324 AQUATIC DR RERF19-0047 SHING ROOF PERM REROOF SHINGLE PERMIT PERMIT NUMBER
j
CITY OF ATLANTIC BEACH RERF19-0047
800 SEMINOLE ROAD ISSUED: 3/25/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 9/21/2019
MUST CALL INSPECTIONPHONE • 14) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + BUILDING
CODE, AND OF ATLANTIC ' CH 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.
• . ADDRESS: DESCRIPTION: VALUE OF • .
324 AQUATIC DR REROOF SHINGLE SHINGLE ROOF $7400.00
TYPE OF
ZONING: :D •
• • GROUP:
171818 5108 AQUATIC GARDENS
COMPANY: ADDRESS:
BIG FISH ROOFING INC 6821 N SOUTHPOINT DR APT 114 JACKSONVILLE FL 32216
• ADDRESS:
MEEKER MICHELLE 324 AQUATIC DR ATLANTIC BEACH FL 32233
ANDREA
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 . . •
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 $90.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date: 3/25/2019 1 of 2
Building Permit Application Updated 10/9/18
i.
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
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Job Address: 2t{ QuW�"� C Dry - e1A,1+-t '&h 41 3�Z23i?ermitNumber: � (S) -0047
Legal Description 5,?-71 17--25 '256- AQI.UA+c WD&nr Lc*r -17 RE# �7� �� ^ 57105
Valuation of Work (Replacement Cost)$ 7q 77 Heated/Cooled SF /(15 C Non- Heated/Cooled y�
• Class of Work: New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door 40JF
• Use of existing/proposed structure(s): ❑Commercial Patesidential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes I)2No
• Will trees be removed in association with proposed ro ect? ❑Yes must submit separate Tree Removal Permit ❑No
Describe in detail the type of work to be performed: \ ,, I'
I D 1 - AL
Florida Product Approval C 10(473 for multiple products use product approval form
Property Owner Information 1
Name hVl,c 11c I Ly 117C t n Address Z`� A Q1,1^1"►'G Dq
City JVHVNVNState el zip 12-A 2-5 Phone C71)c/-
E-Mail 111EE kr;_1L n 702 � . woi
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company 1'6 P1 s tl Acv l=i o Qualifying Agent
Address 7 r, . N. City 75�k5'.1 yr 11 t State 1::i I —zip 3 :DLI b
Office Phone q,04 . fr - Job Site Contact Num4r
State Certification/Registration# LSC 133yg4l E-Mail A,Shh I cf- kt' a,5 FISH evoFm s , Cy,4-L
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer FRSE OR Exempt❑ Expiration Date 12- 3
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 RAN ATTORNEY BEFORE
RECORDING YOUR NOTIC OF COMMENCEMENT.
�� ,fyV 1.12
(Signature of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this l day of Signed and sworn to(or affirmed)before me this 21�_day of
C l`1 Ulf! byMrChC& /Y-)17 Ck ?t'c"�i by 5.1fJ-f.I SCua CSS
#e (Sign/ature of Notary)
STACY SIMMONS
Cor hiss #GG 182462 :+%. STACY SIMMONS
[ ]Personally Known 0 '�
Expires March 3'�� [personally Known OR
-Commission#GG 182462
Baled Thru Try F*insmrow 1300,385 7019 ; `o`r Expires March 3,2022
['eroduced Identificati [ ] Produced Identification S,c;M1o! SWWTkruTroy Fmkaur m80Mw7o19
Tvoe of Identification: I%( Dr Tvoe of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE) �(
Permit No. Tax Folio No.
State of FL 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. -3T- 7/ 1 - -2S _ 2
AQuta-fIC a,A2 VIS
Luff I -(-)
Address of property being improved: �2 f 2.�N"r�C D9
A+LA'g+1 C R,,-AC H; Fr_i 7,20 3 3
General description of improvements:
Owner -G h qt-L77 IMfFKE12
Address �Z �QtIN� ►� 7� f / 1/F{I( lRCr4ch rf 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
yy Name
�y Address
Contractor BIG FISH ROOFING
Address 6821 SOUTHPOINT DR N,SUITE 114,JACKSONVILLE,FL 32216
Phone No.(904)685.8334 Fax No. (904)853-5676
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.
V,
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified): 1
THIS SPACE FOR RECORDER'S USE ONLY j�OWNER
Signed: DATE'S/,
cn
Doc#2019065521,OR BK 18728 Page 2318, Before me this day of /710,-C IA In the -+
C�o-1�n��vf D I,State o1 Florida,has personally appeared '
Number Pages:1 /r►I u I2G �yl���� herein byRecorded d�'
RONNIEFUSSELO19 02:09 PM,
L CLERK CIRCUIT COURT DUVAL himselt/herself and affirms that all statements and declarations herein 3
are true and accurate
COUNTY
RECORDING $10.00a�/, �`���,�,
Notary Public at Large,State of County of u 11-1
My commission expires: 3 '
Personally Known or