1909 S Mealy St RERF19-0074 Shingle Reroof REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0074
800 SEMINOLE ROAD ISSUED: 5/22/2019
105 ATLANTIC BEACH, FIL 32233 EXPIRES: 11/1812019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
shingle re-roof FL18355.1 $4810.00
1909 S MEALY ST REROOF SHINGLE FL15216
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1723540000 LEWIS S/D
COMPANY: ADDRESS: CITY: STATE: ZIP:
JACKSONVILLE ROOFING 10702 HOOD RD. #5 JACKSONVILLE FL 32257
USA UIEC
OWNER: ADDRESS: CITY: STATE: ZI P:
WILLIAMSON ANN MARIE C/O ANN MARIE WILLIAMSON JACKSONVILLE FL 32241-7141
TRUST TRUSTEE
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
BUILDING PERMIT 0 $75 00
STATE DSPR SURCHARGE 2 52 W
STATE DCA SURCHARGE 455��-208-0600 c 52 X
TOTAL:$79.00
issued Date:5/22/2029 1 of 2
Mr-ut1vtU
Building Permit Application el-
City of Atlantic Beach Building Department MAY 22 -2910INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept0coaKus Building DeparIVI Alil
I
JobAddress: Jqnq lk,� Ij 54 je,,497Mt EXPI'Atlantic Beach, FIL
Legal Descriptionazy- 2,2 LL-J-5 S44'w'an RE# 1-7-1101-occlp
valuation of Work(Replacement Cost)$ �6 1/0 Heated/CooledSF 703 Non-Heated/Cooled
• ClassofWork: ONew DAddition DAIteration w6pair DMove 0Demo []Pool 0WIndow/Door
• Use of existing/proposed structure(s): OCommercial Diliee'sidential
• If an existing structure,is a fire sprinkler system Installed?: OYes 211�0
• Will treeW be removed in association with Pronosed Droiect?Dyes imust submit separate Tree Removal Permiti 54.-
Pescribe In detail the type of work to be performed: Kc 900� K mto V,nJ old Iwo' Ja
IASkll Afv ill — � vt'�� I
Florida Product Approval# i for multiple products use product approval form
ProoertviOwner.information
Name-Ada In f, IIII'lliki'll SOA Address
City_ ..,Yle State a, Zip WJ Y!J P
j4r it So, hone 74:7—47q 7
E-Mail--sLipe A.3 Z111 1; zfz�7 -
Owner or Agent Cif-Agent,Power of Attorney or Agency Letter Required)
Contractor Informiat on
NameofCompany -Yack�mlf!Ar 115ALLe- Qualifying Ag
Address IV 70.1- IkInd 9d 5. VZ*5 0
Office Phone-�a
State Certification/Registration# CCC 113 1,$U E-Mail ;e
Architect Name&Phone#
Engineer's Name&Phone#
Application is hereby made to obtain a permit to do the work and installat ions as indicated.I certify that no
Workers Compensation Insurer. :]�n LLrarq�o OR Exempt�. E.pla�t=D.te
siallatloWhas
work or in
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 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 LENDER OR AN ATTORNEY BEFORE
jn:�_NG�YOUR TM=ENCEMENT.
(Signature of Owner or Agent) 1)Xgnafure of Contractor)
Si4nfd and sworn to(or affirmed)before me this Signed and sworn to(or affirmed)before me this nA-fs`%
day of day of
Adak- joll y
WILINS
MYCOM 11 ION 0 .2 MY T SCOTT RAWLINS
GGos&2 2
T 0
10'2'
1 lop sopany Known E IRIE D�ber27.2020 1'<rsonally Known OR EX IRE MISSION#GG058242
S D�IK,27 M20
P'.duced'dentification Produced Identificati
Type of Identification: Type of Identification:
Doc # 2019117777, OR BK 18798 Page 1552, Number Pages: 1,
Recorded 05/21/2019 09:53 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
State of FLORIDA Tax Folio No.
County of DUVAL
To Whom It May Concern:
The undersigned hereby Informs you that improvements will be made to certain real Property,and In accordance with Section 713
Of the Florida Statutes,the following information Is stated In this NOTICE OF COMMENCEMENT.
Legal Description of Property being lnnpmrvedl�
24-92 17-28-29E LEWIS SUBDIVISION 8 11 FT LOT 2.14 29FT LOT 3,S 4OFT OF N 169FT OF E SPY L07 5 BL
Address of property being Improved: Islas MEALY ST fiectic Beach FL 2U?133
General description of Improvements: RE-ROOF
Ow,U: WILUMSON ANIN MAVUE Address: 8483 BERESPORD UN JACKSONVIULE,M 3Zull-7141
Owner's interest in site ofthe Improvement; 01MIER
Fee Simple Titleholder(if other than owner):
Name:
Contractor:
Address: 10702 HOOD ROAD SOUTH SUITE#5 UACKSONVILLE,FL 32267
Telephone No.: 01114)�iw? Fax No:
Surety(Nany)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any persort 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 Tacluve a Copy Of the Lienor's Notice as provided In Section
713.06(2)(b),Florida Statues. (Fill In at Owner's opticn�
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 cliflenent date I
specified):
THIS SPACE FOR RECORDER!S USE ONLY OWNER
Signex:
Selore
at is day.f
m In the County of Duvel,state
Of Florida,han Pank-altY appeared San A
Notary Publk::a Large,State odf Flould CounyufDu
My commission expires;
Personally crown
Produced Identification:," I)L
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