1318 ROSE ST RERF19-0048 SHING ROOF PERM REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
RERF19-0048
s
800 SEMINOLE ROAD ISSUED: 3/27/2019 9� EXPIRES: 9/23/2019
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION • • • 1 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
1318 ROSE ST REROOF SHINGLE SHINGLE ROOF $7660.00
TYPE OF
• iGROUP:
171064 0020 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: '
HAGERTY CONSTRUCTION 12850 WINTHROP COVE DR JACKSONVILLE FL 32224
AND ROOFING INC
• ADDRESS:
HILLMAN WILLIE C 1318 ROSE ST ATLANTIC BEACH FL 32233-2661
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 455-0000-322-1000 0 $90.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date: 3/27/2019 1 of 2
Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: 1318 Rose Street Permit Number:
Legal Description Lot#5, Block#234, Atlantic Beach RE#
Valuation of Work(Replacement Cost)$ 7,660.00 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 Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 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:
new asphalt shingled roof(re-roof)
Florida Product Approval# Shingles FL10124.1 Undedayment FL10626.1 for multiple products use product approval form
Property Owner Information
Name: Willie&Melissa Hillman Address: 1318 Rose Street
City Atlantic Beach State FL. Zip 32233 Phone 1-904-553-6104
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Hagerty Construction&Roofing, Inc. Qualifying Agent: Quin J. Hagerty
Address 12850 Winthrop Cove Drive City Jacksonville State FL. Zip 32224
Office Phone 1-904-992-9960 Job Site/Contact Number 1-904-591-4354
State Certification/Registration# CCC 057779 E-Mail hagertyinc@yahoo.com
Architect Name&Phone# N/A
Engineer's Name&Phone# N/A
Workers Compensation Bridgefield Employers Insurance Company
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.
(Sig a r ontractor) (Signature of*t4w.Mev)
Signed and s rn to(or ffirmed)before me this 22nd• day of Signed and sworn to(or affirmed)b fore me this 22nd•day of
March 19 by Tiffany Sral March 2019 bv I QLfin J. Hagerty
(Signatur of Notary) i natu of Notary)
TMo" ad t R Quin J.Hagerty
NOTARY PUBLIC r NOTARY PUBLIC
STATE OF FLOFWA STATE OF FLORIDA
[�Personally Known OR [)d Personally Known OR � �,
[ ]Produced Identificatio Ciwm*OO=f7 [ ]Produced Identification '� i Comm#GG119052
Type of Identification:
��� Type of Identification: ip E j9�e Expires 6!26/2021
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 171064-0020
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: Lot#5, Block#234,Atlantic Beach
Address of property being improved: 1318 Rose Street,Atlantic Beach,32233
General description of improvements: new asphalt Shingled roof(re-roof)
Owner Willie&Melissa Hillman
Address 1318 Rose Street,Atlantic Beach,32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Hagerty Construction&Roofing,Inc.
Address 12850 Winthrop Cove Drive,Jacksonville,Florida,32224
Phone No. 904-992-9960 Fax No. 904-992-9961
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
different date is specified): C1
THIS SPACE FOR RECORDER'S USE ONLY OWNER m -i
aU-Q
Signed: L'
DATE k ip
Before me this day of in the �.0
Doc#2019066231,OR BK 18730 Page 161, County of Duval,State of Florida,has person y appeared
WILLIE HILLMAN herein by
Number Pages:1 O x
Recorded 03/26/2019 11:44 AM, are true herself and affirms that all statements and declarations herein Cf Z rn 0 W
are true and accurateoG`pTI0N,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
m
COUNTY d'
RECORDING $10.00
r0y Z
Nota c at Lar ,Sta F RIDA County of �� d01M �
My commission expi
Personally Knrnvn or
Produced Ident�catio