36 DUDLEY ST RERF19-0007 ROOF PERMIT REROOF SHINGLE PERMIT PERMIT NUMBER
RERF19-0007
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 1/17/2019
ATLANTIC BEACH. FIL 32233 EXPIRES: 7/16/2019
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 ma 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:
36 DUDLEY ST RERCICIF SHINGLE shingle re-roof- FL-10124.1 $8900.00
& FL-186-Rl
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: -- t_NUMBER: GROUP:
1722050000 DONNERS R/P
COMPANY: ADDRESS: CITY: STATE: ZIP:
PATRIOTROOFING 1695 Hereford RD MIDDLEBURG FL 32068
SERVICES, INC.
OWNER: ADDRESS: CITY: STATE: ZIP:
MKS Homes, Inc. 36 Dudley Street Atlantic Beach FL 32233
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 45S-0000-322-1000 0 $9S.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4S5-0000-208-0600 0 $2.00
TOTAL: $99.00
Issued Date: 1/17/2019 1 of 2
Building Permit Application
r.k City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FIL 32233
Ew,ww' Phone:(904)247-5826 Fax:(904)247-5845
Job Address: 36 Dudley Street Permit Number: bO Cq
Legal Description 19-16 17-2S-29E Donners R/P Pt Lot N 1/2 Lots 6.7 131k 2 RE# 172205-0000
Valuation of Work(Replacement Cost)$ &900.00 —Heated/CooledSF 119'6 Non-Heated/Cooled 275
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/pro posed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 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:
Re-roof i9i
Florida Product Approval# FeltbusterFL-186-Rl Shingles FL-10124.1 for multiple products use product approval form
Property Owner Information
Name: MKS Homes, Inc. Address: 36 Dudley Street
City Atlantic Beach State FL zip 32233 Phone 904-303-4448
E-Mail jeffrabacchi@gmail.com
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Patriot Roofing Services, Inc. Qualifying Agent: Joshua Pennington
Address 1695 Hereford Road city Middleburg State FL zilo 32068
Office Phone- 904-413-7725 Job Site/Contact Number 904-982-4052
State Certification/Registration# CGC1330098 E-Mail
Architect Name&Phone# N/A
Engineer's Name&Phone# N/A
Workers Compensation
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.
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
RECORDIN Y 4RPOTICE OF COMMENCEMENT.
(��re of Owner or Agent including Contractor) (Ognature of Contractor)
rVo day of 1 57, day of
Signed sworn to(or affirmed)before me this_ Signed and sworn to(or affirmed before me this_A_
C b
b Y,
W)J KINS
&ISN S FF939072'
(Signature of Notary) "'.'LdSignat
bIA"W)J KINS
'Sei Pill, CARRIE JAMES ZIS N S FF939072
/c, EXPIRES November 24,2019
Commission*GG 175819 '97,
140 f i 3M4'53 r com
Personally Known OR Expires AP4 22,2022 -T��ersonally Known OR 1
N4w
I Produced Identification coff'.0 ron"'ttAk490 WAM Produced Identification
Type of Identification: Type of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. TaXFolioNo. 172205-0000
State of Florida -
County of ival
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 StaurtOS,the following Information Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improvedi 19-16 17-2S-29E Donners R/P Pt Lot 3 N 112 Lots 6,7 Blk 2
Address of property being improved: 36 Dudley Street
Atlantic Beach, Fl, 32233
General description of improvements: Re-roof
Owner MKS Hornes, Inc.
Address 36 Dudley Street, Atlantic Beach, Fl 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name N/A
Address
Contractor Patriot Roofing Services, Inc.
Address 1695 Hereford Road, Middleburg, FIL 32068
Phone No. .904-413-7725 Fax No. 1-844-272-1819
Surety(d any) N/A
Address mount of bond
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name N/A
Address
Phone No. 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 N/A
Address
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 NIA
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date Is OW(I)y*Wfrom the date of recording unless a
different date is specified),
—THIS SPACE�6R RECOkDER'S USE ONCY EIR
Sig DATE
111=� 11---. -.11 1 in me
Court�of of Florida.has pers6n�tiy appeared
-------herein by
that sh statenwnts and—de—daraborts herein
Doc#201900TT70,OR BK 18654 Page 2395, are tTue and nearallim CARRIEJAMES
Number Pages 1 A01 PVOI
Recorded 01/10/2019 11 14 AM, commission#GG 175819
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Ex&es A01 22,2022
COUNTY
RECORDING $1000 Notary Public at Large.bum Of N Cc
My comn4nion oxplm, �4-7T �*
Porsonaily Knoym or
Produced Idenitticatlon
Doc # 2019008524 , OR BK 18655 Page 2182, Number Pages : 2,
Recorded 01/11/2019 09: 16 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $18.50 DEED DOC ST $700. 00
Prepared by and return to:
Michelle Fusillo
Attorney at Law
Fusillo Law,PLLC
9957 Moorings Drive Suite 201
Jacksonville,FL 32257
904-559-1800
File Number: 1177-18
PaTcol Identification No, 172295-0000
[Space Above Ilds Line For Recording Datal
Warranty Deed
(STNI'MYORY FORM-SEMON 689.02,F.S.)
This Indenture made this I I day of November, 2018 between Charettia Edwards, a single woman whose post
office address is 306 Jerome Ct., Dothan,AL 36301 of the County of Houston, State of Alabama, grantor*, and MKS
Homes Inc,a Florida corporation whose post office address is 14092 Summer Breeze Dr.,Jacksonville,FL 32218 of the
County of Duval,State of Florida,grantee*,
Witnesseth that said grantor, for and in consideration of the sum of TEN AND NO1100 DOLLARS($10,00)and other
good and valuable considerations to said grantor in hand paid by said grantee,the receipt whereof is hereby acknowledged,
has granted, bargained,and sold to the said grantee,and grantees heirs and assigns fbrever,the following described land,
situate,lying and being in Duval County,Florida,to-wit:
The North 112 of Lots 6 and 7 Block 2 Donner's Replat,according to the plat thereof as recorded in
Plat Book 19 Page 16,of the Public Records of Duval County,Florida.
Subject to taxes for 2018 and subsequent years; covenants, conditions, restrictions, casements,
reservations and linWations of record,if any.
Grantor warrants that at the time of this conveyance, the subject property is not the Grantor's
homestead within the meaning set forth in the constitution of the state of Florida,nor is it contiguous
to or a part of homestead property. Grantor's residence and homestead address Is: 306 Jerome CL,
Dothan,AL 363DI.
and said grantor does hereby fully warrant the title to said land, and will defend the same against lawfid claims of all
persons whomsoever.
"Grantor"and"Grantee"are used tbr singular orplural,as context requircs.
DoubleTlrneO