935 SAILFISH DR REROOF SHING PERM REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0020
800 SEMINOLE ROAD ISSUED: 1/28/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/27/2019
MUST CALL INSPECTION • • 914PM FOR NEXT DAY • •
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, AND OF 'CH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, , .
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.
• : ADDRESS: n • • • • •
935 SAILFISH DR REROOF '-,HINGI-E SHINGLE ROOF $6000.00
BI
TYPE OF X j,• r • USE
• •
CONSTRUCTION: NUh�
i .
171255 0000 ROYAL PALMS UNIT 01
COMPANY: CITY:.`� 4 •
DS KILLIAN ROOFING 3898 DUPONT
CIR JACKSONVILLE FL 32254
C171; STATE: ZIP:
• liiis
ALBERTSON CHAD M 935 SAILFISH DR ATLANTIC BEACH FL 32233-4218
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.
7Rolloff container company must be on City approved list . Container cannot be placed on City right-of-way.
7 DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $85.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
TOTAL:$89.00
Issued Date: 1/28/2019 1 of 1
Building Permit Application Updated 1019118
�S
,) City of Atlantic Beach Building Department **ALL INFORMATION
/ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 935 SAILFISH DR AB FL 32233 Permit Number: 9 —o0ZO
30-60 17-2S-29EROYAL PALMS UNIT 1LOT 36 BLK 6 171255— 0
Legal Description RE#
Valuation of Work(Replacement Cost)$ 6, 000 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No
• Will trees be removed in association with proposed pro'ect? ❑Yes must submit separate Tree Removal Permit [:]No
DI� —
ribe in detail the type f work to be performed: RE—ROOF
o � - P,15
Florida Product Approval# FL-10124 . 1 for multiple products use product approval form
Property Owner Information
Name CHAD ALBERTSON Address 935 SAILFISH
• ATL BCH FL 32 912 661 1691
City State Zip Phone
E-Mail CHAD@ SAFEADDRESS.COM
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company DS KILLIAN ROOFING & GC Qualifying Agent DAVID S KILLIAN
Address 1031 MIMOSA COVE CT E City JACKSONVILLE State FL Zip 32233
Office Phone 904 246 7663 Job Site Contact Number
State Certification/Registration#CCC 1328203 E-Mail DAVE@DSKILLIAN.COM
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer ON FILE OR Exempt❑ 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,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 ATT RNEY BEFORE
RECORDI O N TO ICE OF COMMENCEMENT.
(Signatsre#4Xd�ef�6r��ent) (Signature of Contractor)
Signed and sworn to(ar�4ift�ni�y� "fDre��tMs 4LV�ay of Si ned and sworn to Jew,affirmed)before e this�C_.EFay of
(� n Cr �f Py SPERGER
0 A,
Y COMMISSION#FF 924951
EXPIRES: tober. ,2019
Personally Known OR :_Mq EVt CO f f(� Personally Known OR '% p'�;t;°"' scnd2 Tnn,r�oca PUNnde writers
[ ]Produced Identification siri/f, [ ] Produced Identification
Type of Identification: Type of Identification:
NOTICE OF COMMENCEMENT
State of FLORIDA Tax Folio No. 171255-0000
County of DUVAL
1111091 - 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: 30-60 17-2S-29E ROYAL PALMS UNIT 1 LOT 36 BILK 6
Address Of property being improved: 935 SAILFISH DRAtlantic Beach FL 32233
General description of improvements: RE-ROOF
Owner: ALBERTSON CHAD M Address: SAME
Owner's interest in site of the improvement: RESIDENCE
Fee Simple Titleholder(if other than owner):
Name: N/A
Contractor: DS KILLIAN ROOFING&GENERAL CONTRACTORS INC
_= Address: 1031 MIMOSA COVE CT E604
Telephone No.: (904)246-7663 Fax No:
Surety(if any) N/A
r Address: Amount of Bond$ _
Telephone 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. NIA
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:in at Owner's option)
Name: N/A
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
Doc#2019021699,OR BK 18672 Page 1032, Signed: �' )=,ate: T
Number Pages: 1 Before me this day o '�' o t of uval,Statgg
Recorded 01/28!2019 04:08 PM, Of Florida,has personally appealQ� lzOTsov�
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of
COUNTY My commission expires: 8
RECORDING $10.00 Personally Known: B _or
Produced Identification: %T^ io \
Am co if
y'!J9'r B�1