1917 MEALY ST RERF19-0041 SHING ROOF REROOF SHINGLE PERMIT PERMIT NUMBER
r � RERF19-0041
CITY OF ATLANTIC BEACH
v~ 800 SEMINOLE ROAD ISSUED:
ATLANTIC BEACH. FL 32233 EXPIRES:
MUST CALL INSPECTION • • 914 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, ' OF • OF • '
ALL CONDITIONS OF PERMIT APPLY, PLEASE
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:
1917 MEALY ST REROOF SHINGLE SHINGLE ROOF $6140.00
TYPE OF
• • GROUP:
1723510000 LEWIS S/D
COMPANY: • . • .�
TOWNSEND ROOFING & 10418 New Berlin Rd #115 JACKSONVILLE FL 32226
CONSTRUCTIONS SERVICE
• ADDRESS:
LOCKWOOD CHRISTOPHER 1917 MEALY ST ATLANTIC BEACH FL 32233
W
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 45S-0000-322-1000 0 $85.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $89.00
Issued Date: 1 of 2
Building Permit Application Updated S/S/17
Yp j City of Atlantic Beach
.r
800 Seminole Road,Atlantic Beach, FL 32233
0a ur Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: 111-7 114e I Permit Number: �C^i' C�'
Legal Description Z'1-`IL i? 23-11C LtwS '>+bd�r���h S ZI r fLoi IIN 11 r-r L�J-1-5`OF cr N 4,1 FT E#E 3 K 1'Z �� -0 c0_0
II 00
Valuation of Work(Replacement Cost)$ b f `(C' 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 Iden
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yeses 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: )Zc c-t- (CI AL»,t.,'
W_ TlMb2;l.,e N,) sVj, 1 5 rrr iciery / ,s*� 6�krd ul¢_ ; =L z�zY
Florida Product Approval# 101 I q for multiple products use product approval form
Property Owner Information
Name: Lar_kwo,;J, Address: _ 70/ A/A-lni Tof/ AVr-
City PC,-4 -� State Vt4 Zip �2 3 10 7 Phone �V0 7- 66� -_7253
E-Mail Ie12io 15 Sb Im.* /• 6:--,
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: J;�WA>tkd r\9114:-1 Qualifying Agent: .s."
Address 10414, NeW r`d j►S City 'Tc+x State FL Zip 3ZZ"
Office Phone 101 1 - 6115'5657 Job Site/Contact Number q Cy- `I 2 Z- 4
State Certification/Registration# C4c+t3Z 17,9-1 E-Mail G%\,rit (d tow-I,+sch rov�icy, ",-i
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation JJ,r� t-orLe �J�s„c55 Servicr5 1 Lrc. +2 31 I`1
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.
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 wner or Agent) `-----f(Signature of Con c
(in uding contractor) /,,_ (,
Sign d and sworn to(or affinTVi before me this AL May of Signed and sworn to(or a before s of
0!✓C�1 ,b 1� ,by ��//l"IS1e,,d Pr�DC rc �1� ��1 "1
CHRISTOPHER
NOTARY PUBLIC (Signatu e f Notary) ignature of Notary)
COMMONWEALTH OF VIRGINIA
MY COMMISSION EXPIRES JANUARY 31,2020
REGISTRATION NUMBER:76813285 MARTIN AtiELLANO
a�
`. Notary Public-State of Florida
•' Commission a GG 102031
[ J PersonallyKnown OR [�QPersonally Known OR '� �` My Comm,Expir"May10.2021
Produced Identification A [ J Produced Identificationk+� ► v
Type of Identification: Al,A , 6i -+ I J Type of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE:
Permit No. Tax Folio No. 172351-0000
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: 24-92 17-2S-29E LEWIS SUBDIVISIONS 21 FT LOT 1,
N 191•"1'LOT 2,S 401 1'OF N 891,'1'OF E 31:1'LOT 5 BLK 3
Address of property being improved: 1917 MEALY ST. Atlantic Beach, FL 32233
General description of improvements: Roof Replacement
Owner LOCKWOOD, CHRISTOPHER W
Address 70! 14,4A1fL.T,,?& 4VE ha(_1" M Ll VA- 2 3701
O vner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Townsend Roofing and Construction Services,Inc.
Address 10418 New Berlin Rd k 115 Jacksonville,FL 32226
Phone No.904-645-5887 Fax No, 904-645-5442
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 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 �rw
�1
Signed: ._ DATE I� /¢A /Before this day of _— in the
Doc#2019062972,OR BK 18725 Page 1045, County of Dv+ .State of fleri�a,has personally appeared Gkrf�",/c"o
t c/ c clCw ro•{ hirein by
Number Pages:1 himseif:herself and affirms that all statements and deVarations herein
Recorded 03/21/2019 01:28 PM, are true and accurate
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY WAYNE PEELE
RECORDING $10.00 / �r ARY PUBLIC
EALTH OF VIRGINIA
L;C1H;4R1STQPKER
XPIRE"JANUARY 3?.2v2
Notary Public at Large.Stale of Gauntly of N NUMBER:768828h
- —
My commission expires: " —
Personally Kncwn__
Produced identification _