440 GARDEN LN REROOF SHING PERM REROOF SHINGLE PERMIT PERMIT NUMBER
r CITY OF ATLANTIC BEACH RERF19-0021
�~ 800 SEMINOLE ROAD ISSUED: 1/30/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/29/2019
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 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:
440 GARDEN LN REROOF SHINGLE SHINGLE ROOF $9720.00
TYPE OF
ZONING: : • •
• • GROUP:
172020 5214 SELVA MARINA GARDEN
02
COMPANY: ADDRESS:
TOWNSEND ROOFING & 4832 CHARLES BENNETT DRIVE JACKSONVILLE FL 32225
CONSTRUCTIONS SERVICE
• ADDRESS:
HASSI EDWARD D 81-83 GRANT ST#7 JERSEY CITY NJ 07302
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 4S5-0000-208-0600 0 $2.00
TOTAL: $104.00
Issued Date: 1/30/2019 1 of 2
Building Permit Application Updated 5/5/17
� sa
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
o; Phone: (904)247-5826 Fax: (904) 247-5845
Job Address: y q b G<<'du. La hoc Permit Number:
Legal Description IN--M 0-ZS"ZRf o15111Va �&o L-4 7 RE# 1-72020- -52-N
Valuation of Work(Replacement Cost)$ I ��Z�V V Heated/Cooled SF _ Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one):; Commercial Residenti�
• If an existing structure,is a fire sprinkler system installed?(Circle one : es 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: �e`pp�a�„s,� c
Gl7 ) I 1;tx F1 D F � l'�l 7i r{ 1�n�5�t.rt (�jnw✓7� �L�� $>fr�-� r ` I Z-3Zg ti Ll1 �E
Florida Product Approval# I 017-H for multiple products use product approval form
Property Owner Information
Name: Nis s 1� �Q1�. 0-i-ell( _Address: (2ZJ5-
—Pbr �— _
city `_ Y\A'I-'- k" StateZip -2 to L Phone
E-Mail �� �Snss, a 9 mit,I. c�
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) C-,)W In Q,f
Contractor Information // T
Name of Com anY�. WA ekd `09�%a ` Qualifying
ualifymg� •� )
Agent: Iia
Address_ IC1_I3 New 1����n _FLS CJS__ cit 'T"V, State FL zip -3Z7,-3Z7,74Z24
Office Phone_ 101- bH5-5967 Job Site/Contact Number q011- 47Z- ti
State Certification/Registration# Cu.I Z E y E-Mail C-',%--;$ @ ivwti.seh rnn{�h9, G•�✓i
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation r Tnc IZ h3I 1.1
Exempt/Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated.1 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
RECORDING Y �N TICE OF COMMENCEMENT.
(Signature of Twner or Agent) (Signature of Cont c
(including contractor)
Signed and sworn to(or affirmed_) before me thisZ-'2-> day of Signed and sworn to(or"ne )before s ay fif
/ Z-'l ,by AWar •���l nuR 001`) ocM n0i
n •
ec: o
(Signature of Notary) ignature of Notary)
e.
y,pC �, DARLENE R.DIFFEEMARTINAAELLANO
•: + rI NDTARYPIU13LICDISTRICT OFCOLUMBIA r:. NotoyPuWk-StatedFlaid�
ll n 1v r nmm gglnn Expires April 30,201 Commission t GG 102031
oPeis�rTallyKaown OR Personally Known OR y MyCamm.EsAircsMay 10,2021
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Doc # 2019022643, OR BK 18673 Page 1519, Number Pages: 1,
Recorded 01/29/2019 01 :57 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
(PREPARE IN OUPUCATE)
Permit No. Tax Folio No. 172020-5214
State Of Florida County of
To whom It may concem:
The undersigned hereby informs you that improvements will be made to certain real property,and is -
accordance with Section 713 of the Florida Statutes,the following information Is stated in this NOTICE OF
COMMENCEiRENT.
Legal description of property beteg improved:38-39 09-2S-29E SELVA MARINA GARDEN TWO LOT 7
Address of property being improved: 440 GARDEN LN.Atlantic Beach,FL 32233
General description of improvements:Roof Replacement
Owner HASSI,EDWARD D
Address=,-r,15 �� ' 2
Owner's interest in site of the improvement h �.
Fee Simple Titleholder IN other than&*Ter),
Name
Address
Contractor Townsend Rcofmg and Construction Services.Inc.
Address 10418 New Berlin Rd#I 15 Jacksonville,FL 32226
Phone No.M4-6456687 Fax No.904.645-5442
Surety(If any)
Address Amount of bond S
Phone No. Fax No.
Name and address fn y 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 Cornmencement(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 Ot%WER
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hcnselt'I:etsuit and affirms that all datemeras aMdectatabcnihheroin
are true W accuraft --C��•4)
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—DARL•ENE•R DiFFEE
NOTARY PUBLIC DISTRICT OF COLIA 41li k
My Commission Expires Apol 30,201!)