2317 FIDDLERS LN REROOF SHING PERM REROOF SHINGLE PERMIT PERMIT NUMBER
r ' CITY OF ATLANTIC BEACH RERF19-0019
800 SEMINOLE ROAD ISSUED: 1/28/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/27/2019
INSPECTIONMUST AkL • • 1 . , . PM FOR . INSPECTION.
ALL • ' ""' H EDITION1 OF • ' BUILDING
TIC BEACH CODE OF ORDINANCES .
ALL CO ITIO PLY, 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.
is + it ' e • OF i •
2317 FIDDLERS LN REROOF SHINGLE SHINGLE ROOF $18967.00
I AM TYPE •i. BUILDING*�- --
• : e •
CONSTRUCTION: G • "
169463 0122 OCEANWALK UNIT 01
• gee • CITY: STATE: ZIP:
PRIME ROOF 13725 BEACH BLOULEVARD, #13 JACKSONVILLE FL 32224
CONTRACTING LLC
i RESS: CITY: STATE: ZIP:
RAINES PFNNIS K 2317 FIDDLERS LN JACKSONVILLE FL 32233-4681
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.
s
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 $145.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.18
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $149.18
Issued Date: 1%28/2019 1 of 2
Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
Of"� Phone: (904) 247-5826 Fax: (904)247-5845
Job Address: 2317 Fiddlers Lane Permit Number:
Legal Description 42-1 37-2S-29E OCEANWALK UNIT 1 LOT 59 RE#
Valuation of Work(Replacement Cost)$18,967 Heated/Cooled SF 2288 Non-Heated/Cooled 846
• Class of Work(Circle one): New Addition Iteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Iesidentia
• 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: Replace roof with asphalt shingles.
Florida Product Approval#FL10674-R12 (shingles) FL9777-R11 ( I4r multiple products use product approval form
Property Owner Information
Name: Dennis and Sheila Raines Address: 2317 Fiddlers Lane, Atlantic Beach, FL 32233
City ATLANTIC BEACH State FL Zip 32233 Phone 904-246-7894
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Prime Roof Contracting, LLC Qualifying Agent: Mark Young
Address 13725 Beach Blvd Suite 13 City Jacksonville State FL Zip 32224
Office Phone (904) 530-1446 Job Site/Contact Number (904) 860-0230
State Certification/Registration# CCC1329505 E-Mail office@primeroofingfl.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation FRSA Self Insurers Fund Inc. 12/31/19 870-040093/3EE6142 _
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 R
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg E
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 YOUR NOTICE OF COMMENCEMENT.
(Signature of Owner or Agent including Contractor) Signature oftractor) ,
Signed and sworn to(or affirmed)before me this day of Signed and sworn Ac r affirmedd efore me this20-kday of
✓k`I �G, bye 1ZJM�, 2bL� , by iii yAUa
62
�. (��Qt Sig e�/�at�r��iripC (Signature of Notary) ,
" C u'C� (�r'J .� .' Andrew D. Davis
COMMISSION#G�241220
-34C
� COMMISSION*O 241220
[�rsonally Known OR''�ii �.��� EXPIRES: Sept 17, 2022 [personally Known OR �r�,
�ill Bonded Thru Aaron Notary [ ]produced Identification `;,?` EXPIRES: Sept. 17, 2022
[ ]Produced Identification
Type of Identification: Type of Identification: BO(KW Thru Aaron War,
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of Florida 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:42-1 37-2S-29E OCEANwALK UNIT 1 LOT 59
Address of property being improved:2317 Fiddlers Lane,Atlantic Beach,FL 32233
General description of improvements:Re-roof
Owner Dennis and Sheila Raines
Address 2317 Fiddlers Lane,Atlantic Beach,FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Prime Roof Contracting,LLC
Address 13725 Beach Blvd Suite 13,Jacksonville,FL 32224
Phone No.(904)625-1446 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,designated by owner upon whom notices or other
documents may be served:
Name
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
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
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OI
Si DATE
9 l�
Befors me this day of n the
Cou f e-Duval,St of Florida,has personal) appeared
mi C Ne f herein by e
Doc#2019021504,OR BK 18672 Page 492, Nims t/herself and affirms tTiat all statements anddec }y� herein
9 are true and accurate V WIX!' drew De avis
Number Pages:1 • M
Recorded 01/28/2019 02:33 PM, ' COMMISSION (, 241220
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL °K EXPIRES: Sept 17,2022
COUNTY .�
RECORDING $10.00 try ublicat Large.St to i . Co ThnJ Aimn NoWy
My commission expires:
Personally Known or
Produced Identification