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1810 N Sherry Dr RERF19-0124 PERMIT NUMBER REROOF SHINGLE PERMIT r 1) CITY OF ATLANTIC BEACH RERF19-0124 V~ 800 SEMINOLE ROAD ISSUED: 9/11/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 3/9/2020 MUST CALL INSPECTION • •NE LINE (904) 247-581. BY 4 PM FOR . INSPECTION. ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + BUILDING CODE, OF ATLANTIC BEACH • OF ORDINANCES . ALL • • 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK: 1810 N SHERRY DR REROOF SHINGLE SHINGLE ROOF $12994.00 TYPE OF • • GROUP: 172020 0778 SELVA MARINA UNIT 10B COMPANY: ADDRESS: JACK C. WILSON ROOFING 4522 ST AUGUSTINE RD JACKSONVILLE FL 32207 CO. • ADDRESS: LESESNE GAYLE 1810 SHERRY DR N ATLANTIC BEACH FL 32233-4517 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 45S-0000-322-1000 0 $115.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 4S5-0000-208-0600 0 $2.00 TOTAL: $119.00 Issued Date: 9/11/2019 1 of 2 Building Permit Application City of Atlantic Beach 800 Seminole Road, Atlantic Beach, FL 32233 ;�ss> Phone: (904) 247-5826 Fax: (904) 247-5845 Job Address: lo �yAf V� '` < Permit Number: Legal Description �� c_�_7�,.� C. J�v�`- lvt �J� � "17 RE# ' Valuation of Work(Replacement Cost $- Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move e�,o Pool Window/Door C�B•.,(O-T— • Use of existing/proposed structure(s) (Circle one): Commercial Residential If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No /N A.� • C . ._ • 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: Florida Product Approval# `I,l for multiple products use product approval form ProperPropell Owner Information (vjA�\� 1 s: 4 {� Name: �Q , _ a� .�,\r L. Addres ��l�V City ---t% l State_ zip_ .3,: - ?�Phone 1 :�•. E-Mail `llAX '1;L Q�. `` Cly - — Owner or Agent(If Agent Power of Att rney or Agency Letter Required) Contractor Informatio 'n Name of C m any; ' U v_.1� i� 0 ( ' \�1.� Address Qualifying Agent, Office Phone c'"� c' t9 c. f i\tY \ll State ` ' 'zip b Si /Gofhtact Number State Certification/Registration# E-1y13i1 l) �j" Architect Name& Phone# – _ Engineer's Name&Phone# Workers Compensation t�,r�, _, �� . 'Pr t . •�` 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. 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. (Signature of Owner o Agent includ tra for Si na h ( g ture of Contractor) Signed "arid worn to(or affirm�e ) before me this da of Signe and sworn to(or affirm#Ignatu d bfe this 43 Y 7�arOh h �� "RL, 2 byf t day of (Signature of Notary Notary) tate of Florida re Personally Kr,cvvn OR Personally Known OR yEi n GG 329847 [ j Produce Identification [ ]Produced Identification023 i ype of Identification: Type of Identification: LAST WILL AND TESTAMENT OF AI'LE LESESNE-AJDHINS I, GAYLE LESESNE-ADKINS,a resident of the State of Georgia,Peach County,being of sound mind and disposing memory, do hereby make, publish, and declare this instrument as and for my Last Will and Testament and hereby expressly revoke any and all Wills (excluding Living Wills, if any), Cddicils, and other testamentary dispositions heretofore made by me. ITEM 1 IDENTITY OF TESTATRIX'S FAMILY I declare that I am currently unmarried and have no living children. ITEM 2 DEBTS I direct that all of my debts,my fwieral expenses,and the expenses of administration of my estate be paid out of my estate by my Executor,hereinafter named, as soon after my death as may be practicable. In the event that any property or interest in property or life insurance passing under this Will, by operation of law or otherwise by reason of my death, shall be encumbered by mortgage or lien, it is my intention that such indebtedness shall not be charged to or paid from my estate, but that the devisee, legatee,joint owner taking by survivorship, or beneficiary receiving such property or interest in property shall take it subject to all encumbrances existing at the time of my death. V ITEM 3 REAL PROPERTY (a) I give, bequeath and devise my house located at 1810 North Sherry Drive, Atlantic Beach,Florida,to my brother, Michael Kent Lesesne, in fee simple. (b) Z give,bequeath and devise my house located at 595 Felton Wood Road,Byron,Peach County, Georgia,to my brother,Michael Kent Lesesne, in fee simple. ITEM 4 P+RSONAL PROPERTY (a) I give and bequeath to my brother,-R lti Er3esne,my 2002 BMW X5,in fee simple. f (b) I give and bequeath to my brother, Michael Kent Lesesne,my 1999 Mercedes 430E, in fee simple. (c) stephei.�esesne�.r �ami�-cel. -in-f�e f si i1.t '1ti.Lam' Z- G� � +' (d) I give and bequeath to myfir,R-e �e,my coin collection,in fee simple, (e) I give and bequeath to my niece, Monique Lesesne, all of my jewelry and fur coats, in The simple. , (f) I give and bequeath to my brother, A dr4j,,r my 1990 Jaguar XJS,in fee simple. (g) .All the rest, residue and remainder of my personal property, I give and bequeath to Michael Kent Lesesne, Ronald Lesesne, Austin Lesesne, Christopher Lesesne, Jacques Lesesne, Monique Lesesne, and Andre Lesesne, share and share alike,in fee simple. I--, (h) I hereby vest in my Executor full power and authority to determine what items of property are included in the foregoing description contained in this ITEM. ITEM S STOCKS BONDS MVS INSURANCE ETC. Any stocks, bonds, individual retirement accounts, certificates of deposit, insurance Policies, checking or savings accounts,and all such other accounts which I own or have an interest in which are not otherwise effectively disposed, such as by a beneficiary designation card, shall pass pursuant to the provisions of this my Last Will and Testament and shall be administered by my Executor pursuant to the provisions contained herein. I hereby vest in my Executor full power and authority to determine what objects of property are included in the foregoing description contained in this ITEM. ITEM 6 APPOINTMENT OE EXECUTOR (a) I hereby nominate and appoint my brother, MICHAEL KENT LESESNE,to serve as Executor under this my Last Will and Testament. In the event he is unable to act, I hereby nominate and appoint my niece, MONIQUE LESESNE, to service as alternate Executrix. I hereby confer upon my Executor or alternate power as such to administer my estate, expressly excusing and relieving them from giving any bond or making any return, inventory or appraisement whatsoever, and I expressly confer upon my Executor or alternate full power and authority to sell or dispose of all or any part of my estate,either realty or personality or both,either together or in parcels at either public or private sale, for cash or on terms, as my Executor or alternate in its judgment shall deem proper, without the order of any court and without any advertisement or notice whatsoever. I further authorize and empower my Executor or alternate, as the case may be, to exercise any of those powers enumerated in O.C.G.A. 953-12-261, which are incorporated hereby by reference for all purposes. us believing said Testatrix to be of sound mind and d'i'sposing memory at the date set out above. WUNESSES: Ad residing at 233 Carl Vinson Parkway Warner Robins, Ga 31088 residing at 233 Carl Vinson Parkway Warner Robins, GA 31088 STATE OF GEORGIA. ) COUNTY OF HOUSTON) Before me the undersigned authority, on this day personally appeared GAYLE LESESNE-ADKINS, �7a i� � � G and vY'� �� Qkis ��•1 known to me to be the Testatrix and the witnesses, respectively, whose names are subscribed to the annexed or foregoing instrument in their respective capacities, and all of said persons being by me duly sworn, GAYLE LESESNE-ADKINS, Testatrix, declared to me and to the said witnesses in my presence that said instrument is her Last Will and Testament and that she has willingly made and executed it as her free act and deed for the purposes therein expressed. The witnesses, each on his or her oath, stated to me in the presence and hearing of the Testatrix that the Testatrix had declared to them that the instrurnent is her Last Will and Testament and that she executed same as such and wanted each of them to.sign it as a witness; and upon his or her oath each witness stated further that he or she did sign the same as witness in the presence of the Testatrix and at her request;that she was at that time 14 years of age or over and was of sound mind; and that each of said witnesses was them at least 14 years of age. GAYLE ESES 2E KINS fitness Witness Sworn to and subscribed before me by GA "E LESESNE-ADKINS,Testatrix,and sworn to and subscribed before me by � �J- and �k�s, n _ � ��n. witnesses, this ��- day of 20 O� GB �e YD CLARK =S Notary Public STATE OF GEORGIA my Comm. EXP-3/14116