123 Pine St RERF19-0113 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0113
800 SEMINOLE ROAD
ISSUED: 8/26/2019
~��;���,r EXPIRES: 2/22/2020
ATLANTIC BEACH. FL 32233
MUST CALL • i • i + + BY / PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT ISTH EDITION1 OF • '
CODE, ' OF • OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READCAREFULLY.
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:
123 PINE ST REROOF SHINGLE SHINGLE ROOF $5150.00
TYPE OF
• • GROUP:
170636 0108 SALTAIR SEC 03
COMPANY: EfT
ADDRESS: '
SUNRISE ROOFING 762 7TH AVE S JACKSONVILLE FL 32250
COMPANY
• ADDRESS:
GARRETT KAREN S 123 PINE ST ATLANTIC BEACH FL 32233-4011
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 455-0000-322-1000 0 $80.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
TOTAL: $84.00
Issued Date: 8/26/2019 1 of 2
',-- Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 Q
Job Address: 123 PINE STREET,ATLANTIC BEACH, FL 32233 Permit Number:
Legal Description 10-16 21-2S-29E.057 SALTAIR SEC 3 N1/2 LOT 682 RE# 170636-0108
Valuation of Work(Replacement Cost)*15,150.OzHeated/Cooled SF 1824 Non-Heated/Cooled 443
• Class of Work(Circle one): New Addition Alteratio Rep A�M ove De o Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Reside 'a
If an existing structure,is a fire sprinkler system installed?(Circle one): Y No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: RE ROOF WITH OWENS CORNING DURATION ARCHITECTURAL SHINGLES AND
RHINO SYNTHETIC UNDERLAYMENT
Florida Product Approval#FL10674-R13 SHINGLES,#FL15216 RHINO UNDERLAYMENT for multiple products use product approval
�Vfterty Owner Information
Name:KAREN GARRETT Address: 123 PINE ST.,ATLANTIC BEACH, FL 32233
City:ATLANTIC BEACH State: FL Zip:32233 Phone:904-�j3+-i" r15J
E-Mail:karen-garrett@comcast.net
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company:SUNRISE ROOFING COMPANY Qualifying Agent:TRAVIS BERKEY
Address:762 7TH AVE.SOUTH City:JACKSONVILLE BEACH State: FL Zip:32250
Office Phone 904-323-1929 Job Site/Contact Number:TRAVIS BERKEY 904-495-1835
State Certification/Registration#CCC1331238 E-Mail:LESLEY@SUNRISEROOFS.COM
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation: EXEMPT
Exempt/Insurer/Lease Employees/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 regulationg
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
RECORDI G YOUR NO ICE OF COMMENCEMENT.
(Signature of Owner or Agent) (Signature Contractor)
(including contractor) ^�
Signed and sworn to(or affirmed)before me this It r'-'day ofAUG Agned and sworn to or affir kedbefore me thisZ c day oZo% R ,by Kwc>-m C-�Quc--jT , byV F
KIMBERLY STAN i nature of Notary) ur )
Commission# FF 921664 TONIGINDLESPERGER
- - M mi i Expires [z �;`-:(:'
r x' " CSO s p f #FF 925951
er iia `�noxn [ ]der§oral . "
,ober 6,2019
e b9 2019 [ Produced ldgattfic �gc e rte /� ?
Type of Identification:.
Doc # 2019193119, OR BK 18903 Page 2045, Number Pages: 1,
Recorded 08/19/2019 02:57 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No. 170636-0108_
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: 10-16 21-2S-29E.057 SALTAIR SEC 3 N1/2 LOT 682 _
Address of property being improved: 123 PINE STREET,ATLANTIC BEACH,FL 32233_
General description of improvements: RE-ROOF
Owner KAREN GARRETT Address: 123 PINE 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,TRAVIS BERKEY
Address:762 7TH AVE.SOUTH,JACKSONVILLE BEACH,FL 3250
Telephone No.:_904495-t 835 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 Lienors 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 Cotnmencemen he expiration date is one(1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECO ER' USE ONLY OWNER
Signed: Datc: Q,• tip,, t�
Before me this 1(+,' day of Rt,p r; r in the County of Duval,State
Of Florida,has personally appcared ju_\aEtJ Gtgtajar=rs
Notmy Public at Large,State of Florida,County of Duval.
My commission expires: 9 2-L4 • n
Personally Known: X, or
Produced Identification:
KIMBERLY STANTIAL
Commission N FF 921664
3
My Commission Expires
*tib;
9.,;10 September 24, 2019