1901 Hickory Ln RERF19-0056 Shingle Roof REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0056
u .
800 SEMINOLE ROAD ISSUED:4/19/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 30/16/2019
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 BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS
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:
1901 HICKORY LN REROOF SHINGLE SHINGLE ROOF $8700.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
SELVA MARINA UNIT
172020 1322 12B
COMPANY: ADDRESS:
LOCKHART
CONSTRUCTION & 5380 TIMBERLINE DRIVE JACKSONVILLE FL 32277
ROOFING SERVICES
• ADDRESS:
MORTON JOAN G 1901 HICKORY LN ATLANTIC BEACH FL 32233-4577
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.
DESCRIPTIONACCOUNT QUANTITY PAIDAMOUNT
BUILDING PERMIT 4550000-332-1000 0 $9500
STATE OBPfl SURCHARGE 455-0000-308-0]00 0 $2W
STATE DCA SURCHARGE 455-0000-208-0600 0 $200
TOTAL:$99.00
Issued Date:4/19/2019 1 of 2
Building Permit Application Undated1DI9118
City of Atlantic Beach Building Department '*ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-DeDt(o)COaIJ.Us IS REQUIRED.
Job Address: Ictot Hiesurif
II Permit Number: I `EpY 1-C)os(o
Legal Description 3c-7(, CqoS: 2j E: MA4 NA k )A" 12-R 4VKllD
Valuation of Work(Replacement Cost)$ 8?OO.DO Heated/Cooled SF Non-Heated/Cooled
• Classof Work: ONew OAddition DAlteration ❑Repaiirr/'OMove ODemo DPool OWindow/Door
µr
• use of existing/proposed structure(s): OCommercial esidential
• If an existing structure,is a fire sprinkler system installed?: Dyes ❑No
• Will r removed in association with proposed orclect? m r Tree Removal P rmi
Describe in detail the type of work to be performed: �EI`L'IOVC RN,p �C�� RCC �op FIN
ghln le IszlCo
Florida Product Approval If FG- It SSS for multiple products use product approval form
Property Owner Information
INA Name HPI Address I'
City State zip 82232 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Infoninatio�n' /� 1
Name of Company i.nGCgk�l \ ucrooN J Pll�alifying Agent AMES 1... J.�CiL1J A'CT
Address 438D� M13 rocs I orvl F deKsot I stat C zp 3�1T�T—
OfficePhone 404- 994-2-igi—T Job Site Contact Number $o4- 99d.3RL--�—
State Certification/Registration k00 E-Mail / e/ t' I B CnM r,AQJJA I
Architect Name&Phone q (�_
Engineer's Name&Phone p
Workers Compensation Insurer OR Exempt Expiration Date 2oZI
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 ATTORNEY BEFORE
RECO ING Y j OTI�E OF COMMENCEMENT.
�yav OyZ'Ax w O
(Signatures Owner or Agent) (Signature of Contractor) Q
Signed and sworn to(ora m )bef re a is day of oro to(ora r d)lbe !t * LC-;Uayof
b ma 6 �1i*V-sMY COMMISSION YFF 924%1EX IR S.October 6,2D19WKPowa _ nP,*U9de.. I I Personally Known ORI PrducedIdentification 9
Type of Identification S pefIdentificatiomn
NOTICE OF COMMENCEMENT
State of Ftadac Tax Folio No.
County of Orval
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 fallowing information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being Improved: 3676 09-2S-29E Selva Marina Unit 12-B Lot 10
Address of property being improved: 1801 Hickory Leve,A0en8o Beech,FL 32233
General description of improvements: remove and replace roofing
Owner: Joan Morlon Address: 1901 Hidx ry Left Aarall Beach,FL 32233
Owner's interest in site of the improvement: k.ekaale
Fee Simple Titleholder(if other than own er): Doc#2019087835,OR BK18758 Page:3 '
Number Pages:I
Name: Recorded 04/17201908:45 AM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
Contractor: L°dBiYfYwaductlrn and R--ms Eaay—LLC COUNTY
RECORDING $10.00
Address: 5380 Timberline Drive,Jacksonville,FL 32277
Telephone No.: (ON)X865 Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the Improvements
Name:
Address:
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:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienors Notice as provided in Section
713.D6(2)(b),Florida Statues. (Fill In at Owners 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 RECORDER'S USE ONLY OWNER
Signed: 1 D7 _ Date: 'J
.,pr rap HANANSNAHN Before m ism day of inthe Courdy of Duval,State
4s':'•'+t'
Dann Of Florida,has Personally appeared a
ExpirasNmen0 ��✓�
R , wwnGG 12aa0
a 3er 14102) Notary Publican Large,State of Florida,County of Duval.
�Pq Adr• yrgn,,,yyxarny,y
My commission expires:
Personally Known: 1-S or
Produced IdentiflraH