1915 Oak Circle RERF19-0141 Shingle ,;51..m.--,,;„ REROOF SHINGLE PERMIT i. PERMIT NUMBER
��. ; CITY OF ATLANTIC BEACH RERF19-0141
�'r ISSUED: 10/17/2019
800 SEMINOLE ROAD
'��-'';1`'" ATLANTIC BEACH. FL 32233 EXPIRES:4/14/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA 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:
1915 OAK CIR REROOF SHINGLE SHINGLE ROOF $20520.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 1250 SELVA MARINA UNIT
12A
COMPANY: ADDRESS: CITY: STATE: ZIP:
TOWNSEND ROOFING & 10418 New Berlin Rd #115 JACKSONVILLE FL 32226
CONSTRUCTIONS SERVICE
OWNER: ADDRESS: CITY: STATE: ZIP:
LEAS MICHAEL R 1915 OAK CIR ATLANTIC BEACH FL 32233-4506
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 455-0000-322-1000 0 $155.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.33
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $159.33
Issued Date: 10/17/2019 1 of 2
C`L`�f REROOF SHINGLE PERMIT PERMIT NUMBER
RERF19-0141
_ CITY OF ATLANTIC BEACH
ISSUED: 10/17/2019
800 SEMINOLE ROAD
' . r EXPIRES:4/14/2020
l
rill.f BEACH. FL 32233
Issued Date: 10/17/2019 2 of 2
(;---.-7-3---N. Building Permit Application Updated5/5/17
1f:: City of Atlantic Beach
800 Seminole Road, Atlantic Beach,R 32233
���;:1>� Phone: (904) 247-5826 Fax: (904)247-5845
f� 5 f, I A c-KF« - 0 L 4 (
lob Address: ' 1 I l�Ll� c,,-,t� Permit Number:
Legal Description '3t.-0 (71-,..5-Z F. 5:a..7.1 Pie V,,;I- 1z-A L- $ el RE# 17?c-Q - /ZSt __
Valuation of Work(Replacement Cost)$ 2-0i 5 20 Q% 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 esidenti
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes t/ 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: pycr..c, 0,e...c, rt c c vnz✓t — s, \i
6m `I r(; N � & .TyQr Pa�J uj, rItivmer, f rL / syi7
Florida Product Approval# 1 01 Z`i for multiple products use product approval Corm
Property Owner information
Name: /11 i -_,l,.i.-et L_ZhS Address: I1 15 Oak C.r-(.:it_
City ,4+ ( ..}ic_ e0.ich state [-L- up 7_233 enone 90-i-556-it to
E-Mail ry e 1 f,s her fo.,5z7. c Owl
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required)
Contractor information
Name of Company: tgetjt+•A! Fvs"�; r L�+y#f+4c-''�n 4..,,n,..4
Agent: . ,/ Trwoiti.J
Address IN l4 he.) Alin Rd -ii5 ___City 'TA C State Ft- Zip 322.2
Office Phone ID'i- V15-057 Job Site/Contact Number 'W1- '1 2-- 4 Y71
State Certification/Registration# Cil-13Z Z- E-Mail t.-1N r it 43 '1ts,er,J j-oo 47...:-A.,), c a,✓l
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Jcr fort fN).hiss St-I,,.},' S Ia/3iIll
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 uric 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 or Agent) L----------(Signature of . .-,13711P-
(including
r(including contractor) (1 • •rh
Signed and sworn to(or affirmed)before me this 7 day of Signed and sworn to(or a.. )before : s _ ,.y of
0 ( l11vU/, 2i(ila ,by ,4); :,I^1eI L-. -,, L: it - , 7-- 1/ 2 /----. r , ,,N-oi .,e.
57------/1 /lr f%
nature of Notary) ��
( 1 ,. ignature of Notary)
g
e
_.<;.i;.'''••••.. MARTIN ARELLANO
jd`!'a:.P�'a<<, CHRIS TOWNSEND .: NotaryPublic-StateofFlorida
•r * Commission#GG 183366 • '' _ Commission•GG 102031
Personally Known OR : „� (X Personally Known OR `a3 ^ My corm Expires May 10,2021
Expires March 25,2022 °":•.' do ANl*ro pmcn>mrrAsv�.
Produced Identification '�F P P [ ]Produced Identification - u4r
I I oFF0) Bonded ThruBudget Notary Sendai Typeof Identification:
Type of Identification:
Doc # 2019231704 , OR BK 18959 Page 916, Number Pages: 1,
Recorded 10/08/2019 10:21 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 172020-1250
State of Florida County of Duni
To whom It may concern:
The undersigned hereby informs you that Improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:36-64 09-2S-29E SELVA MARINA UNIT 12-A LOT 9
Address of property being improved: 1915 OAK CIR. Atlantic Beach, FL 32233
General description of improvements:Roof Replacement
Owner LEAS, MICHAEL&GALE
Address 1915 OAK CIR.Atlantic Beach,FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Townsend Roofing and Construction Services,Inc.
Address 10418 New Berlin Rd#115 Jacksonville,FL 37776
Phone No.9°4-645-5887 Fax No.904-545-5442
Surety(if any)
Address Amount of bond$
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
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 specified):
THIS SPACE FOR RECORDER'S USE ONLY (Ati/� le ER f 7
Signed: • DATE eV[. tA5L
Before me this '4 day of %C.1-0.42 in tl
County of Duval.Stale of Florida.has personally appeared
/t�' hacI Lr1af herein by
Himself!herself and affirms that 1� rents ander 1pfdtY,t}�,piart•R1a
are hue and accurate 4-6%""..(E` nnw rwnwClt ` //
;1M} * Commission#GG 183366 ! I'
0 '17 4c Expires March 25,2022
"'poi f,Js* goaded nvu Budget Notary Sam ae
Notary Public at Large.State of Sr-L . Coutly of C, 'v.
My commission expires: '3I7 s 1 L Z
Personally Known X. of
Produced Identification