576 Aquatic RERF18-0257 REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF18-0257
- , ISSUED: 11/5/2018
80NTICBE CH.OLE ROAD EXPIRES:5/4/2019
ATLANTIC BEACH, FL 32233
INSPECTIONMUST CALL
• (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
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• • • • • • • r • • • •
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
• . . . r • • • OF • •
576 AQUATIC DR REROOF SHINGLE $5500.00
TYPE OF BUILDING
CONSTRUCTION: NUMBER: GROUP:
171818 5192 AQUATIC GARDENS
COMPANY: rr •
KINNECORPS, LLC 8761 Perimeter Park Blvd JACKSONVILLE FL 32233
• ADDRESS:
WORTHINGTON JOHN R 576 AQUATIC DR ATLANTIC BEACH FL 32233-3838
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 QUANTITY PAID AMOUNT
BUILDI
ATE NG PERMIT 4550004322-1000 0 $8000
STTE SU RCHARGE 4550000408-0]00 0 $240
STATE DCA SURCHARGE 455-0004208-0600 0 $200
TOTAL:$84.00
Issued Date: 11/5/2018 1 of 1
Doc N 2018160396, OR BK 18449 Page 1049, Number Pages: 1,
Recorded 07/10/2018 12:27 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
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NOTARYPUELIC
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Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone:(904)247-5826
Fax:
'(90-4).{2=447 5845 Email: Building-Dept@cc/foaab..uus� IS REQUIRED.
Job Address: John Worthington 6-76 1 "'I WM ' C- Permit Number. z�+- P- j&�—OL.-S 1
Legal Description 38-7117-25-29E Aquatic Gadens LOT 1-0 REg 171818-5192
Valuation of Work(Replacement Cost)$5500 Heated/Cooled SF Non.Heated/Cooled
• Classof Work: ❑New DAddition OAlteration VJRepair 01yove ODemo ❑Pool OWindow/Door
• Use of existing/proposed structure(s): mmta
Co
ercial esidential
• If an existing structure,is afire sprinkler system installed?: QYes [:]No
• Will trees be removed in association with Proposed ro'ect? es(must submit separate Tree RemovalP r
Describe in detail the tyyppe of work to be performed:
Reroof/Shingles/6 PITCHrrownhouse/14 SCIS
Florida Product Approval ifFL10674-Rl2 for multiple products use product approval form
Property Owner Information
Name John Worthington Address 576 Aquatic Drive
City Atlantic Beach State FL Zip 32233 Phone SlDil-710A675
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Na
Contractor Information
Name of Company Wnnecorps,LLC Qualifying Agent Roger van den Bosch
Address 8761 Pedmeler Perk Boulevard Ste 201 City2acksawOle State FL ZiP32216
Office Phone 904351-0333 Job Site Contact Number 309-318-1057
State Certification/Registration fl RC29027575 E-Maild'dsg@kinnecorps.com
Architect Name&Phone x
Engineers Name&Phone JI
Workers Compensation Insurer The Holmes Organization of Florka,Inc OR Exempt O Expiration Date 05/2412019
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 regulating
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 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 PR PERTY. IF YOU INTEND
TO OBIN FINANCING, CONSULT WITH YOUR LENDER OR N BEFORE
o
TO 71liG NRN9TICE OFCOMMENCEMEN
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(Signature of Owner or Agent) ( ' afore of Contractor)
iC7orn[o or affirmed)before me this 3 day of Signed and sworn (or affirmed)before me this,_day of
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(Sigreture of Notary) (Signature of Notary)
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NOTARY PUBLK:
I Personally Known OR Personally Known OR STATE OF FLORIDA
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