1226 HIBISCUS ST - ROOF 1."---1'- '1.7--/.„ REROOF SHINGLE PERMIT PERMIT NUMBER
,. CITY OF ATLANTIC BEACH RERF18-0235
\Y.� , 800 SEMINOLE ROAD ISSUED:
g_`• ATLANTIC BEACH. FL 32233 EXPIRES:
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 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1226 HIBISCUS ST REROOF SHINGLE $10000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171057 0050 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
A CROWN ROOFING INC 6504 BEACH BLVD JACKSONVILLE FL 32216
OWNER: ADDRESS: I CITY: STATE: ZIP:
Chimal Juan Gabriel Aban 1226 HIBISCUS ST ATLANTIC BEACH FL 32233-2664
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.
FEES
1 DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $105.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $109.00,
Issued Date: 1 of 1
•
Building Permit Application Updated 12/8/17
City of Atlantic Beach
' 2 800 Seminole Road,Atlantic.Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 •
Job Address: 1226 Hibiscus St Atlantic Beach, FL 32233 Permit Number:1C.�'"�(' O235
Legal Description 18-34 17-2S-29E SEC H Atlantic Beach FL 32233 - RE# \7\057 - 3°5U
Valuation of Work(Replacement Cost)$ (0 00() Heated/Cooled SF 133 Li Non-Heated/Cooled 133 L(
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes m 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:
REROOF
Florida Product Approval# F(. 10( RZC\ FLtS-2:tb for multiple products use product approval form
Property Owner Information
Name: Chimal Juan Gabriel Aban Address: 1226 Hibiscus St
City Atlantic Beach State FL Zip 32233 Phone 40c-/- g yj 5-LI b L(
E-Mail •
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: A Crown Roofing J Qualifying Agent: ( \ta•rrt 1)Y\\-\
Address 9791 Old St.Augustine Rd City JACKSONVILLE State FL Zip 32257
Office Phone 904-619'8790 Job Site/ContactNumbg• 9Q 23`7- ` ri-i.
State Certification/Registration • CCG Z•521 E-Mail V4�d '(\ �(,'�b 11.k\oO-F'•�y (p`Y\
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation ..4.;4 //Vee L6,4-cf/e5
Exempt/Insurer/Lease Employees/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 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 AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
(Signature of Owner or Agent) Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this I t day of Signed and s •. n to(or affirmed)before me this i f
day of
,( () ,by S rw1Z. , 2t2/ ',by a.),/4,7/3,2 G12OA i l"
• / (Signature of Notary)
� CHANTEL WILLIAMS
rs
( I Penally Known O• �MY COMMISSION f GGI70012 Personally Known OR ';fit"..s;,5, DON M.WATERS,JR.
dA. ,= MY COMMISSION M FF 905875
roduced Identificati:n'a i EXPIRES:December N.202) ( I Produced Identification : nay. a� EXPIRES:August 3,2019
Type of Identification: Type of Identification: ?? ;:�
Doc # 2018216402, OR BK 18525 Page 701, Number Pages: 1,
Recorded 09/12/2018 03:48 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
•
NOTICE OF COMMENCEMENT
Permit No
State of FLORIDA Tax Folio No. I 7 lo 5 7-QQ j Q
County of DUVAL
To Whom It May Concern:
The undersigned hereby infomis 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.
Legal Description of property being improved: 18-34 t7-2S-29E SEC H ATLANTIC BCH LOTS 5.6 BLK 230
Address of property being improved:1226 HIBISCgIS ST ATLANTIC BEAC11 FL 32233
General description of improvements: REROOF
Owner: CHIMAL JUAN GABRIEL ABAN Address: 1226 HIBISCUS ST ATLANTIC BEACH FL 32233-2664
Owner's interest in site of the improvement 100%
Fee Simple Titleholder(if other than owner):
Name:•
Contractor:A CROWN ROOFING
Address: 9791 OLD ST AUGUSTINE RD JACKSONVILLE FL 32257
. Telephone No.: 904-619-8790 Fax No:
Surety(if any)
Address: Amount of Bond S
Telephone 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,desi ted b owner upon whom notices or other documents may be
served: Name: A Cl r o n Qj t r1
Address' Rt!,t6
Telephone No: Fax No:
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(I)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY Signed �h _ p
Signed: 7.
Date: et - 5 1 0
Before Inc this day of s„tJt e o,..ein the County ofDuval,Stale
�ttil.
Of Florida.ties personally appeared _ri c� l
,rpic..,,
Notary Public at Large,State of Florida,County of Duval.
D,My commission expires: 1 - 'V -a 1
Personally Known: 1)
or
Produced Identification:
uCHcAtM1xtTwEsL lo11nIo-LuAnooMlS] n IV
LN\`/D
s- EXPIRES Deruber20,2021