405 Skate Rd RERF19-0015 ROOFING PERMIT REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0015
' 800 SEMINOLE ROAD ISSUED: 1/22/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/21/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • '
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:
405 SKATE RD REROOF SHINGLE SHINGLE ROOF $8000.00
TYPE OF
ZONING: :D •
• • GROUP:
171530 0000 ROYAL PALMS UNIT
02A3.00
-COMPANY: ADDRESS:
BUILDING UNLIMITED 12620-3 BEACH BLVD # 181 Jacksonville FL 32246
ROOFING & SOLAR
• ADDRESS:
PHILLIPS ALFRED C 405 SKATE RD ATLANTIC BEACH FL 32233-3821
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 . •
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
br, 2
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 4SS-0000-322-1000 0 $95.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4S5-0000-208-0600 0 $2.00
TOTAL: $99.00
Issued Date: 1/22/2019 1 of 2
Building Permit Application Updated 10/9/18
r 4p ' City of Atlantic Beach Building Department "ALL INFORMATION'
N I a
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us t5 REQUIRED.
Job Address:
li_ t, } i.`, Permit Number: 4 `u `I`��' C)C)(�
Legal Description i ], "k - L L`Ii k}� �)e. 1 '�i Ni. , , },�[ /a f 'G' _RE# 1-71 !SSO •-0000
Valuation of Work(Replacement Cost)$ _,•,,�._ Heat Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial [31e�-idential
• If an existing structure,is a fire sprinkler system installed?: Dyes all
• Will trees be removed in association with proposed ro'ect? ❑Yes must submit separate Tree Removal Permit [moo
Describe in detail the type of work to be performed: -_
� 1(,Q., i..
Florida Product Approval# Lt [ 2 IZ Z 0 ' for multiple products use pr duc approval form
Property Owner Informations S ' FL)5 •R5 GAS Sy--�e- 7 G) - X46 aylydA
NameAddress
City 1\1-,,-, ,f, I� ' 4 StateH. Zip .,2-:L -3 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information Ke
-
Address
of Company _a.__: �._ Qualifying Agent 1'1
Address _City___ State Zip
Office Phone 'lob Site Contac.
State Certification/Registration# t i l: E-Mail T 14
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer____ __ OR Exempt 0 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 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,oi•
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. YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTOR BEFOR
RECORDING YOUR NOTICE OF COMMENCEMENT.
�Signature of Owner or Agent) ! (Signature of Contractor)
Signed and sworn to(or affirmed)before me this�tn day of Signed and sworn to(or affirmed)before me this 2z day of
tAAr (. b A 'R" �an ZO iq,by Yi a NI4} 11 ---
. ::j i a ure R" LISH
MY COMMISSION#FF 927559 ►�••. JACOD BRADLEY
EXPIRES:February 14,2020 �P• `: Notary Public SUrte of Florida
Bonded Thru Notary Public Underw iters ` Commission t GG 230778
[ ]P sonally Known OR A D" k]Personally Known OR '?toy�d"�'' My Comm.Expires Jun 20,2022
[ roduced Identification o ,,� [ ]Produced Identification `. .Bonded through National Notary Assr.
Type of Identification: VAM �1�S kL& rx-' Type of Identification: ___
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No. 1-71530 — 000
County of Duval
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: 31-16 38-2S-29E, ROYAL PALMS UNIT 2A R/P, LOT 11 BILK 18 _
Address of property being improved: 405 Skate Road,Atlantic Beach,FL 32233
General description of improvements: Roof replacement
Owner: Amy Franqui Address: 405 Skate Road,Atlantic Beach,FL 32233
Owner's interest in site of the improvement: _
Fee Simple Titleholder(if other than owner): _
Name: �1 j
Contractor: CinV�vtl Q /a
&
Address: I Z�v Z o,'h t3r� d Sok �n kF�L 322116
Telephone No.: SU Z 35 8 3 0-7 Fax No:
Surety(if any) N k
Address: Amount of Bond$
Telephone No: Fax No: Doc#2019016242,OR BK 18665 Page 1621,
Number Pages:1
Name and address of any persojaking a loan for the construction of the imp Recorded 01/22/2019 01:00 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
Name: COUNTY
Address: RECORDING $10.00
Phone No: Fax No:
Name of person within the Stat ry�of Florida,other than himself,designated by owner upon whom notices or other documents may
be served: Name: t + !�
Address:
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 i at Owner's option)
Name: N �
Address:
Telephone 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 OWNER
Signed: r,t 1 ayj qN,c Date:
. CHRISTINAM.MEDRANO Before me this i�t v day of D C rv+ _ in the County of Duval,State
i?" Of Florida,has personally appeared k,
MY COMMISSION;k GG 208590 Notary Public at Large,State of Florida,County of Duval.
Z. EXPIRES:July 22,2022
FOFF°• BoWWTh.NotaryNblicU ers My commission expires: 0
Personally Known: I or
Produced Ide tificat on:
i