion Date R
Application is hereby made to obtain a permit to do the work and installations as indicated.I 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 WJTH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF NCEMENT.
a[ure of Owner or Agent ng Contract Signator of ontractorl ��//
S' sworn t l(or affirmed)before me this r, ay of Sigped and sworn t or af' me b ore at is t�R v of
QI�•by
naturelW,Nyla T. Davis (Signature of Notary)
au, -:
JW
_« ,= ceMMlssloNiFF16oe4s .'.v` Andrew D. Daws
IXPIRES: Sept. 17, 2018 'L _ COMMISSION d FF160849
P rsonan Known OR ',aa�y�� wwAARONNOTARY.CSM (`Y6ersonally Known OR '-x " EXPIRES: Sept. 17, 2016
I I Y -''"l l� n o"°�`` Produced lderuftation .$
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I Type
of ldediticatiocation �' ^( Type of Identification: �
Type of Identificatipn: IY/
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of Florida County of Ouval
To whom N may concern:
The undersigned hereby Informs you that Improvements will be made W 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 prope(ly them,Improwid:Jew 17-2S29E ROYAL PALMS UNIT t LOT 25 BLK t
Address of property being Improved:eo5%ere'AtiaMa each,FL 32233
General description of Improvemsrds:Re rsif
Owner James Augustine
Address E05 Plaza.AWMI Beatl,,FL 3Y1J3
Owners interest in site of the improvement
Fee Simple Titleholder(If other than owner)
Name
Address
Contractor Prime Roof CMxreass,LLC
1 � Adtlre5513T25 Beatl,BFN 5uHe 1J,JatluomllM.FL 3Y12<
P Phone No.19x1 B2%lu6 Fax No.
Surety(,any)
Address Amount of bora S
Phone No. Fax No.
Name and address of any person making a loan for the consWctlm Of Me improvements.
Name
Address
Phone No, Fax No.
Name of person within Me State of Florida,other then himseH,designated by owner upon whom maces or other
documards may be served:
Name
Address
phone No Fax No.
In addition to himself,owner designates Me followin,person to receive a copy of the Lienor's Notice as provided in
Section 71306(2)to).Florida Statutes.(Fill in at Owner's opium).
Name
Address
Phone No. Fax No
Expiration date of Notice NCommenxmeM(the expiration dam Is one(1) a,from Me data of remaing unless a
different data is specifwd):
THIS SPACE FOR RECORDER'S USE ONLY C 2 I
y�y DAre—lLi
_ yhm
OocM 2019151720,OR BK 180.96 Pa9G 2755.
aria w"M° Andrew D. Davis
hlmwwhema aanrma x.l (la,d c= COMMISSION/Ff160849
Number pagmI ere ima.aa re
Recorded O9R7(A190a:1t PM, E`uJL' '` EXPIRES: Sept. 17, 2818
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL �,%�R �.AARONNOTARY.COM
COUNTY
RECORDING 810.00 sec MLege sM DouMyol
[ertanlMlm agates'.
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