117 Ardella Rd RERF19-0123 ShingleREROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0123
800 SEMINOLE ROAD ISSUED: 9/6/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 3/4/2020
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.
10B ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
117 ARDELLA RD REROOF SHINGLE SHINGLE ROOF $7749.00
172153 0000 DONNERS S/D PT LOT 2
17-
• ADDRESS:
PREFERRED ROOFING LLC 2332 DUNN AVENUE JACKSONVILLE FL 32218
• ADDRESS:
REED MICHELLE GLORIA 117 ARDELLA RD ATLANTIC BEACH FL 32233-4352
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.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
TOTAL: _$94.00
Issued Date: 9/6/2019 1 of 2
DESCRIPTION
ACCOUNT
QUANTITY
PAID AMOUNT
BUILDING PERMIT
455-0000-322-1000
0
$90.00
STATE DBPR SURCHARGE
455-0000-208-0700
0
$2.00
STATE DCA SURCHARGE
455-0000-208-0600
0
$2.00
TOTAL: _$94.00
Issued Date: 9/6/2019 1 of 2
Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
Phnnp: (904) 247-5826 Fax: (904) 247-5845
Job Address: k I T Elfdej Ia PJ A4Z 4 ' to
eL 32fL33 Permit Number:
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Legal Description ✓0i�1Q l�_S ►�P��� P Ra( -CQ] r A-eCd RE# 171 -D ID 0 0
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Valuation of Work (Replacement Cost) $ �� ) 3 , HeatedyCooled SF _Non Heated/Cooled l 2
• Class of Work (Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): Commercial esidential
• If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No
• 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: P � rob
5 Ni :�C�L C l�
Florida Product Approval # L F1- I Fbe)la. I e.2 -for multiple products use product approval form
Name: L ,C $ 112 I&V[j Address:
City State �:_ Zip - �P Z5 3 Phone Z
E Mail -i-Oi A -f S /&i �r?" a d'"d Erni /'), h ""S
Owner or Agent (If Agent, Power of Attorney or(Agency Letter Required)
Contractor Information
Name of Company: Pr4 00 -t j-nq Qualifying Agent:
Address_12 wCity �Q State �_ Zip 3
Office Phone C1 6LJ Job Site/Contact Number
State Certification/Registration # CCP l $Z 7g 9 E -Mail + 1 11 ?_S ® (eJe,((e.JQ rbij O •%, 7—
Architect
Architect Name & Phone #
Engineer's Name & Phone # _
Workers Compensation A9>rid9,e leLd C—_y�m]OUerS SL�fghGC %Dyttl�cvtu ) ZOZU
-0 Exept / Insurer / Lease Employees / Expiration Da
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
RECORDING YOUR NOTICE OF COMMENCEMENT.
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(Signature of Owner or Agent)
(Signature of Contractor)
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Signed and swom to (or affir before me this day of<
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Doc # 2019207125, OR BK 18924 Page 369, Number Pages: 1,
----Re-corded 09/09/2019 10:11 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00 '8
NOTICE OF COrylMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. �'✓R 'r ~ O I z3 Tax Folio No. —J-4 N
State of f{1 OV 1 a County of PW ,/ Gel
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. �J Q
Legal description of property being Improved:'-
l�nn l7 _ 2p IQ - Ar Ce I CC
Address of property being Improved:.
General description of Improvements:
Owner L�:-1 wl.1Y 1 Gj Ii 1�
Address E I j cdlaia Q
Owner's Interest ;n site of the Improvement,
Fee Simple Titleholder (f other than owner)
Name
Addrer-
Contractor
Addre:
Phone
Surety (If any),
Address
—
Phone No.
Fox No
of bond
Name and address of any person making a loan for (he construction of the Improvements.
Name
Address
phone No. Fox No.
I
Name of person within the State of Florida,. other than himseir or herself, designated by owner upon whom
notices or other documents may be served:
Name
Phone No. _ Fox No.
In addition to himself of herself, owner designates the following person to receive.a copy of the Lienors Notice as
provided In Sectlon'713.06 (2) (b), Florida Statutes. (Fill in at Owners option).
KI
Address
Phone 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 speclfed): 7
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE.EXPIRATION OF THE NOTICE OF ;A,
COMMENCEMENT ARE CONSIDERED. IMPROPER PAYMENTS UNDER.CHAPTER 713, PART I, SECTION 713.13,°'•'°�
FLORIDA 5TATUTE5; AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. Tr-rD
s
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST «oma
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING _WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT..
THIS SPACE FOR RECORDER'S USE ONLY o NER
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sl,nad:
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f If and-brRans that al efatemtnct and dada
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