1970 MIPAULA CT RERF19-0046 SHING ROOF PERM REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0046
8
ISSUED: 3/25/2019
00 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 9/21/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ 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:
1970 MIPAULA CT REROOF SHINGLE SINGLE ROOF $17387.00
TYPE OF
• • GROUP:
169506 1020 SELVA NORTE UNIT 01
COMPANY: ADDRESS:
BIG FISH ROOFING INC 6821 N SOUTHPOINT DR APT 114 JACKSONVILLE FL 32216
• ADDRESS: STATE:
PARSONS PAUL B 1970 MIPAULA CT ATLANTIC BEACH FL 32233-4555
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $140.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.10
STATE DCA SURCHARGE 4S5-0000-208-0600 0 $2.00
TOTAL: $144.10
Issued Date: 3/25/2019 1 of 1
Building Permit Application Updoted10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
r 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS IS D.
Job Address:—1910 ±�,cau1Q C'+ Permit Number: 13 E 2F 19—00 6!2
Legal Description —9LI C)S 2S 9,g Sztvcc Oha L aJ IU_RE# /to'9-5_19 0
Valuation of Work(Replacement Cost)$�"?, rh'� ='— Heated/Cooled SF 2yeq Non-Heated/Cooled t o
T'
• Class of Work: WNew ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door✓ o T
• Use of existing/proposed structure(s): ❑Commercial Residential
• If an existing structure, is a fire sprinkler system installed?: Dyes 19V0
• 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: n oQ�` Q e P I acev"\Q,%J,,'
Florida Product Approval# �L 0 1 7 � 3 for multiple products use product approval form
Property Owner Information
Name P. ,l b P�rr) y Address cl, cl U I C1 �-
city A State hL. Zip__ zz 15hone�t
E-Mail
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company • e h f ualifying Agent S-4 iv tv-) 1,A, Scow" o- f
Address1. City '1 State L_ ?22 I b
Office Phone 6 14 Job Site Contact Number A 1A 11 4) 3
State Certification/Registration# wee 133 C 491 E-Mail A A2 h w•
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer S OR Exempt❑ Expiration Date I2 —3 1- 19
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 OR ATTORNEY BEFORE
RECORDING YY�IJR OTICE OF COMMENCEMENT.
(Signature of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this 27 day of Signed and sworn to(or affirmed) before me this 2<-day of
yY1r h U19 by Rawl 8•_ >ou���5 1vY« c� ?� I�i by
r :rl. ya5YAPC1� Ml STACY SIMMONS
;.; Commission#GG ta2462 ` ' �:Corrunission#GG 182462
Expires Marcia 3,2022 personally Known OR q Expires March 3,2022
[
]Personally Known OR 'a"ik" ga, T Fainbawam8*38L7p o (� •.? s;`
[L'Produced Identification [ ] Produced Identification
.°�^••' S wiled Th.Troy Fain Inwramw 8003857019
Tvoe of Identification:Cl_ 0 L Tvpe of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE) Q
Permit No. Tax Folio No. 1 �yt" - 102-0
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. L'f o O—aS 2 Ye
:5a-VA hok:n' uyl► t o✓iF'
G.U-T (D
Address of property being improved: 1170 / AtALA C -
AttAN4,ic Bc.h Ft -32. 33
General description of improvements: ?by F R���A-Cc-rn��f
Owner '�ALAL R ?AtES00 //
Address 1 G%7o JM� �AKLA C-(- AtjIl✓4r(_ C/� G/ 2233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
n Contractor BIG FISH ROOFING
J,U1`I'�Ir/ Address 6821 SOUTHPOINT DR N,SUITE 114,JACKSONVILLE,FL 32216
Phone No. (904)685-8334 Fax N0. (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. ...........
+ • ;
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
"'1
different date is specified): y
THIS SPACE FOR RECORDER'S USE ONLY OWNER if 9
Signed: W DATE
Before me this_2_:,L day of J)'WA-t. In the
Doc#2019065522,OR BK 18728 Page 2319, ror�my of Duv I,Stat Florida.has personae a�pered M'
Number Pages:1 / tt-I Q✓3 oil S �! > herein by
Recorded 03/25/2019 02:09 PM, himself/herself and affirms that all statements and declarations herein +�
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL are true
�,,M accurate
COUNTY C"� t r�,1 c AC/K--e
RECORDING $10.00
Notary Public at Large,State of L County of
My commission expires:
Personally Known or