221 SEMINOLE RD - ROOF r-S�=L`Ji�
i�3 CITY OF ATLANTIC BEACH
0 800 SEMINOLE ROAD
__..
ATLANTIC BEACH, FL 32233
'!.0;3 !•)%' INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0205
Description:
Estimated Value: 5000
Issue Date: 8/16/2018
Expiration Date: 2/12/2019
PROPERTY ADDRESS:
Address: 221 SEMINOLE RD
RE Number: 170527 0000
PROPERTY OWNER:
Name: THOMPSON JAMES DOUGLAS ET AL
Address: 1643 BOONE HALL DR
CHARLESTON, SC 29407
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: IA Development Corp
Address: 177 E Blackjack Branch Way
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$7,500.
y1. 1.. Building Permit Application updated 5/5/17
k il City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
us:9r Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: '1 ii\k/�' 144- � 1 Q
- G & CkPermit Number:
Legal Description RE#
Valuation of Work(Replacement Cost)$ 5b0 C.) Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteratio Repai Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial sid ne the tia
• 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 of No Tree Removal
Describe in detail the type of work to be performed:
12.. .- 12.00 R — A'7p(iitt sHiN5c- S
Florida Product Approval# 1\1OA--i I0Sl1 •7 J L i5 2(, for multiple products use product approval form
Property Owner Information, \ / ((��
Name PM�s 11+o Kest() Add ress:22i SzM1\-o . Ck,-
City 4\-1•((p.{,t_4iC, VjL,QG1 State;F.. Zip 3'ZZ,]G Phone o'OLf_—] ..- ---703 o _
E-Mail L VU • -I Op-i, i v &at l,CCU ,
Owner or Agent(If Agent, Power of Attorney o Agency Letter Required)
Contractor Information
Name of Company: 4 Zvi✓0r ME. Go Qualifying Agent:
Address I2&2-1 1i JOSR fid, th s0 City -1(0( State PL- Zip 31-Z-2.:�
Office Phone L . Site/Contact8?2 .3 O 2 Coo ci
8� '30"Z(c�G�s - Job Number
State Certification/Registration# E-Mail JC'Pc{� 2,iak/C,CA.Cg1 . U',
Architect Name& Phone# J
Engineer's Name&Phone#
Workers Compensation '111._---7(2,02,C, ,
Exe Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to dose 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.
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 A-
N ATTOR +• : Fe =
RECORDING YOUR NO C OF COMMENCEMENT.
1 , , T / 4 r4. , ok
-- ---- iterc.
(Signature of Owner or Agent) (Signatur• of on .ctor)
(including contractor) `
Si ned and sworn to(rr affirmed) .-core me this day of Sig ed and sworn to r affir e i-for- me this 1'.day of
t 16 ,by / AI _,�� ,by
=; 'fly' ? PETE LOFTIS ;a ✓ W
V,
_,i rel' MY COMMISSION#GG 1, � 3 of Notary) -,'n:;;; ----7-"Trill) •f Notary)
"'!��'Oc EXPIRES:A ust 15,2� 1 •• n, ;._ MY LOFTIS
1,,,,FOF f,to o u9 n`;i CO MISSION 8$61
Bonded Thru Notary public Underwriters r•^`.'p°; EXPIRMt N#GG 12
,,,j,;,,••'go Th ES:qugust 15.2021
[personally Known OR [ ]P sonally Known • NNotarypu�k
[ ]Produced Identification [ Produced Identification f `C c .;— -
Type of Identification: Type of Identification:
Doc # 2018193772 , OR BK 18495 Page 72 , Number Pages : 1 ,
Recorded 08/16/2018 01 :27 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
l ,
it
NOTICE OF COMMENCEMENT
(PREPARE IN Dl1PLCATE)
Permit No. I Tax Folio No.
State of ( Ott' County of -1 1 &••
To whom it may concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT. !! Q i
Legal description of property being improved: I U i tn`�s—26
Sa I4-a•).-- scC- I 4ia.-7
Address of property being improved: 2-21 L i\11 11� an fi
General description of improvements: z C-"'O AS�' t- S f I t �
Owner J°M-C EJ '71/1911-11 A) / ii ,,,AM An. _c
Address 22-f Se's y "t5C �L ��"(�,,;YI i�r(i �f
Owner's Interest In site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address /� J` p
Contractor 14- DELVE UNioC,/ // ,yr
4 Address ,u(27 Cam._ ).f9� Nvek_ .S11(. Sc) Fi" 32.1;2
Phone No. Fax No.
q. / Surety(if any)
C/ Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name - -
Address
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
Phone No. Fax No. -
In addition to himself,owner designates the following person to receive a copy of the Lienors Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill In at Owner's option).
Name o
Address
Phone No. Fax No. cn a
pri
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a o Zo
different date Is specified): E
z
THIS SPACE FOR RECORDER'S USE ONLY OWNE•' tf// V _ 2
Signed: .DATE '`lV. 0 $
Before this_ • day of in the '�
Coifg,.f D . I: •.f• n
r r 1 renin by
hlmse herself and aft. s th• ment'and fir.ns herein � •' , bo
are true and accurate �i•.i'1�"►ARO:
Notary Public at Loge,Slate of County of "
My commission ex.fres: .4IE* r
Personally Known - or
Produced Identification