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285 Main St RERF19-0072 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER J CITY OF ATLANTIC BEACH RERF39-0072 800 SEMINOLE ROAD ISSUED: ATLANTIC BEACH. FL 32233 EXPIRES: MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PIVI FOR NEXT DAY INSPECTION. CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF 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. JOBADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 285 MAIN ST REROOF SHINGLE SHINGLE ROOF $10600.00 TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170868 0000 ATLANTIC BEACH SEC H COMPANY: ADDRESS: Rhino Roofing of 11318 W. Distribution Ave#1 Jacksonville FL 32256 Jacksonville LLC • ADDRESS: ABELLANA DEOGRACIAS L 285 MAIN ST ATLANTIC BEACH FL 32233-2527 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 BUIL DING PERMIT 455-0000-322-1000 0 $10500 0TE eRPR SURCHARGE 4S5-0000208-0700 0 $200 STATE DCA SURCHARGE 455-0000308-0000 0 $2.00 TOTAL:$109.00 Issued Date: 1 of 2 Building Permit Application UPd.1cd1019118 City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone:(904) 247-5826 Email: Building-DeotCcDcoab.u5 IS REQUIRED. Jab Address: 45 '03 -�C 0 7v4. � � — Number: Z Legal Description REN )7 aj69' — 0060 Valuation of Work(Replacement Cost)$ lD GOO Heated/Cooled SF Non-Heated/Cooled • Classof Work: ONew OAddition OAlteration VRpair []MOve ODemo []Pool []WlndOw/Door • Use of existing/proposed structure(s): OCommercial 611esidential � • If an existing structure,is a fire sprinkler system installed?: OYes R<. • Will reeke removed!in associa ion with proposed Oro'ect?OYes(must submit separate Tree Removal Pormitl VI Describe In detail the type of work to be performed: S K(i,- C L� cc11 RG- to of n' 6x J�n g BL la n� Florida Product ApprovalN FL IOZ4 y- for multipleproducts use product approval form Property Owner Informationr Name ]�e�a(iLa)f�(I � Address �-Q5 Mail, AFI " Aa $t - 1. State Pf,_zip 7. 37 Phone o4 — 012 E-Mail rle Ae.Ilu-- I © � .11 f0n.. Owner or Agent(if Agent, Power of Attorney or Agency Letter Required) Contractor Information J1� Name of Company_X�'uts.D Qualifying Agent Address G I city t&Leksar,s,d lit. State�i�Zip 3223] Office Phone- apo-6Nloh Site Contact Number State Certification/Registration N CCC 133117 7 E-MaillL -Lnat2gQ96] [3-n.*,I . COab. Architect Name&Phone N Engineer's Name&Phone N Workers Compensation Insurer (te c Ira _ Str,:.r, OR Exempt O Expiration Date p5 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 ofthis 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 RECOR�jING YOUR NOTICE OF COMMENCEMENT. }} �~ (Signature of Owner or Agent) _14�� nature of Contractor) Signed and sworn to(or affirmed)before me this 15Kday of Signed and sworn to(or affirmed)before rAe this 15+i day of —� Oil ,by - are, T!!If Af' do Alay Mal �by44. I (Signal a of Notary) F (Signa r of Notaryd ) JONN y11UN0 NGIIYEN �/ ( Personally Known * n t JOHN TRW19 N9UYEN �. Notary Pu91k 91a1e dl FlorNa i Personally Known 0R I j Produretl Identifca Commission a FF 912239 I I Produced[dent do '*' +n Notary Publk-Stale of Florida Type of Identification: %N Type of ldentifcadon: ,E Commission/FF 912239 "•,,,,o;n,,+' en m0q 12,2019 BOMadinuph NNlwl Npary Aa•n. "thopll NatloW NNNy Astra. NOTICE OF COMMENCEMENT C qI 1v1-�� (%iFPARE IN WPLICATE) Permit No.R E r I " r o Tax Folio No. State of f wv4 a County of (AVa I To whom It may concem: The undersigned hereby Infomro you that Improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following Inbrmation Is stated In this NOTICE OF COMMENCEMENT. ,,/I Legal tle ripu0n of property being Improved: g _3 N �1 -ZS -2�E Y A§c 1?GcrH Sec N LQL 2 �oF C used R OILD �! LS — R4 17 SLK l0 Address ofproperty being Improved 2- 5 Mti SI' kr--IaL N Rr 1 FL {2233 General description of improvements: Q G Rep F Owner T�_..w.-nm �GOfllufa5 f�)'r'UIGna. Aedress_ ds •iirwiln uci ,Anrlaa.Sic�taA��FL Owners interest f site of the Improvement ahec Fee Simple Titleholder(if other then owner) Name Address COnirettor D Cay,.la^L.Phy\ OF TA Lino .ill! Address Il .I 1i s $I 7a 'k L 7 22' P/ Phone No �90{ 5'W0- 6774 Fax No. Surety(if any) Address at of bond E Phone 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 or herself,designated by owner Upon whom notices orother documents may be served: Name Address Phone No. Fax No. In addition to himsetlor named.owner designates the t011ewl g Person to recehe a copy of the Lienors Notice as provided in Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option). Name Address Phone No, Fax No. Expiration date of Notice of Commencement the expiration data Is one(1)year from the date of recording unless a se different date is specified): $ THIS SPACE FOR RECORDER'S USE ONLY OWNER is S g ftm„ pATE ,I�j aew.me for hale C."Yo a eFbmah. IY•GPwnd "ray Doc#201 9113231.OR SK 18792 Page 2400, www n.n.n amore •feel Swan• ana cue Morsh". E c A Number Pages:I We ve ^ 9 Recorded 05)1&201911:49 AM, A RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY ggeh+i RECORDING E10.00 ryewyP�. .t�>n. ._ b . C•u4v 3 MYwmmlebn exPks: r fat, Pamntll rc n �?r . Ihoauaaydemsunm —