1285 Main St RERF19-0098 re-roof permit REROOF SHINGLE PERMIT PERMIT NUMBER
r sr� RERF19-0098
CITY OF ATLANTIC BEACH
v~ 800 SEMINOLE ROAD ISSUED: 7/16/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 1/12/2020
MUST CALL INSPECTION PHONE •0. . . PM FOR . INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT • 1 OF i
CODE, OF ATLANTIC •DOF ORDINANCES .
ALL CONDITIONS OF PERMIT , . • PLEASE . , , 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:
1285 MAIN ST REROOF SHINGLE shingle re-roof FL10124-R20 $8750.00
& FL15216
TYPE OF
ZONING: :D •
• • GROUP:
171053 0040 ATLANTIC BEACH SEC H
• ADDRESS: ZIP:
FLORIDA ROOFING 4320 DEERWOOD LAKE PARKWAY
JACKSONVILLE FL 32216
EXPERTS 1001-403
• 1�,� ADDRESS: likes
NOTTINGHAM MEGAN 1285 MAIN ST ATLANTIC BEACH FL 32233
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 • i
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 45S-0000-322-1000 0 $95.00
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$99.00
Issued Date: 7/16/2019 1 of 2
REROOF SHINGLE PERMIT PERMIT NUMBER
RERF19-0098
CITY OF ATLANTIC BEACH ISSUED: 7/16/2019
800 SEMINOLE ROAD
'"—will ATLANTIC BEACH, FL 32233 EXPIRES: 1/12/2020
Issued Date: 7/16/2019 2 of 2
BUILDING PERMIT APPLIC.'T7flN
CITY OF ATLANTIC BEAT
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 105 Rt,,-n 5t-, , a�Permit Number: �F '0 y7
Legal Description Z-EL 2 Lour 5 l31x 22-1 Parcel#
1~ oor Area o q. t. �'t
Valuation of Work$ -1 eb O Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s) (circle one): Commercial esidential
If an existing structure,is afire s rinkler system installed? (Circle one o N/A
Florida Product Approval # 12'-k - .Ft, ►`j� 1 �For multiple multiple products use product approval form �7 J
Describe in detail the type of work to be performed: 1�P ronc - , Xsf?a)
Property Owner Information:
Name: Q �v\ JAM Address: I a$5 M ash. 5A
City / -1 tx'1'1'f G t�P� I� State dip A33 Phone 7 �f 3
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Qualifying Agent: �C'O►V�� S` � '
Address: City _'�-e-ILV--bWvi 112 State Zip 16M\Co
Office Phone nCa ) Sl_%-Lo M LO Job Site/Contact Number j fc�y1J Fax
State Certification/Registration# CLL1'3'Z�109-1
Architect Name &Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6j months, or if construction or work is suspended or abandoned for a period of six(6j months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
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 RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereby cert that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type o/ work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local!aw regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
ezE
Print Name f 1,r�11.. ... S.�.I........V.�Y
.... ...................... �' '�..... Print Name ►..................
Sworn to and subscrib d before me Sworn to and subscribed before me
this L'VDay of J✓r2 20 /1 this Day of 1 U 20 19
Notary Pu �c -
P'I MART P LILES JR FA NEA
_State of Florida-Notary Public f PaY"gym
, V my COMMISSION#GG229074 Revised 01.26.10
+= Commission # GG 2022002, ;
=�+ eF My Commission Expires w� EXPIRES:JUN 14,2022
''�n,,;°�� April 01, 2022 '-w?�a Bonded through 1st State Insurance
Doc # 2019162178, OR BK 18860 Page 1762, Number Pages: 1,
Recorded 07/11/2019 11 :39 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
�-'NOTICE OF COMMENCEMLNT
State of �L- Tax Folio No.
County of Ud il(0
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: f*—L A �-\� L Se�•��,
Address of property being improved: O.L
General description of improvements: '�,e rnnP 3
Owner: MeA&K E J V1 ho gko,4^ Address: );S5 A I Oar ,St. f lan h G {FG-3. 33
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: P 'F�ca2c~
Address:
Telephone No.:No )32g–(/14(D Fax No
Surety(if any)
Address: Amount of Bond$
Telephone 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,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 receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
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 different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
.y� 3t Signed: Date:
Before me this y Q in the Cour of val.State
M Florida,has personally appeared '—
Notary Public at Large,State of Florida,Coutify of 13ruval.
My commission expires:
MARTIN P LILES JR Personally Known: or
State of Florida-Notary Public
Produced ldentificarion:
•` Commission#r GG 202200
u, ,rt My COrnMiaalon Expires
April 91.2021