364 4th Street RERF18-0248 REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF18-0248
ISSUED: 10/12/2018
800 SEMINOLE ROAD EXPIRES: 4/1012019
ATLANTIC BEACH. FL 32233
t
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In ad ition 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 aswater management districts,state agencies,or federal agencies.
JOBADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
364 4TH ST B REROOF SHINGLE SHINGLE ROOF $9184.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1698240002 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN ROOFING OF 2117 University Blvd. S JACKSONVILLE FL 32216
JACKSONVILLE
OWNER: ADDRESS: CITY: STATE: ZIP:
FOX LAURA A ET AL 352 7TH ST ATLANTIC BEACH FL 32233-5434
roperty
FNE n Ed n he equirc, ermn h is nal es ,,timonssappica b I e tom h0i 5 P
r tr c
t OTIC y I a to Itio tot r m ts of t P ition at per It required fr ther
hat ma be u rudinthe pu blic reco d s of th is co
govern menta I entities such a sw ter anage en r fede ra gene es
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT UANTI PAID AMOUNT $1ou'00
BUILDINGPERmin 45S-00G0-322-1UUQ a
0 5200
STATE DBPR SURCHARGE 455-COW 208-0700 —
STATE UCA SURCHARGE 455 COM208-0600 0 $2,00
TOTAL:$104.00
issued Date: 10/12/2018 1 of 2
REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF18-0248
ISSUED: 10/12/2018
800 SEMINOLE ROAD EXPIRES:4/10/2019
ATLANTIC BEACH. FL 32233
issued Date: 10/12/2018 2 of 2
Building Permit Application Updated 1218/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FIL 32233
Phone:(90,1)247-5826 Fax:(904)247-5845
Job Add MSS: 364 4th Sox,An..aean,h,IL a2z33 — PermitNumber: R6P_F ( &_(DZ49
Legal Description 5-69 ATI.ANTIC BEACH LOT 23 SLK 5 RE# 16982�02
Valuation of Work illeplacement Cost)$%!"00 Heated/Cooled SF 1500 Non-Heated/Cooled 2162
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use ofexisting/proposed structures)(Circle one): Commercial Residential
• 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
FDescribe in detail the type of work to be performed:
F�;�
Complete tear off and roof replacement. — t0Ko(-C_
Florida Product Approval#FL 16305 7— t'5G 0 15Ackt4ca" or multiple products use product approval form
Property Owner Information VK rz�-u
Name: l Address: 364 4th sheen
City mianx,saxich -State FIL Zip U233 Phone
E-Mail
OwnerorAgent(IfAgent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: American Roofing of Jacksonville,U.C. Qualifying Agent: DonKinkel
Address 2117 University Blvd S City Jacksonville State FL Zip 32216
Office Phone 904-385-4375 Job Site/Contact Number 904-385-4374
State Certification/Registration# RC29027546 E-Mail admin@americanroofing ax.com
Architect Name&Phone#
Engineer's Name&Phone If NA
Workers Compensation Builder's Mutal Insurance#WCP1052393,expiration 5/3/2019
Exempt/linsuner/unse Empil Expiration 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:I certify that all the foregoing information is accurate and that all work will be done in compliance with ail
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 INTE))D
)RI
TO OBTAIN FINANCING, CONSULT WITH YOUR LEND:ER OR AIN ATTORNEY BEF( E
RECORDJNQ YOUR NO CIMMENCEMENT.
(Signature mi'themer or Agent) (Signature Of Contractor)
fincluding contractor)
Signed and sworn to(or affirmed)before me this)a:!�_; of t!��edd sworn to(or a I before me t a of
by
_\_Ill 1b,
ING
i.recrfl�Iy),
COLLEENA.Ilill (Signa tai I, igna N
'*,. kk"'Its
yen �R b;." r all
1 01401
i!V2 ]Produce" .0 SSIONOFF924951
11...... OIL �'d Id ntifito MN
'0
L Type of ldernnl�4UVFI E; IRE.':U
Type of Identification:
Doc # 2018243044, OR BE 18561 Page 410, Number Pages: 1,
Recorded 10/11/2018 01:58 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
11ij 74P la"�( C
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 169824-0002
State of Florida,County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance
with Chapter 713,Florida Statmes,the following information is provided in this Notice ofCommencement.
1. Description of property(legal description of property and address if available):
5-69 ATLANTIC BEACH LOT 23 ELK 5
364 4TH STREET,ATLANTIC BEACH. FL 32233
2. General Description of improvements:
Complete Tear-Off and Re-Roof
3. Owner Information:
a)Name and Address: LAURA FOX,364 4TH ST.ATLANTIC BEAC H, FL 32233
b)Interest in 100%
c)Name,and address ofsimple titleholder(ifother than owner):
M
4. Contractor Informatim:
a)INanneandAddress: AMerican Roofing of Jacksonville
3047 St Johns Bluff Rd. Ste 7. Jacksonville, FL 32246
b)Ph.Number: (904) 385-4375
5. Expiration date ofNetice ofCommoricamorat(the expiration date may not be before the completion ofconsartmfion
and final payment to the contractor.but will be one(1)year firom the date ofmording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PlkRT 11
SECTION 713.13 FLORIDA STATUTES, AND CAN RESULT IN YOUR 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 FIN NG,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORI
YOURNOTICE OF COMMENCEMENT.
Under penalty ofperjury,I declare that I have read the foregoing notice of commencement and that the finx;stated
=th C tm�to the best ofmy wledge and belief.
Z,44�111t �ZV Laws Fox,Owns
Sigrfim'ni ofOwner or Owner's Authorized Officer/DirecomParner/Manager Signatory's Primed Name&Titletoffice
The forte to onowledged before me this 14A. . 107- 20 T
by_ )76Z " day f
(NameofPersonmal,ingstatonent)
NOTARY PUBUC,STATE OF F
Print Nitric:
0 Personally Known V
0 Identificationrype:
Rcmiseckl/01/18