1861 Beachside Ct RERF19-0051 Shingle Roof REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0051
ISSUED: 4/3/2019
800 SEMINOLE ROAD EXPIRES:9/30/2019
ATLANTIC BEACH. FIL 32233
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 BUILDIN(k
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,orfederal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1861 BEACHSIDF CT REROOF SHINGLE SHINGLE ROOF $16000.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1695420560 BEACHSIDE
COMPANY: ADDRESS: CITY: STATE: ZIP:
PIMENTEL ROOFING INC 402 St. Augustine Nvd. JACKSONVILLE FIL 32250
BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
WHITTINGTON FAMILY 1861 BEACHSIDE CT ATLANTIC BEACH FIL 32233
TRUST AGREEMENT
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.
DIESCRIP-MON QUANTITY PAID AMOUNT --
COUNI
BUILDINGPE,." 455�OCWO 32711000 $135.00
STATE DEER SURCHARGE 455 00M208 07W a $2.03
STATE DCA SURCHARGE 455 0000 208 0600 0 $2,00
TOTAL:$139.03
issued Date:4/3/2019 1 of 2
REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0051
800 SEMINOLE ROAD ISSUED: 4/3/2019
ATLANTIC BEACH. FL 32233 EXPIRES,9/30/2019
I�ued Date;4/3/2019 2 of 2
Building Permit Application bpdaWd 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FIL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Build ing-Dept@cciab-tis 15 REQUIRED.
JobAddress: 19,4' 1 R-CAC-4 S:Ib6 CT —Permit Number: -00i� L
Legal Description 47, 14 Oct - 2S- 2 `[FJ3 2=�CVkbj RE#.J 6 q 542--06,�
Valuation of Work(Replacement Cost)$ A�,0,9&sO_ Heated/CooledSF_Non�Heated/Cooled
• ClassofWork: ONew OAddition gKiteration CIRepair DMove DDerno OPocil OWindow/Door
• Use of existing/proposed structure(s): DCommercial 931(esidential
• If an existing structure,Is a fire sprinkler system installed?: ElYes 9xilo
• Wil I treelsl be removed in association with proposed proiect?Oyes(must submit sensarate Tree Re
Describe in detail the type of work to be performed:
Florida Product Approval# F) CrA V- ;?,5 4C)qA�D�for multiple products use product approval form
Property Owner Information 1!5�,,,v; (0 �—�-0+
Name I N C-ro F:A'YI IV T)&a Address I K 6 64cnn616 Cr
city-A-r)-4 N-ne Af/4 C.H—' State r L zip 3223L3 Phone (,TO!l ) ;4q�4-0 `77 n
E-Mail J3u-rUS:/hC P-3`10NO. C-O/A
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Z021 Qualifying Agent
Address 02 6 city y zip 322,6in
A4L. AlAx- State Al,
Office Phone 00 —JobSite Contact Number 6'�Zl- a5,e
State Certification/Registration# Pez I iLiolng' E-Mail
Architect Name&Phone#
Engineer's Name&Phone If
Workers Compensation Insurer OR xempt M/Expiration Date 9- 21-20,zo
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 AN FORE
RECO�=U 01� F N -0-7_�;7'
(Signature of Owner or P& (Signat&9-of
1� ($ ' "", ,
-ed and sworn to(or affir I
Sli ned and sworn to(or affirmed)b dayofk4gn - ieZf�k1k4Sr1th,*' 11 day of
by by
c,igrat n Wary
Z PU
ersonally Known OR %
vPersonally Known OR R� 1/ 111#11,10%
I Produced Identification 0 LI Produced Identification
11,,1,rc
Type of Identification, F Type of identification:
NOTICE OF COMMENCEMENT
State of Tax Folio No.
Countyof bV-VA&
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 irdormaticm'�tarted;th,!;NOTICE OF TIMMENCEMENT.
— -S IDI�AcftSi L-04 11�
Legal Description of property being improved:
V,
Address of property being improved: Q61 6"CI-%SiDd1= Cl- A-I'LAilfrW-w�1 ",C� 3 7-7-3 3
RE- -�ALI
General description of improvements:
0,0
wner:W14 4-IVAN WPI!ftTOJ0 Address: J861 864-- iicloe cT. /97L"77C
0 0 71 Cj4j F 1.3 2
wner's interest In site of the improvement: F64�� 6
Fee Simple Titleholder(if other than owner):
Name:
Contractor:
Address:-,Foz, WIM, UA-le, Z", *=7� -3 ->-7,90
Telephone No/'9,!9 Spo�� Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
PhoneNo: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be sewed:Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienoes Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill In at Owner's option)
Name;
Address:
Telephone 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 RECORDERS USE ONLY OWNER
Doc#201907351o. 01
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Number Pagm:1 1 4
R�xxxro�04103=19 09 26 AM ne this ay of �Int IN, State
RONNIE FUSSELL CLERK ClFiCUIT COURT DUVAL Of Florida,has personally appeared A", t 4�171
COUNTY Notary Public at Urge,State of Florda,County o 356 5
RECORDING $10.od My commission expires:
Personally Known: 111:14?bk I or
Produced Identification:—JF OE IV