1104 Rose RERF18-0165 & NOCPERMIT 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.
a
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
-
ATLANTIC BEACH, FL 32233
�>
INSPECTION PHONE LINE 247-5814
o;
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO:
RERF18-0165
Description:
SHINGLE ROOF
Estimated Value:
6525
Issue Date:
7/23/2018
Expiration Date:
1/19/2019
PROPERTY ADDRESS:
Address:
1104 ROSE ST
RE Number:
171007 0100
PROPERTYOWNER:
Name:
ATLANTIC RESTORATION COUNCIL INC
Address:
233 BAY ST E STE 920
JACKSONVILLE, FL 32202
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name:
Sunbelt Homes and Roofing LLC
Address:
450 SR 13 N Suite 106 Pmb 409 ST
JACKSONVILLE, FL 32259
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
Job Address: 1104 ❑,0 S1! Permit Number: t0�
ru �r, rte .. t. WT 6L,
Legal Description 14C l tl ATLA.191L QE'A(h Skr 11 S Io F/ RE# 111001 0 10 9
Valuation of Work (Replacement Cost) $ 6 S t,f — Heated/Cooled SF _ Non- Heated/Cooled
• Class of Work (Circle one): New Addition Alteration Repair Mo emo ool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commerci Resl
• 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 removeo or Affidavit or No I ree Kemoval
Describe in deal] the type of work to be performed:
(LERoU G I °I tr Sh/,JCLEJ —
Florida Product Approval#EL 1eJS-f,/7/J• 6L/s%/6 & o for multiple products use product approval form
ProDertv Owner Information
Name: 0. rt u Cu L Address: °1.11 E QAV.S� STC 910
City L State li Zip 11tol.- Phone 124-4911
E -Mail
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: )Ail,)' N E\ i (to L JC Qualifying Agent TN
Address 450- 10(, Srt. 111/ g4n0. CItyrA Imo{ S�rti.,t Statel Zip ]Li S9
Office Phone 91 4, Clk "iM9 Job Site/Contact Number
State Certification/Registration# CCC 110t0i) E -Mail S IUL'rLANAN mhd GAOL Cdr
Architect Name & Phone #
Engineers Name & Phone #
Workers Compensation ��Ipl.'I—y 4
Exempt/Insurer/Lease Empbpes/ExpW*Io nate
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 maybe additional restrictions applicable to this property that maybe found in the public records of this county, and
there maybe additional permits required from other governmental entities such as water management districts, state agencies, or
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 I OVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCI ,CON WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOU OT OF COMMENCEMENT.
IJ /J.M
(Signature of Own rAgent) (Signature of Contractor) 3r ✓/
(includin ntractor) v`
Signed and sworn to(or affirmed) before me this Lday of Signed and sworn to (or affirmed) before methis _day of
L. 01 IUI% by MAY S'ln 1LY TLL 101% by ThbmA.i (S SaIJAh
,01011fttureo hRN $rdjl!`�
'+��+, T1pM45aRP➢LEvsNITH , Lrcmwnswnaaplmasarr�
iY W OOlamisslouoacoaelos
Personally Known OR _ Personally Known OR �'{ EXPWEs:SplxnhrtB. tOA
Produced Ida Iication '. ~ ENPIRESM —..alto .i%duced ldentificati9p "•Wn n^'�r° 'ra^`I"
I] ¢' eaaea mvrva3ryPlatis Lnaenmmn ISL nrrvcf Ltcans�
Type of identification: pe of IdeMifra[ion:
NOTICE OF COMMENCEMENT
(PREPAREInnnPLICAM)
Permit No. Tax F0110 No. 111 hb1 -0)
State of L.a.DA County of ()f -..AI
To whom it may concern:
The underslgned hereby informs you that improvements will be made certain mal property, and In
accordance with Section 113 of Me Florida Statutes, the following Infomaatlon Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property, being imixo al' RAH 11 1.. -19 L� (A .J `1 A-rLAfl C- _
aelfticm SEC N S IoK Lof 4. tJ 10(f Lof L W1 9'
Addnessdprop"ImInglmprewd: Ho'i nos( sir ATLAdl4(. 11EA01 FL-
Geramldescdptionoflmpmvananb: RC rt f -
Owner ATL.ArJf-1(- fLC,ITUAA'f1IJ CUL-rJca l.- 1tJC-
Addmes -Tt G Mly Sr 92L1 'ror Allwl Jl. LLL`- GL- 3T.LG L.
Owner's Interest In age afro lnlpmw:med
Fee Simple Toodaider Of ama than owner)
Add.
PConnector
AdAaararee 95J IJ( S(L- 11 IyNU9 SAaw/( �olm.1 i 1t1�9
Phone No. qOL) Of -70)S —F.Ma.
Sally Of any)
Adder Amo,dofbamt$
Nemo ab address deM Parson mating a ban tw Ne mnahudbn otNe hnprovenanta.
Phone No.
Name attainment wflbin the Stale of Florida, offer Man himself. designated by owner upon whom reduce or other
doo mod, may be semed:
Name
Phone No. Fax No.
In addition b Nmult, ownerdesignatea the fdbwing parson to receive a copy ofthe Lienors Notice es provMed in
Section 713.08 (2) (b). Florida Statutes. (FBI In d Comer's option).
Plwre
Fax No.
Exp,,,m, data of Notice of COmmencemeM(fhe expiraflon data fa one (1)year from the date ofrecon ine unless a
different data Is Wedged):
THIS SPACE FOR RECORDER'S USE ONLY GINNER
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arewam.ecurem
Number Pages:1
ReCedad 02:39 PM,
RONNIE FUSSELLLCLERK
CIRCUIT COURT OUVAL �a{/f1' �✓
COUNTY
RECORDING $10.00xx+ m a:sm n a te. coyyy�,