1502 Jordan Roof18-0097 ROOF NON SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ROOF18-0097
800 SEMINOLE ROAD ISSUED: 11/7/2018
ATLANTIC BEACH. FL 32233 EXPIRES:5/6/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In additiontothe requirementsof this permit,there maybe 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1502 JORDAN ST ROOF NON SHINGLE SHINGLE ROOFING $3300.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1722950020 ED SMITH S/D
COMPANY: ADDRESS: CITY: STATE: ZIP:
EMPIRE ROOFING SALES& 2806-1 GI GIBSON RD JACKSONVILLE FL 32207
SERVICE
OWNER: ADDRESS: CITY: STATE: ZIP:
DUNCLIFF TRADING
COMPANY LLC
WARNI NG 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.
DESCP*'PT'ON ACCOU!T QUANTITY PAID AMOUNT
BUILN�TPIR.'T �.c 0
ATE DBPR SURCHARGE 455-DOW-2�0700 0 SIM
STATE DCA SURCHARGE 455-0�2�600 0 52.00
TOTAL:$74.00
issued Date:11/7/2018 10f2
UILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
00 ScInitiolz Road,Atlantic Beech,FL 32233
Office(904)247-5826 Fooc(904)247-5845 f-\cK:>r-- I S, -OD97
Job Address; 1502 Jordan St Atlakic Beach FL 32233 FormlitNumber:
Legal Des 26-5017-n�29E 063t SMITH SID PT LOT I3MCDOIR 15731133HI-Kpareelgi 1722950020
Noor Sq.Ff
-��hmtedtcooled, non-heated/coolerl_
valleatiod of Work$ Propw'ed 'Work
Class of Work(circle one): New 'Addition Alteration Repair Move Demolition pool/spa window/dow
Uleofoxisning/purc, osedstructuare(a) ircicoue)' Commercial i Ni
Ifanalistingirfirciefoors,isafiresprin, arsysteno installed?(Circle one. 06 No (EP
Florida Product Approval 4 K, L t&-Z Z C,- 12- c:6, 1 cl,(ftl
For multiple promicts we pro um a pro".&A
Describe in detail the type of work to be perfomed: I?ejqav-- qto( Qepjoce� Qji Rd.-&y X4*YkLc
Propem O�11dorniatigir
N ame: L ddress: 1 1�31 Vldl�
city
P,MaicrFax,
C trac
r,ompsery Name. -"-"----Ag=t —. ea�d Ah4glt�;,-
Address: 150AZU, 11,11- Statc-R. Zip -5,24 0
Office Phone b Site/ComactNurober
State Certification/Registration 9
Architect Name&Phone#
Engmener's Name&Phone 4
Fcc,Simple Title Holder Name and Addr a
Bonding Company Name anti Address
Mortgage Tcndt Name and Address
4,1som u b �t bnontop..no, Wooed I...ofy th.,no..A whillroos h.
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T. and finit ,0,
WARNING TO 0 R: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY SULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY, IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOM NOTICE OF
COMAIENCEMENT.
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Signature of Owner Signature of Contractor
Print Name - ------------------ PriwN -61
tb�f,ie` Day of Novewaetz 20 kA
CaA,1L n5&=�td
Notary Vuldic "MY SCAMILLA I!i0turyPUb1IV`
Comm, #2154223 .
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EXPIRESAugustili,2021
Doc # 2018263477, OR BK 18589 Page 907, Number Pages: 2,
Recorded 11/07/2018 08:53 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $16.50
NOTICE OF COMMENCEMENT
State or 041IGrhi!5 Tax Folio No.
Comity.fAAS Ano
to who.it may Concem:
The undersigned hembi informs you that improvements will be made to certain reef property,and in accordance itb Section 713 of
the Florida Statutes.the following information is smted in this NOTICE OF COMMENCEMENT
Legal Description ol-po,porty being improved..4,o-sp :46
-� pead q4Z 111016 _Z10 a-aae
Address of property being impro,cd;
GeterAl de,,ci plion of improvements:
0'roet Address LtUf— —�W-------
owner's nurw5t in site of(tic improvement:
Fee SimpicTiflilholi other than owner).
I.Mc.
Contractor
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T'hiplume No: qpq-3 1 -007 F.N.I..
Addicas: Amount of Bond S
lolephone,No; Fax N.:
Name end nutted of tiny person MaXing a loan for the construction of the improvements
.\am,:
Phone No: Fax No:
Name of person within the Sim of Florida,ralver,han himself.designated by owner upon whom neefices or other doomments may be
�,vb& Noun:
Athi
fdl�phmve No Fax NO:
in addition to himself. fidille, designated the Follo,ii person to recc;ve a cop) of the Licoor's Notice as provided in Section
(FilimittOwner'ler,601)
Name.
Address
Telephone No: Fax Noi
Expiration,date of Notice of Commencement(the expireamn date is one(1)year from the date of mordling unless.different date iv
specified,:
THIS SPACE FOR RECOROCR'S USE ONLV OWxER
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OR EK 18589 PAGE 908
CALIFORNIA CERTIFICATE OF ACKNOWLEDGMENT
ic or other officer completingthis cestificanesterifies only the Identig,of.
who signed the document which this terminate is arturched,and net
A accuracy,or ustildity of that document.
State of Califorrila
County of /-0
OnOCA61 31 "' t-.2016bbeforeme, �Iifl" C /Y ?U/,(,,
personally appeared
who proved to me an the basis of satisfactory eirldencis to be the person(s)whose name(s)Is/am subscribed to
the within Instrument and acknowledged to me that he/shelthey executed the same in his/her/their
authorized capacityries),and that by his/herAheir signature(s) on the instrument the perwn(s),or the entity
upon behalf of which the person(s)acted,executed the Instrument.
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I certify under PENALTY OF PERJU RY under the lam of the
State of Callfomia that the foregoing paragraph Is true and correct
JENNY ESCAMILLA j
WITNESS COMM. #2154223
my nd and official seal. Notary Public-California
My LoAngelesCoamity
C�ExpimsM22,?V
;�LSIgnature
(Seal)
OpHonall Information
A111=h.t.ho irformandon in this arecrain 15 rics required!by lina,it could prewntiraudulent normw and nnutichment of this adnowledgmenttoan
u. document and may ch�e useful to oasnamor rely on the attached document
Description of Attached Document
The preceding Certificate of Acknowledgment Is attached to a document Method of signer dionefficartion
titled/for the purpose of Ott" of
Ofonsohdauffication Ocatchei,,manstast
Notarial ewmv,Is donated!in ransTiournal on:
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