780 Jasmine St RERF19-0063 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
J CITY OF ATLANTIC BEACH RERF19-0063
'oma• 800 SEMINOLE ROAD ISSUED: 5/1/2019
ATLANTIC BEACH. FL 32233
EXPIRES: 10/28/2019
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 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:
780 JASMINE ST REROOF SHINGLE SHINGLE ROOF $8995.00
TYPE • ING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:•
170927 2040 ATLANTIC BEACH SEC H
COMPANY: ADDRESS:
DS KILLIAN ROOFING 3898 DUPONT CIR JACKSONVILLE FL 32254
• ADDRESS:
PARTLAN KIRSTEN JOY 780 JASMINE ST ATLANTIC BEACH FL 32233-1712
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDINGPERMIT 4550000322-10000 $9500
STATE DBPR SURCHARGE 455-0000-208-W 00 0 $2'00
STATE OCA SURCHARGE 455-0000-208-0600 0 $2'00
TOTAL:$99.00
Issued Date: 5/1/2019 1 of 1
Building Permit Application updated 1019118
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL HIGHLIGHTED IN GRAY 32233 IS REQUIRED
Phone: (904) 247-5826 Email: Building-Dept@ .
coab.us IS �
780 JASMINE ST Permit Number: K ��� I 1 - oC"�3
Job Address: 170927-2040
18-34 38-2S-29E . 145EC H ATLANTIC BEACH RE# —
Legal Description BB
Valuation of Work(Replacement Cost)$ qf'O�- < Heated/Cooled SF LI 92 Non-Heated/Cooled s
• Classof Work: ONew []Addition []Alteration ETRepair []Move ❑Demo OPool []Window/Door
• Use of existing/proposed structure(s): i7Commercial 211esidential
• If an existing structure,is a fire sprinkler system installed?: []Yes ANO• y��
Will trees be removed in association with to xed ro eCt? Dyes Must RESIDENCE se arate Tree Removal P rmit 41,10
Describe In detail the type of workto be performed:
I�
�1 IOIA4. �I` - 73 0, for multiple products use product approval form
Florida Product Approval q r
Property Owner Information 780 JASMINE ST
Name FARTLAN-KIRSTEN JOY Address
City..:
AS State FL Zip 3 Phone 904 607 0931
must
E-Mail
Owner of Agent(If Agent,Power of Attorney or Agency Letter Required)Contractor Information DAVID S KILLIAN
Name of Company DS. KILLIAN ROOFING & GC qualifying Agent
1031 M SA O E City JACKSO State FLZip
Address SAME
Office Phone lob Site Contact Number
State Certification/Registration It CCC 1328203 E-Mail DAVEODSKILLIAN.COM
Architect Name&Phone U
Engineer's Name&Phone q
Workers Compensation Insurer ON FILE OR Exempt Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or instal lation 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 maybe additional restrictions applicable to this property that maybe found in the public records of this county,and
there maybe 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 LENDE R AN ATTORNEY BEFORE
RECORDING YOU Qf COMMENCEMENT.4 ^`
of owner Agent l5ignature of Contractor)
Signed and sworn to(or affirmed)before me this 'L_dayof Signed and sworn to(or affirmed)before me this_day of
ARCO( by 'cs�tn +4
it
t pftNUW WNHSTON (Signature of Notaryl
27.p
_ MY CAMMIaeIONa GG a629M
EXPIRE g:Gctobel.urieSU
[ IPersonallV Known OR Y'<,8j,d e°"tl°tlTw ntlaN PuWk UntlenniMa [ )PersonallY Known OR
�. ,oduced Identificau. , I )Produced Identification
Type of identification: �t �` t ' cnS Q- Type of Identification:
NOTICE OF COMMENCEMENT
State of FIa1°' 0x0
Tax Folio No. 170927'2
County of Duvel
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 38-2S-29E.14 SEC H ATLANTIC BEACH S 30FT LOT 4,N 30FT LOT
Address of property being improved: 780 JASMINE ST ATLANTIC BEACH,FL 322331712
General description of Improvements: RB-roof 8retttply HQUid Met
Owner: PARTLAN KIRSTEN JOY Address: Same
Owner's interest in site of the improvement: ReeMence
Fee Simple Titleholder(if other than owner): NIA
Name:
Contractor: DS Kllllen Rooms aGeneml conaeMminc.
Address: 1031 Mimosa Cave CT E
Telephone No.: nxo )2x 7653 Fax No:
Surety(if any) wA
Address: Amount of Bond$ —
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: NIA
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: WA
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person.to receive a copy of the Uenor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name: wA
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
Doc#201909359x,OR BK 18766 Page 2280, Signed: 1�✓1 Date: H- I Z19
Number Pagea:l Before met s -'fi� dayof, L ty inthe County of Duval,State
Fift,adad 0�24QOHS 10:57 AM, Of Florida,has personally appeared l
fien [ G"A �4I1
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public at Large,St f orida,Caunry
COUNTY ,.•';',."". JENNIFFRJOHNSTON
RECORDING $10.00 My commission expires: 4
41
Personally Known: _
Produced ldentfication: 1Hs