20 17th St RERF19-0129 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
' RERF19-0129
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ISSUED: 9/17/2019
"--Urii>� ATLANTIC BEACH. FL 32233 EXPIRES: 3/15/2020
MUST + LL INSPECTION PHONE914247-5814 BY 4 PM FOR + INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ BUILDING
CODE, AND OF ATLANTIC BEACH • OF ORDINANCES .
ALL • i OF PERMIT APPLY, +SE 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:
20 17TH ST REROOF SHINGLE SHINGLE ROOF $9300.00
TYPE OF
• • GROUP:
169591 0010 OCEAN GROVE UNIT 01
COMPANY: ADDRESS:
TOWNSEND ROOFING & 10418 New Berlin Rd #115 JACKSONVILLE FL 32226
CONSTRUCTIONS SERVICE
• ADDRESS:
SCHIFANELLA THOMAS J 20 17TH ST ATLANTIC BEACH FL 32233-5810
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.
L — -
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $100.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $104.00
Issued Date:9/17/2019 1 of 2
REROOF SHINGLE PERMIT PERMIT NUMBER
JS •Sd
CITY OF ATLANTIC BEACH RERF19-0129
J yr 800 SEMINOLE ROAD ISSUED: 9/17/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 3/15/2020
Issued Date: 9/17/2019 2 of 2
Building Permit Application Updated 5/5/17
td
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
`•,-:=�11819%'
Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: Gro +� S f` Permit Number: R E RF 1 `3- 01 Z S
25 �y p 2 ('f le 7 c1 0k ilct2-7G ►1l I
Legal Description ii9� � cep^ �i�•x (Jn,� Ne �' Q�4 L.F la,Q.tc a��;K 6,,�3--b� 1 5 ci+- RE# It 5fl' 00 l o
Valuation of Work(Replacement Cost)$ 3` a, Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial idea
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes & 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: F.,o, f
HO �sy 7
Florida Product Approval# (C f 7-`( for multiple products use product approval form
Property Owner Information
Name: 4(- k. �TkTJ^AX Address: Z° I.'t- 5-f
City ark,C.. C_k State fit: Zip -i'Z3; Phone 104 - i,iZ — -7YYL
E-Mail -15c- +cte,1(A P15itieo�zrja"c_ cy . Gprvt
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information J
Name of Company: wnSehGT �otFk'"1 r Cc+x Strv-+'-"A -Qualifying Agent: 1�p§`J
Address 10914 New Rd -44- 115 City _IAx State FL- Zip 3ZZZE
Office Phone 101 - 6'f5-5637 Job Site/Contact Number 121- '177-- '1 Y 71
State Certification/Registration# 641—13-1-E 7,411 E-Mail G�\rp t P ft t 1154-111 J'�O 11rr. c a:✓1
Architect Name& Phone#
Engineer's Name& Phone#
Workers Compensation JJCrti" el,4>;kt55 1(N+r411 51 Z)31 I��
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.
(Signat of Owner or Agent) (Signature of Cont c
(including contractor) /r(A f�
Signed and sworn to(or affirmed) before me this 7�l day of Signed and sworn to(or a e )before, s ay o�
n / 717 , byi•svl s SLS ? na�( <, .fit' {{+ +�r 20'0(
s�AYP11dci -CHRISTOWNSEND
•�...,• n
Commission#GG 163366
* (Signature of Notary) gnature of Notary)
a� Expires March 25,2022
Bonded Thru Budget Notary Services MARTIN ARELLANO
Notary Public-State of Florida
• Commission tGG 102031
Personally Known OR [ Q Personally Known OR My Comm,ExDiresMay10,2021
''�F°FFl-c�? Eor•gled throw F National Notary Assn.
[ ] Produced Identification [ ] Produced Identification e
Type of Identification: Type of Identification:
uvc ff Zuly2u /9b2 , OR BK 18925 Page 1407 , Number Pages : 1 ,
Recorded 09/09/2019 04 :45 PH, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No _ Tax Folio No. 169591-001_0
State of Florltla 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:0"&� oc-rv+GRove UNIT NQ,Pr WT 7 er Lar w 8Fm om BKW93-Q 6LK a ON BK GZWJ161
Address of property being improved:20 17TH ST.Atlantic Beach, FL 32233
General description r>f improvements: Roof Replacement
own,SCHIFANELLA, THOMAS & BETSY
Address 20 17TH ST.Atlantic Beach, FL 32233
O,,vner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Townsend Roofing and Construction Services,Inc.
Address 10418 New Berlin Rd#115 Jacksonville,FL 32226
Phone No.904'8455887 Fax No.904-645-5442
Surety(if any)
Address Amount cf bond S
Phone 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 or herself,designated by owner upon whom
notices or other documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself or herself,owner designates the following person to receive a copy of the Lienor's Notice as
provided in Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
eifferent date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
fht day of_ the
Countyo(o v�..SG of Floritta,hp onally Fpeared
I�L �I t all-h-i 'rte f_l q roan by
hlmadt/herself and affirms Itwt all sta5orrants and dadaratiorri heroin
are true and accurate t�'Y PV CHRIS TOWNSEND
i ��,•�� Commisslcn#GG 183366
. .
�
Expires Mach 25,2072
��BCI ft�P� badfo Tray&AW M-Urr&nkm
Nctary RA;lic al Large,Stare of rf� L County M K
My commission expires: f 1 Lf I LU _
Peraonaiy Known
! Produwd Ident6cahon