44 5th St RERF19-0112 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
RERF19-0112
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 8/26/2019
D '19 ATLANTIC BEACH. FL 32233 EXPIRES: 2/22/2020
MUST + LL INSPECTION • • • 1 BY 4 PM FORDAY • •
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' ! + BUILDING
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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
44 5TH ST REROOF SHINGLE SHINGLE ROOF $24590.00
TYPE OF
ZONING: :D •
i • GROUP:
170160 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
SUNRISE ROOFING 762 7TH AVE S JACKSONVILLE FL 32250
COMPANY
• ADDRESS:
TRUST HOWELL DONALD 44 5TH ST ATLANTIC BEACH FL 32233-5308
WILLARD ET AL
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 . •
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 $175.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.63
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
TOTAL: $179.63
Issued Date: 8/26/2019 1 of 2
rs'��''� Building Permit Application
} •9r� Updated 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
J
v 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: !ki 5YnSt , A 116,41h( J0 F L �>Z.Z;77S Permit Number: R C`�cP�F- �� on Z
Legal Description 5 '{o q ►(, ZS- q Z, 3 q<� Aj Lfi Nj�C ACN N IIZ LOTS ARE#� Q 1-10 I'(,,,C - 00o 0
Valuation of Work(Replacement Cost)$ 2 141, 59 0,000 Heated/Cooled SF 3 5(P I Non-Heated/Cooled 13(o �)
• Class of Work: ❑New ❑Addition *Iteration ❑Repair ❑Move ❑Demo []Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial Residential
• If an existing structure, is a fire sprinkler system installed?: XYes ❑No
• Will trees be removed in association with Proposed Pro'ec ? ❑Yes must submit separate Tree Removal Permit No
Describe in detail the type of work to be performed:
Sk%.-1 J l e ,ro CA-
1
Florida Product Approval# r �'-�-(�t ?j for multiple products use product approval form
Property Owner Information
Name u I E A G O W C-LL Address �5+`" Stv-t Q 'I—
City ✓� \ Q G i^ State L Zip �Z�i;�_Phone �'C�—�Z3 - 11 Z q
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company ac7 �inC„ CL• Qualifying Agent 7yay I S 15Pr-Lk k4
Address +Y-Ve . City t%6 1- Pe ar.l\ State .17L- Zip
Office Phone q () - L - 1 Ct�)-C1 Job Site Contact Number C1 0 t4 -LffGi S�-l8 J<;
State Certification/Registration# C C L 1 ?' E-Mail_ J S I� (� 5 Lthn<-e
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 PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC RDING Y UR NOT OF COMMENCEMENT. 7 -
Signature of O ne or en
� (Signature of Contractor)
jn�ed a d s orn to(or affir before me thisl ay of ned and sworn to(or affir ' d)b e m this day of
���,b v AR IGEY
eo
C nthia Young
Y P Y 9j , 1UNI u'N)LESPERGER
o'.� Gee Notary Public MY COMMISSION*FF 9249
[ ]Personally o ° [ J P ovally Known OR `` EXPIG:October 6,2019
State of Florida ;lic Underxriters
[Produced tific roduced Identification
ype of Ident is roa, fission Expires 10/0512020 Type of Identification: 0-C\V':y\ SO
Commission No.36480
Doc # 2019190055, OR BK 18899 Page 1908, Number Pages : 1 ,
Recorded 08/15/2019 08:42 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
State of FLORIDA
Tax Folio No. 170160-0000
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 improved: 5-69 16-2S-29E.394 ATLANTIC BEACH N1/2 LOT 5,LOT 6 BLK 21
Address of property being improved: 44 5TH STREET.ATLANTIC BEACH,FL 32233
General description of improvements: RE-ROOF
Owner: JULE ANNE JOHNSTON qyJ i�(1 Address:44 5TH STREET,ATLANTIC BEACH,FL 32233
Owner's interest in site of the improvement: OWNER
Fee Simple Titleholder(if other than owner):
Name:
Contractor: SUNRISE ROOFING COMPANY
Address: 762 7TH AVE.S_,ATLANTIC BEACH,FL 32233
Telephone No.: (904)495-1835 Fax No:
Surety(if any)
Address: Amount of Bond S
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): Q
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signe - Date• J � _
Before me this day f i the County of Duval State
Of Florida,has personally appeared i
Notary Public at Large,State o Flo Co my of uvaAy p wylmllcl IVU
ng
My commission expire ,B. NOf3fy Public
Personally Knownto 0 Fieflda
Produced Identification .a 10/05/2020 5/2020
Commission No.36480