602 Main St. ROOF19-0022 Shingle (1, %\ ROOF NON SHINGLE PERMIT PERMIT NUMBER
� " ROOF19-0022
4y J
r-tr.. CITY OF ATLANTIC BEACH
'r x ISSUED: 2/21/2019
800 SEMINOLE ROAD
"'t o'' 'rATLANTIC BEACH. FL 32233 EXPIRES: 8/20/2019 I
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA 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:
602 MAIN ST ROOF NON SHINGLE SHINGLE ROOF $7638.00
TYPE OF I REAL ESTATE I ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170916 0000 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: I STATE: ZIP:
PREFERRED ROOFING LLC 2332 DUNN AVENUE JACKSONVILLE FL 32218
OWNER: ADDRESS: 1 CITY: I STATE: I ZIP:
BARBER BRIAN L 602 MAIN ST ATLANTIC BEACH FL 32233-2532
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $90.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $45.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.03
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $139.03
Issued Date: 2/21/2019 1 of 2
Building Permit Application Updated 12/8/17
'' %y City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: LOC? main Permit Num r. C 0 r' 1 9 —/w`
Z:e___
IN K Tv
Legal Description ja-34 5b45iE.102 fc es SEe .i6l 4
-R EH noglCO— MoCi
Valuation of Work(Replacement Cost)$1(46.a`-) Heated/Cooled SF ia 6 a Non-Heated/Cooled 155 g
• Class of Work(Circle one dei Addition Alteration Repair Move 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 /A
• Submit a Tree Removal Permit Application if any trees ar@ to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: kerooc
c, 3 d 0.-)r , rLIOID--cf., 1 (._ 01- • Ro-oe,5)-e-(- uiv6ALTivAq -"- -El_10(an
Florida Product Approval# 2 p._ 1 of o , J for multiple products use product approval form
Proper Owner Information (��t^�
Name: Addws -(L_'0 or � L A �r�
City_ 60 h.
State Zip ��J Phone '-I? {g�� _
E-Mail 1't4C,Op GI �q_ L c. '•''
Owner or Agent(If Agent,Power of Atto ey or Agency Letter Required)
Contractor Information f� ,ikt ( /�f�+
Name of om any: fve �w yl-pJ Qualif ting Agent: �l a--__ _� isr�c
Address
_. �S�Q� �.., City"t)C�� State Zip
Office Phone ! `, t� Job Site/Conta t Nutn/�r
State Certification/Registration ft V3' g�� E-Mail it —10.: MI L'.a I •.. 4 to:
Architect Name&Phone tf
Engineer's Name&Phone#
Workers Compensation _
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
RECORDING YOUR NOTICE OF COMMENCEMENT.
ail, /Orz2j __ ,
----'‘-'."--C-11-ii"? (Signatu of Owner or Agentt2.L—}) (Signature of Contractor)
(including contractor)
Sig and savor to %affir ed)before e this V` day of Sii'nOed�and sworn 9�t�o�csr affirmed before me this ('I day of
7 by 6 d► i J . - 4 �! ck i T ,by! I/.I. . ' I „�
// / L/i/ / ..i/ .1 4...../
/�i -_
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(S:nature of Notary) "(Signature of Notary)
( 1 Personally Known OR Fr<sonally Known OR
(affi-of Id ed idento catlor° ; �L I Produced Identification
cati
Type of Identification: ll Type of Identification: _. .. _ -r-�a,
blic
of
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a��°�qo Notary Public State of Florida Y° MedganWolflat0Firmaay hleaganWolflaMyCommission FF 982745' My Commission FF 982745�4
10,r o Expires 02/t8/2020ExPir•s02/tBl202 �f`�.w :CI:"
uoc # 2019033953, OR BK 18688 Page 994, Number Pages: 1,
Recorded 02/11/2019 03:39 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPUCATE) �I �/y,f�
Permit No, // Tax Folio No (C-/`i "cttc
State of i L County of Lt 1,10.1
To whom It may concern:
The undersigned hereby informs you that Improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information Is stated In this NOTICE OF
COMMENCEMENT. 22 q
Legal description of property being improved: 1C8 J� c� 4 , /ba
64-taiwr c,
Lot- co 1III !3
Address of property being improved: � 4111.- 0161gfe)
L
General description of improvements: ru ••
Owner di 6
Address (Qo2 /hr�'1 / WL41`e. 5 6
Owners interest In site of the Improvement • r',■' d . •�•,
Fee Simple Titleholder(if other than owner)
Name
Addre6s�) �7
Contractor}1Ir• " •P Chi `r i00Pi
a `
Address
rPrVie.. 3;Z7)1_- r
ccPhone No. r-- --E� A Fax No.
Surety(if any)
Address Amount of bend$
• Phone No. Fax No.
Name and address of any person making a loan forthe 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 Llenor'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):
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, aos•,ty
FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. p ,1
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST A9:oA.:
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY s z
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. �.. ..
THIS SPACE FOR RECORDER'S USE ONLY / •WNER
Syne•. .:L fir. '.i DATE, "COO/• �t
Berme mama i day of r'_'a.• r.& to the r��o
Doty !,Slat Fier;la,fas rs ty apgored y T a g •
r ere:n by d T
Wed!!henna nd aft that ail ate••ante and dedaratlons herein ;Q g
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are true and accurate
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