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375 1ST ST RERF19-0006 REROOF PERMIT PERMIT NUMBER REROOF SHINGLE PERMIT CITY OF ATLANTIC BEACH RERF19-0006 8 ISSUED: 1/15/2019 00 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 7/14/2019 MUST CALL INSPECTION • • • 1 / 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' BUILDING CODE, • OF BEACH CODEOF 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: 375 1ST ST REROOF SHINGLE shingle re-roof FL10124-R20 $8000.00 TYPE OF i • • ' 169772 0000 ATLANTIC BEACH ADDRESS: A CROWN ROOFING INC 9791 Old St Augustine Rd JACKSONVILLE FL 32257 • ADDRESS: KERBER FREDERICK A 375 1ST ST ATLANTIC BEACH FL 32233-5227 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. :.3 DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $95.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $99.00 Issued Date: 1/15/2019 1 of 1 Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Fax: (904) 247-5845 Email: Building-Dept@coab.us IS REQUIRED. Job Address: 3 7S /S 7t�e� � •t y�-;c, k3tc Permit Number: K-F( C1 — Qr��n Legal Description �5 {�C ti� - �� 12 Z Q� _RE# (69 77Z.-• OQQQ (k 500 ly63 Valuation of Work(Replacement Cost)$—r S4,6m Heated/Cooled SF I,2�-Non-Heated/Cooled L12-9 • Class of Work: i7New ❑Addition ❑Repair ❑Move []Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): C Tommercial ®Residential • If an existing structure, is a fire sprinkler system installed?: I les R%No • Will trees be removed in association with Proposed ro•ect?f les must submit separate Tree Removal Permit ®No Describe in detail the type of work to be performed: R� ` 900� Florida Product Approval# -1 11) Z for multiple products useproduct approval form Property Owner Information Name ^✓ ,n .� Address ' City 7- Gls9 y'r G &e_,QCL, State AEL Zip 3 2,`4_3 'r, Phone D — `j 5- E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) n/a Contractor Information 1 Name of Company Qualifying Agent w l�i0.y11 (�d4,n Address 9( S �' City n4 StateF L Zip Office Phone 4 - d Job Site Contact Number 90q-Z3 7^7z(ZL( State Certification/Registrati CCL13z9S L( E-Mail G ►� Rood ► am Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer K -K �,(UYYI_ . YY1p�e� L �>, OR Exempt❑ Expiration Date Application is hereby made to obtain a permit to do the work an I y p tl 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 PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN-A-TTORNEY BEFORE RECORDING YOUR NOTICE OO MENCEMENT� (Signature of O�er or Agent) (Signature of Contractor) Signed and sworn to(or affirmed) before me this day of Sign d sworn to(or affirmed)before me this day of Js✓u�ti y Z©/'j by — Pi kea-6elrt by /9 .tern (Signature of Notary) (Signature of Notary) .....a...:r.��,._ �y ....� N DON M.WATERS,JA. "a �v�; DON M.WATERS,JR. ... [ ]Personal) Known OR MY COMMISSION A FF 905875 [N,/` ;.; MY COMMISSION N FF 905875 Y ' 1 Personally Known OR a� EXPIRES:August 3,2019 :�'•. a� EXPIRES:August 3,2019 [ ]Produced Identificatioff��r "• p;� BandedThruNotaryPubhcUnderwriters ]Produced Identification 'fig ' BondadThru Notary PowcUnderwmers Type of Identification: �J ype of Identification: Doc M 2019003728, OR BK 18649 Page 1694, Number Pages: 1, Recorded 01/07/2019 11:53 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 NOTICE OF COMMENCEMENT (PREPARE IN DUPUCAM) Permit No. State of _ Tex Folio No. County of ��� ---- To whom it may concem: The nforms you that accordance with goeuoonn 71-31of the Florida Statu ss,the following information�sn�in thand in is OF COMMENCEMENT,egedesccr4moproperty beilgImproved, Z5 '7q r AtI LOA- v - 27�� t Address of property being imxovad:LLs I S Y S�, }41)rxtn , n �'t/ Generalydescription of impirmwents. Re-Rr'v1 Address�r`Q, — Owners Interest In site of the improvement Fee Simple Titleholder(if other than owner) Name Address Contractor q4t Address (A Phone No. Fax No. Z Surety 0f any) Address Amount of bond S Phone 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 then himseif,designated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax No. In addition to himsoff,owrrar designates the Section 713.06(2)(b),Florida Statutes,(Pili following person to reosive a copy Of the liendr'9 Nonce as provided in In at Owners optlon). Nerve Address 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): TNIS SPACE FOR RECORDER'S Use ONLY _ N exon n,r dyx 1—i�f�L. Cpunty oi0uvel, to a IgorMe, p pe G"IY oppaemd Fn,A�fYY IC Yhaf h. himWp Mt*f and affirms that au EMterttlMt foci def90fUlhne min by Broin IM trill eMt antra � n ttN1DOCX •�•� r AA'Cd>e119910N 1 tiO iti/ge r LUPAiES:Atgug1�,20t0 �gFOP� am.M7tivuddptRudryerMow r' tl .et.te or canHa IMY), an exgree: PMdUQ@d Nb lama son or