77 W 9th Street RERF19-0062 Shingle N' REROOF SHINGLE PERMIT PERMIT NUMBER
J CITY OF ATLANTIC BEACH RERF19-0062
ISSUED:4/30/2019
ATLANTIC
800 ROAD EXPIRES: 10/27/2019
C BEACH.
EAFL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL
WORK MUST CONFORMTO THE CURRENT 6TH EDITIONI 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 . rr • s • OF • •
77 W 9TH ST REROOF SHINGLE shingle re-roof FL10674& $8320.00
FL9777
TYPE • BUILDING SUBDIVISION:
CONSTRUCTION:
170813 0080 ATLANTIC BEACH SEC H
CODDRESS: CITY: STATE: ZIP:
NELIGAN CONSTRUCTION 910 S lith Ave JACKSONVILLE FL 32250
BEACH
• ADDRESS: CITY: STATE: ZIP:
RIVERAANA 77 W 9TH ST ATLANTIC BEACH FL 32233-3464
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 . r
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 4550000-322-1000 0 $95.00
,BU
ATE DoPRSURCHARGE 455.0000-208-0700 0 $1.00
STATE DCA SURCHARGE 455-0 208-0800 0 $200
TOTAL:$99.00
Issued Date:4/30/2019 1 of 2
® Building Permit Application Dpdated 12/6/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: 77 V19th St. Atlantic Beach, FL 32233 Permit Number: 264F 19-00 Cea.
Legal Description 18-34 38-2S-29E.090 Atlantic Beach, Lot 4 Blk 87 RE# 170813-0080
Valuation of Work(Replacement Cost)$8320.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use ofexisting/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Grcle 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: Roof replacement ,FL 10674 Owens Coming Shingles,
Owens coming se#adhering undarlayment,FL 9777
Florida Product Approval It for multiple products use product approval form
Property Owner Information
Name: Ana Rivera Address: 77 W 9th St.
City Atlantic Beach State FL jp 32233 Phone 904-MO-7239
E-Mail artemisa acr@hotmail.wm
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Neligan Conebucton&Roofing, LLC qualifying Agent: Brian D Neligan
Address 910 11th Ave.South City Jax Beech State FL Zip 32233
Office Phone lob Site/Contact Number Nk4&lewio 61394]1
State Certification/Registration# ccctaaaee E-Mail"eiss..eniponilk"'al...
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Bddgefield Employers Insurance 0830-29147 exp 3/23/2019
Esempt/lmurer/Lease Employees/Upimbn pate
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. 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 munty,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
RECORDING YOUR OF COMMENCEMENT.
(Signature of Owner Or Agent) (Signatureof Contractor)
(Including contractor) �1,
Signed and swom to(or affirmed)before me this 2�' day of S' ned gqd sworn to(or affirmed)bgfore me this dilly of
X0/9 by /�.�/win2A,M.8w, A5 vlJ bye 11
;,,.ec. '. (SigBMDBNEIMNK3 (Signa[ of Notary)
' MYCOhwiSSKwaGG235534 e
erwnally Known `::.a... 'a EXPIRES:NowllBer5,2022 rh Personally Known OR .".'...,` SHERRI L EM4HISER
[ ]Produced ldenufica '"SEn eona.a ihurAtM Rueklxaerxnl.n [ ]Produced Identification ;;�g p�0a' Hotary.1-1.Public-Stae27 Fl46
rFf [ommlaabn R GG 2]21,
Type of IdeM#Ication: Type of Identification: M Camm.Eaplres May 11,2029
Bonded through Natronal 40ary 11n
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 170813-0080
State of FL County of Dwal
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: 18-34 8-25-29E.090
Atlantic Beads Sec H E 3911 of W 4411 Lot 4 Blk 67
Address of property being Improved; 77 W 9th St Atlantic Beach,FL 32233
General description of improvements: Roof replacement
Owner Ana Rivera
Address 77 W 9th St Atlantic Beach FL 32233
Owners interest In she of the Improvement
Fee Simple Titleholder(t other than owner)
Name
I"I
Address
COnIfB9bf Neligan Construction and Roofing,LLC.
Address 91011th Ave.South l Iaorwille Beech,FL 32250
Phone No.904a 5523 Fax No.904'572-1211
Surety(If any)
Address Amount d bond$
Phone No. Fax No.
Name and address of any person making a ben 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 whore notices or other
documents may be served:
Name
Address
Pham No. Fax No.
In addition to himself,owner designates the following person to recelve a copy of the Llenors Nature as provided In
Section 713.06(2)(b).Florida Statutes.(Fill in 9OwrleYs option).
Name
Address
Phare No. Fax No.
Expiration data of Notice of Commencement(the expiration date is on,(1)year from the dale of remming unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
sig Dnre t IQ
dna.as me m to
c my oro III atrey7.Flo,aep EORpy PoRPPB NKS rein pY
Da;#2019099170,OR SK 18Tr4 Page IM, d
hinmlrre .1IYYry`tMYS9IINISSKtl!#gptidr;liglyne n
n<t '
Number Pages:) en nue an eep ,.`,;e; EXPIRES;Naremi 5,2022
Recorded 17.03012019 02:12 PM _ ` rondo rho finery Punic unC«xnrcrs
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00 Notary 9La id ou«y_m
expar: s c Z
PraWwE ion