342 SKATE RD REROOF SHING PERM REROOF SHINGLE PERMIT PERMIT NUMBER
RERF19-0016
CITY OF ATLANTIC BEACH ISSUED: 1/25/2019
800 SEMINOLE ROAD
�W09 ATLANTIC BEACH. FL 32233 EXPIRES: 7/24/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT • 1 OF • '
CODE, OF • 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:
342 SKATE RD REROOF SHINGLE shingle re-roof- FL10124- $8900.00
R15 & FL18686-R1
TYPE OF
• • GROUP:
ROYAL PALMS UNIT
1716610000
02A3.00
COMPANY: ADDRESS:
RELIANT ROOFING INC 4230 Pablo Professional Court Jacksonville FL 32224
• ADDRESS:
LANG MIRANDA ET AL 14030 ATLANTIC BLVD APT 3312 JACKSONVILLE FL 32223
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.
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 455-0000-322-1000 0 $95.00
STATE DBPR SURCHARGE 4S5-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $99.00
Issued Date: 1/25/2019 1 of 2
t
i=l l City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone: (904)247-5826 Fax:(904)247-5845 s�
Job Address: ��K�� __._• _Permit Number: Oy �p
Lea[ZDes rippttion - 5- �AZ K& D-f CLQ ItE#_
Valuation of Work(Replacement Cost)S_ fQDO.00 Heated/Cooled SF JL_Lq_7_Non-Heated/Cooled i LH
• Class of Work(Circle one): New AdditionAlteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No ', v
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal .
Describe 0 detail the type of work to be performed:
rey-mt R0 3/IZ pack , Sh,nylel FLIDI z1-l- P-1 J5 F �
Florida Product Approval# 1 _ for multiple products use product approval form
Property Owner Information ����""
Name: 1..e,�n Address: .— �4llJ� A _
�/IL ---.. - -------- '2' T I
City `-":�i —� - ------- State.�j�_.Zip_�.]t�2 �—Phone.._ 15—'l 7(of (o —
E-Mail
Owner or Ag nt(I Agent,Power o Attorney or Agency Letter Required)_— —
Contractor Information (n�
Name of Company: Iry r1A _Qualifying Agent: JS�M:Cg= _
Address,4l.,2n n1n�47 CityX State Zip
Office Phone I �=���=Q � _-Job Site/Contact Number){ 'SM
State Certification/Registration 11 E-Mail�Anri(l�aA relia ML-A. Q rim
Architect Name&Phone 11
Engineer's Name&Phone# _ ___-_
Workers Compensation?_� i 'T �{�00 g!12- 08 /PXOit'Q{ioyl I a-a 201of _
Exempt/Insurer/Lease Employees/txplration 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.
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.
Ew
ouaipned by: / —raln�a //
#Ua4WAMmr or Agent including Contractor) (Signature of Contractor)
Signed and sworn to(or affirmed)``before
--me this,9__5 day of Signed and sworn to(or affirmed)before me this dpay of
by._ 1.t(tt_ _l�Ql ----- J�_..-.. a01� by Qwl(Y1PJ b�_ uTT—
1
(Signature of otary) - (Signature of otary))
AMANDA JACKSON
W-V
AMANDA JACKSONState of Florida-Notary Public(personally Known Commission#GG 205328 Personal) KnownOR � State of Florida-Notary PublicProduced Identitic ' jMy Commission Expires Y y Commission#GG 205328« ( )Produced Identification ,, `o.,� My Commission Expires
Type of Identificatlon �"""' April Ora,2022 T o,,w•
— ype of Identification: _• ?�in�"� ri109 2022
Doc # 2019019368, OR BK 18669 Page 1425, Number Pages: 1 ,
Recorded 01/24/2019 12:51 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.--
State of--:a — County of T-AAVQI
To whom it may concern:
The undersigned hereby informs you that Improvements will be made to certain real properly,and in
accordance with Section 713 of the Florida Statutes,the following information Is stated In this NOTICE OF
COMMENCEMENT. �1
Legal description of pope ty being improved: l l l l0 3 g_ S-- -RF 2 �P
C �(' a� Va1YY1C,- A6� 2 ALo+ 11 41 k 2�
Address of property being improved: 34a n KQ+P
FL
General description of improvements
Owner-Ms{-and ------------------
Address 3q?- S knA& dY+
Owner's interest in site of the improvement—OLA)nt4r --- _
Fee Simple Titleholder(if other than owner)-------------_-___---
Name
Address — —_
Contractor 9,0A j11I
Address A2Val. CA . t 55 L 37 -L?
Phone No. ���6r?7— OW 0 Fax No.
Surety(if any) _
Address Amount of bond$
Phone No. Fax No.
Nance 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
different date is specified)' —
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed:_ rAliYnu.��(naj DATE 1/iz/2olo
Before me tits 6ay3t'°':",._..'_� J� _..._.... _In the
C2 of Duva"l�Stat of Florida.has personalty appeared
[1A 044 herein lo
NrnselU he,selt and s tbwuwaml all statements
AMANDA JACKSON
are true and accurate .1'ay ptsG
2° s=_State of Florida-Notary Public
_ Commission#GG 205328
A
`? ,.".` MY Commission Expires
o
Aor.109,2022
Notary Wic at Large.Slate of
Aly c mission ezpirL ,�/.'
Pe ally Known�--------------_.or
Pro used Idenhfrcal