368 8TH ST RERF19-0014 ROOFING PERMIT rr'r''`irls REROOF SHINGLE PERMIT PERMIT NUMBER
r RERF19-0014
V� CITY OF ATLANTIC BEACH ISSUED: 1/23/2019
800 SEMINOLE ROAD
" °j:>>�. ATLANTIC BEACH. FL 32233 EXPIRES: 7/22/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' + BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL i • OF PERMIT APPLY, PLEASE READCAREFULLY.
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: PERMITTYPE: DESCRIPTION: VALUE OF WORK-
368 8TH ST REROOF SHINGLE SHINGLE ROOF $10700.00
TYPE OF
• • GROUP:
169940 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
D &S ROOFING OF N. FL, PO BOX 1986 ORANGE PARK FL 32067
INC.
• ADDRESS: STATE:
CALLIHAN STEPHEN R 368 STH ST ATLANTIC BEACH FL 32233-5436
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 45S-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: $109.00
Issued Date: 1/23/2019 1 of 2
Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 /`�
Job Address: ro V �'` Permit Number: R & RFI `Q, -`� 0
Legal Description Lq-, 3 `>L- `&,9 PT1-ANT �i C NC kA RE# 1 G9'A413 - &-�-'_'O
Valuation of Work(Replacement Cost)$ t O __X_31D Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration epair ove 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 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: -t-s'(Z!2�O F SHO'-( Llf<l70 '30 S�k4AQS
Florida Product Approval#G AP S N+I" O12`�.((o':T�IL� Q*S for multiple products useproduct approval form
tt•�f►61t1rd�ME�"t
Property Owner Information WL 104SCo
ST t= _ro CA L-L-t 368 g'_1`` S i
Name: A��- �^IAn� Address:
Cit \,L 3u�-Ctt State (7- Zip 322-33 Phone 014-24\' (XA
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) 57 661%-ktN-, C A U-i ieA,,J
Contractor Information /� ,
NameofCompany: 3�-S�c"V\P' aF `vrRil-k Cjj�-\OAQualifyingAgent: S -Ofr
Address 11-IS L-FICKCj 2 k',= +-N, City State F C_ Zip 3 2-Ur13
Office Phone D'A -2'I(o 03 4 Job Site/Contact Number G04 -2\ l'-u2_65
State Certification/Registration# CCC ?--`aU Sy E-Mail D5 Rc.DOPVQe442) 3i?c.LSC)t4 i A
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation CX Cf—fl T
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
RECORDINP YOUR NOTICE/DOFF COMMENCEMENT.
(Signature of Owner or Agent) (Signat a of Contractor
(including contractor)
Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or a fir d befo e s� d y of
y �o I u-b
MY COMMIISSION N FF1
EXPUAtU Apri121 2019 (Signature o Notary) (Signa t ry)
NOf1�M Otp r�wi„u v�w.cam
[ ]P sonally Known OR Personally Known OR 70NIGINpLESPERG
•ti'�r•Pyr•'%
Produced Identification I ]Produced Identification :_ = MY COMMISSION#FF 924951
Type of Identification: Type of Identification: -*` ;a EXPIRES:October 6,2019
%F OF Bone N
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. \ 199 LtC� - C 0CAD
State of V L C�P_0.4 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:
Address of property being improved:
General description of improvements:
L->= N
Owner S`
Address (_,b 43�� S^.� Zt�NT�C ' Lk Actk
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address^
Contractor `)':VSdt
Address ILLS t-4(C K-C 11 Ly co.� L J, GMS c'_ QM4 11;�L. `32cn_3
Phone No. 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
Phone No. Fax No.
Name of person within the State of Florida,other than himself or herself,designated by owner upon whom
notices or other documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself or herself,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
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a w~
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY WNER
Signe - ( L ✓1 DATE f .� t Yxn> .�
Before m this day of i
County,of Duval,State of Fbric�a,has personally appeared ; O
i e k-A c- ' �P1Lt...1 tlA.J herein by
himself/hersdf and affirms that all statements and declarations herein > N
Doc#2019017056,OR BK 18666 Page 1521, are true and accurate
Number Pages: 1
Recorded 01/23/2019 08:52 AM, N
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL o
m
COUNTY
TDING $10.00 ` Notary Public at Large.Sta of R A. of ctUJ RECORe
My commission expires: ►�
Personally Known or
Produced Identification