486 Aquatic Dr RERF19-0096 Shingle rs''VJr REROOF SHINGLE PERMIT PERMIT NUMBER
r ?; CITY OF ATLANTIC BEACH RERF19-0096
V~ 8ISSUED: 7/15/2019
00 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 1/11/2020
MUST CALL INSPECTION • • • 1 i PM FOR • INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • BUILDING
CODE, AND OF BEACH CODEOF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE
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:
486 AQUATIC DR REROOF SHINGLE SHINGLE ROOF $8500.00
TYPE OF
• • GROUP:
171818 5162 AQUATIC GARDENS
• PANY: ® A. . • '
SKY HIGH ROOFING, LLC 7643 GATE PARKWAY, SUITE #104 JACKSONVILLE FL 32256
• ADDRESS: CITY: STATE: ZIP:
HATCHER KATHERINE 486 AQUATIC DR ATLANTIC BEACH FL 32233
SUZANNE
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 455-0000-322-1000 0 $95.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $99.001
Issued Date: 7/15/2019 1 of 2
Building Permit Application Updated 1019118
r ..., P1 City of Atlantic Beach Building Department "ALL INFORMATION
J r,, 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: L-1 U� P 2,un+l L- -c� V Permit Number: I \ 67R I - 09
Legal Description3,FS r_-2c-) QUO�� t L1D'f�Y G RE#
G o �
valuation of Work(Replacement Cost)$ Heated/Cooled SF _ Non-Heated/Cooled_ T
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial *Residential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes 99No
• Will trees be removed in association with proposed ro'ect? ❑Yes must submit separate Tree Removal Permit NO
Ebe in detail the type of work to be performed: R,E'_ — CD
Florida Product Approval# L for multiple products use product approval form
Property Owner Information �e���
Name Y-I Y11-!E!-5 Address 1--A f�U�1t( _ r
City QTko t'1+U L >` State P( _ Zip 3 2> Phone 8,n
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information I / yy ,,
Name of Company I IN �C Qualifying Agent 0� t KC p G v� ►� / p
Address � S ,E f � 1 S City SG�-G KC 0,101 1':6tate f-- Zip
Office Phone Job Site Contact Number Q G
State Certification/Registration#C-( ' O E-Mail n)k�:4 k l Gh 1'u o�(r)G (--L C.. COM
Architect Name& Phone#
Engineer's Name& Phone# _
Workers Compensation Insurer 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 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 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.
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 P R/TY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER O A Y(BE OR
RECO�R,PINPYOUR O IC FCO NCEMENT. y )
(Signature 6f Owner or Agent) (Signature of Contractor)
Signed and sworn to r affirmed) before me this day of Signed and sworn to(or affirmed) before me this s day of
NAL �� by �rtv (am. .��.��•
SA2tWF@ 8i Ne-1 (Signature of Notary)
w o JAMES S.BARDEN
!z@ 'E� MY COMMISSION#GG135259
[personally Known OR EXPIRES.AUG 16,2021 fir. LUZ ADRIANA SANTAMARIA
[ ] Personally Known OR = MY COMMISSION#GG051019
[ ] Produced IdentificatioOf Bonded through 1st State Insurance [�] Produced Identification =;;.
' EXPIRES April
Type of Identification: Type of Identification: �� ��` 06,2021
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of C71 C-3e-l 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. Q n C
Legal description of property being improved:
Address of property being improved: 14?6
•Vn ' /its 4--,
General description of improvements:
Owner
Owners interest in site o�mprovement (,�-)Wlo _
Fee Simple Titleholder(if other than owner)
Name
Address _
Contractor
Address
Phone No. Fax No.
Surety(if any)
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the imp r vements.
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 or other documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself or herself,owner designates the following person to receive a copy of the Lienor's Notice as
provided in Section 713.06(2)(b), Florida Statutes.(Fill in at Owner's option).
Name
J
Address j
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a a) o
different date is specified): U
".T
M
THIS SPACE FOR RECORDER'S USE ONLY "afFlorld.
w ,USigne °D a,U
Before m thi _ in theCounty f Duvas personally appeared m Ln Of
burn, JAMES S.BARDEN �.�' h r'l �--�✓u/Yl�� herein by Q o-j
r�'` 1 MY COMMISSION#GG135259 himself/herself and affirms that statements and declarations herein O J o
�:� Ci
EXPIRES'AUG 16,2021 are true and accurate Lo N w
u� aNi 2 U) c7
m l z
LL
Notary Pyblic at Large,State f County of n'2 2 z O
My com issto expires: E °z U
Personally own or o M �i O O w
Produced Identification / 0 z of W U of