775 Sabalo Dr RERF19-0150 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0150
\' ►�: �� 800 SEMINOLE ROAD ISSUED: 10/29/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 4/26/2020
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:
775 SABALO DR REROOF SHINGLE SHINGLE ROOF $8400.00
TYPE OF REAL ESTATE 1 ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171304 0000 ROYAL PALMS UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
ROOF IT RIGHT LLC 2175 KINGSLEY AVE SUITE 207 ORANGE PARK FL 32073
OWNER: ADDRESS: CITY: STATE: ZIP;
HITE JEFFREY ET AL 775 SABALO DR ATLANTIC BEACH FL 3223
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 $95.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $99.00
Issued Date: 10/29/2019 1 of 1
RECEIVED
OCT 25 2019
Building Permit Application Building Department
City of Atlantic Beach City of Atlantic, Beach, FL
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 \1 �R�- `0 _0( SO
Job Address: 775 5/-1f�nc0 DKIxtE Permit Number: ' 13GCV$
Legal Description.30.q'-j 17-2C-20E. j2dNAL l-\LMS 1WiT 2- LOT-ci 6LgIl RE# (%J t -/-0 000
Valuation of Work(Replacement Cost)$ r3'100.Co Heated/Cooled SF I Iq(„ Non-Heated/Cooled /3/7
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial (ResideI ntia
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes 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:
IZE Lc-0 sEll/�C-,tis
Florida Product Approval 4 171.I C'I•)-I / P for multiple products use product approval form
Property Owner Information
Name: I AY Lr rL I-1 17 C Address: 775 .SA ,A--p DR!vE
City ATI.-AAJTI I3LACe-I State r L Zip _3,x,).35 Phone
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: I.c-s r, tT I-I-,t,r Qualifying Agent: IJKiAr/ C-snnctzoni
Address 3`-ky CityrAI&Js =. k'K State ) Zip .3ZIC'73
Office Phone CI0,1 5y I I lei l Job Site/Contact Number (icO &No()
State Certification/Registration# CCC I Cl l ip-I E-Mail L)'S o(op(rl r 1cit+-{'I. i Orr,
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation I`r2AAdlu C Ctu\ _
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.
(Sign re of Owner or Agent including Contractor) ,,,/ (Signature of Contractor)
Sign d and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this "-I day of
,by 1,,q c oft I-f, , ?O/'i ,by &IAP/ CAmL-X-ON
tt�« l LCftctC L j na LI U k�
(Signature of Notary) (Signature of Notary)
DANA WHITELAW
'� `F,.. .`Commission 0 GG 241011
Expires July 21
[ ]Personally Known OR f•-t Personally Known OR ��;1��;,,,i' 0, n,.0 Troy Fain 2022
Personally •,
1,1-Produced Identification [ I Produced Identification
Type of Identification: Ct Cc Type of Identification:
�•wDANAWHITELAW
Commission#GG 241011
y`o;
Expires July yFintrln2
.,,,• OanhPIN, Troy Fain wrancc ate J85-1019
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of FLI pi\ County of Li Ai.
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:
'30-(-11-1 1 1 2-5 -- 2c1g; ROYAL PAL AS LLJiT 2
LCT () 13L� CI
Address of property being improved:
17'3 SAI3tu- 1-LRIv;t A i'LAyvi1C .BOFCfl FL 371-33
General description of improvements:
kCRcCF �F1In CI1
Owner TAYtTc
Address '7'75 SAeALo DRIv'E ATLA,JT1C BEp -I FL_ .3.0-33
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Roof- IT IZ1c,ui LLC.
Address 3i-Is-1 KA. LvvALLKLc As,.I' LL.G
Phone No. C10L) 5L(I I lc)I Fax No. c.5111 I ICi,2
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): 13\'I
THIS SPACE FOR RECORDER'S USE ONLY
Signed: ^ '` DATE LE11141
Before me this ,2, day of Cc/CC'c. . _ in the
Doc#2019246005.OR BK 13979 Page 1796 County of Duval.State of Florida,has personally appeared
rt_ herein by
Number Pages. I himself/herself and affirms tha
Recorded 1024/2019 01.55 PM. are true and accurate
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL '•"y,. DANAIYHITELAW
COUNTY Commission#GG 241011
RECORDING S10.00 Expires July 23,2022
y� Bonded Nu Troy rain Insurance B00J85.7019
Notary Public at Large.State of /:••/__ . County of C_-/L V
My commission expires. 7.1d,.3C,�J_
Personally Known or
Produced Identification , e-L cGn,ac