1034 Big Pine Key RERF19-0060 Shingle Reroof REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0060
800 SEMINOLE ROAD ISSUED: S/6/2019
``t D ATLANTIC BEACH, FL 32233 EXPIRES: 11/2/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALLYYfikiHAYST CINFIAM • THE CYRRE74T iTH E1ITJ174-aJ17) IF • • • • .
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF
F
CE: In addition to the requirements of this permit,there may be addRional restrictions applicable to this property
may be found in the public records of this county,and there may be additional permits required from other
nmental entities such as water management districts,state agencies,or federal agencies.
• • • • • • r • OF • •
1034 BIG PINE KEY REROOF SHINGLE shingle re-roof- FL10674.1, $7195.00
19948, 16160.1
TYPE OF SUBDIVISION:NG USE
CONSTRUCTION: NUMBER: GROUP�
172027 5058 SELVA LAKES
COMPANY: rr •
JACK C. WILSON ROOFING 45225T AUGUSTINE RD JACKSONVILLE FL 32207
CO.
ADDRESS:
HEFFNER PHILLIP L 1034 BIG PINE KEY ATLANTIC BEACH FL 32233-4363
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
RDII off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT I QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $9000
STATE DBPRSU0.CHARGE 455-0000-208-0700 0 $2A0
STATEDCASURCHARGE 455-0000-20&0600 0 $2.w
TOTAL:$94.00
Issued Date: 5/6/2019 1 of 2
`^ REROOF SHINGLE PERMIT PERMIT NUMBER
J CITY OF ATLANTIC BEACH RERF19-0060
800 SEMINOLE ROAD ISSUED: 5/6/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 11/2/2019
Issued Date: 5/6/2019 2 of 2
Ask Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
.,.. Phone:(904)247-5826 Fax:(904)247-5845
[Jobress: 0 � �i"g— / permit Nu ber. '�f-F �� -scription ' a REa1n of Work(Replacement Cost)$ 1��5 Heated/Cooled SF Non-Heod/Caoed
Class of Work(Circle one): New Addition Alteration Repair Move Pool Window/Door Ct,((�Use of existing/proposed structure(s)(Circle one): Commercial a xllnfIf an existing structure,Is a Bre sprinkler system intolled7(circle one): Yes No
• Submit a Tree Removal Permit Application if any areas are tools removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
Florlda Product Appmval# r for multiple products use product approval forth
Pro O ne Inform "oName: t L Add
City
Zip Phone
E-Mail -� E11 �
Owner or agent(If Agent Power of Attorney or Agency Letter Required)
Co off rinfom
ratl
a
Name of Company: n =QualifyllgAgent: D-
Address Ory State Zip
Office Phone Job Site/Contact Number S`'(;
State Certification/Registra8on# E-Mail
Architect Name&Phone If
Engineer's Name&Phone#
Workers Compensation
E"m0 mm Lea"EmPI es Emintlonors
Application is hereby made to obtain a permit to do thew nd installations as indicated.l 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
kms,
RECORDING YOUR NOTICE OF COMMENCEMENT.
(Sign caner ora ceding Contractor) (9gnatureof0mmactor)
Sig ed and swom to(or affirmed)befrre me this_ ay of SI and sworn So_(gr afOrme ) efore me this da`�of
`` C. �1/`f 4 S.S
5 ature of oto �Slanatu[e,.iNbyytyt.
_:pY'" .yv CHRISTOPHER VOSS a ] tLD,-:t�GFuAAI,wiVIt;NT 6AKFR
,. MYCOMMISSION#GG18a1g8 ` rr„nv hl Of FbrWa
rt44WWl ACG 5780
s+ 'e” EXPIRES.Oecemeara.2021 r rvpresOv,22?Q0
I 1 rsonally Known W-:Ro:�p„T' gadgT�gryry RyBw�m I jPf M.11lY Known OR ��:�L.._..
m
Type .....�
I Produced 11 OUR (pZduced Identificati ^'
Type of Identification: T of lderdNication: LK.
(PREPARE W DIRIM M l
Permit Na, Tax Folio No.
state Of County of
To whom It may concern:
The Undersigned hereby Informs you that Itr PADVemonts Will be mage W cartaln real Properly,and In
accordance with Section 717 of the Florida Statmw,the fath d 9 Information Is stated In this NOTICE OF
COMMENCEMENT. I ��1 (/
Logo]descvbw of property wing improved: 1.6c -rj
IJ
Address of ProParty being knproved:
l 33
General description of knpmwnenig (/
Owner
Address
OwlrershI%mmlInsbofthebmpmv hxad
Fee Skple TilidWoder(tumor than ownar)
Nemo
Address
Contractor
Address OUDLI'll%WAIIIII
'e
Phoma No. 0:::'0^.".,.9, -
Fax No.
Surety(If my) (+j4)356:1443
Address - A^'of bond$
Phone No. Fax No.
Name Wall address of MY Parson making a ban Mthe oonsimUm of the kwrovanssb.
Nemo
Address
Phone No. Fm No.
Name Of Person wlmin the Stele of F1odda.War gen himself,designated by owner upon whom notices or other
documents may be served: 4
Naam o
Address W r
Phone No. Fax No. OF o
In addition to hklsell,owner desUnstas Ua fdlowing Penson In recelve a copy of the Idenm•s Notice as provided in #F
Sechlon 719.08(2)(b),Florida Statutes.(Fill In at Owners option). ii EI
Name j
Address '.f�4•.,
v.
Phone Na. Fax No. .q�¢... .C•F
Explration date of Nodes of Commerwarant(the sglYWtlan NY Is ons(1)year than the date of raartling uNesse v"• i
difererddate laepedped):
TM SPACE FOR RECORDER'S USE ONLY 0 INER
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Mleealer wtlelMa /ddrderWalwW
Doc d 2019098559,OR BK 18773 Page 1880, rekrwae aed
Number Pages;1
Ro!carded 04010201910:51 AM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00 d
ShrmrWrrhar
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