1550 MAIN ST - ROOF C !?4, REROOF SHINGLE PERMIT PERMIT NUMBER
- ', RERF19-0002
- CITY OF ATLANTIC BEACH ISSUED: 1/3/2019
800 SEMINOLE ROAD
;11.9; EXPIRES: 7/2/2019
ATLANTIC BEACH, FL 32233
i 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 .
1 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:
1550 MAIN ST REROOF SHINGLE SHINGLE ROOF $9500.00
TYPE OF REAL ESTATE i ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172380 0000 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
MONAHAN ROOFING 2050 S KING CIR NEPTUNE BEACH FL 32266
OWNER: ADDRESS: CITY: STATE: ZIP:
BIDLACK GORDON W 1550 MAIN ST ATLANTIC BEACH FL 32233-1939
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
BUILDING PERMIT 455-0000-322-1000 0 $100.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$104.00
Issued Date: 1/3/2019 1 of 1
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH A.<k\
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 LA
Job Address: %SSU /7')a.�t �J-L Permjt_Nuy�7RG RFl -000Z
Legal Description (-25- 29 4- . ,D 1 J f ,7 S / 114'e4 t,'Parcel#
oor • ea o q. t. q. t
Valuation of Work$ 9,S-00. Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
installed?an existing structure,is a fire sprinkler system (Circle one): Yes No N/A
Florida Product Approval# Fi-
For multiple products use product approval form
Describe in detail the type of work to be performed: C oir p let R c c. F Sk I,1-31.Q. , u a 1 f G PcP i M M b hn
Property Owner Information: ,
`� 1� Address: / S S o Ai OA t /I s/ �
Name:Got1 �J d /
City If'F L i3/A State}rtZip $23) Phone 9 oy A91 /??/
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: ()'10 nee.hk r, RDU r►r.S Cor t rc..c cc,/ Qualifying Agent: p i (I
Address: 7csS0 ki,.S J CI«t 4 City flee 1u, State Ft-, Zip 3 2acc
Office Phone ..S'G.d —Y9Zo Job Site/Contact Number T/1-7 • Fax#
State Certification/Registration# 4c.Go Liz 3-1`i
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical {York,Plumbing,Signs, Wells,Pools, Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc
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 BE OMERTCORDING YOUR NOTICE OF
COMI herebycertify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type owork will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
((�� 1 \
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Signature of Owner,�NiJ�/l , �e Signature of Contractor 47,,,,,'".---
!�� Print Name ..-770 k- L filo,�4 A Q-'
Print Name Gof�.c�.h .1.j.f....�....l�i.G
Before me Before rhe
this c Day o )Jt'.L` 20 / this ay of "46.61--
,
' �l , 20 IR
Aw.fp.;;, KATHERINE PERRY ——
` �omrmssion#rh 191152 ��'
• Nota PubI-: �,
Notary Public *. n- r:< Expires February 6,2019 : ; ; MY COMMISSION t 941898
.4,pr t o,. BoMed Trw Troy Fain Inewarte KO.3857019 1."... 't1-' EXPIRES:JanI t S�,2A2� 7 � 4.12
- 'rt '''' Banded TAN Notary Ftut t�1G11teA
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
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.
Legal description of property being improved: 1r- 7.5-- 9c ,
P� ).oy- 1 Pee V/ 13-51 k7 - 2 4" 7,
Address of property being improved: •1 SSo M0.•' f
General description of improvements: Ce m e _ -& r0 - w. t h 6-P F -TJ;r,
Owner 6-040„ e‘'d
Address /SSo
Owner's interest in site of the improvement /aG'2---
Fee Simple Titleholder(if other than owner)
Name
L Address
Ir Contractor J
Address 2-03'o rte.. s G r-c,l L- SQA N •eR}ti..-4- AFL 3 2 Z G L
Phone No. . S�l�-' 12 Fax No.
Surety(if any)
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 �f /
Phone No. !V 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 fL//
Phone 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 Statutes. (Fill in at Owner's option).
Name
Address i 1
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OwR r
Signed:�Yjer1. �6� � 'u DATE �i 19&C
Me !�
Before e this day ot ,zc /CC in the
Co ty of D val,State of rid l as perso a appeed
Doc#2019000246,OR BK 18644 Page 1983, �(Z^ Q� I herein by
Number Pages:1 himself/herse f and affirms tha all state -
Recorded 01/02/2019 10:12 AM, are true and accurate Y' CINDY J.MCINTIRE
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL 41',,'"*.-;, Commission#FF 192145
COUNTY ti• 's Expires February,14,4319
RECORDING $10.00 '0aF� dtm.TcoyRon i .r:,eoo-xs4G:9
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Notary Public at Large,Sta '--I.fmy of 1.(�
My commission expires: 7 -�
Personally Known or
Produced Identification
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