373 6th St RERF19-0143 Shingle „-,s-->>�r,,, REROOF SHINGLE PERMIT PERMIT NUMBER
J1 t
CITY OF ATLANTIC BEACH RERF19-0143
” ISSUED: 10/31/2019
1.74...91111P-;)
ir 800 SEMINOLE ROAD EXPIRES: 4/28/2020
vJ'i" ATLANTIC BEACH. FL 32233
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:
373 6TH ST REROOF SHINGLE shingle re roof FL15487 & $6920.00
FL10124
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169904 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
TOWNSEND ROOFING & 10418 New Berlin Rd #115 JACKSONVILLE FL 32226
CONSTRUCTIONS SERVICE
OWNER: ADDRESS: CITY: STATE: ZIP:
BARKS BRENDA KAY 373 6TH ST ATLANTIC BEACH FL 32233
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.
i
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $85.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $89.00
Issued Date: 10/31/2019 1 of 2
' Ii, REROOF SHINGLE PERMIT PERMIT NUMBER
`=' RERF19-0143
-411171�� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 10/31/2019
1 9 ATLANTIC BEACH. FL 32233 EXPIRES: 4/28/2020
Issued Date: 10/31/2019 2 of 2
J %�_.,f ll
Building Permit Application Updated5/s�
fCity•
_;,_ -,.
of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
=`d Phone:(904)247-582.6 Fax: (904)247-5845
Job Address: '3 7 3 e k 51" Permit Number; (2-Ft 4-0 1 (l 3
Legal Description15-0 IL-ZS Z1I /}HAta4i, f k•-c(t IN".SFT IAA-3c; 1 4‘fT 64.3• Y11= $ RE# I 01 O9— oak.1
Valuation of Work(Replacement Cost)$mel Z•U y _-_-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): CommercialfEesidert(ial
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes fo 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: j.,,,,,Ji gce. 1 Re Ir.c µ,re'1
%•
''-i Ti,NIxrI•nY 1'1}1•1
6A I" /yr_RAI,.., U:1r ;:ley/vcu,1-1i r-L 15 1$7
Florida Product Approval M i 012-1 _ ,_for multiple products use product approval form
Property Owner InformationpI�)k �
Name: ,'"2' PiI r L5 Address: 5-ii.
City .1q... - (jen4 _State FL Zip ' .Z33 Phone '7011—$.3$ - q q 4&4
E-Mail ins%r�S�f+rcvc /�.LA t•'• Aol. Ctfy^+
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Informationvv.:. �!
Name of Company: —It J?i5ced i cif:tei 7' C 1.5tr�.Ne" Qualifying Agent: ,)A-'17cL✓ ,S.;'J1 _ __
Address JP-1 I L Ne.- i.e.I:r gid 44"IIS _City -%c•,‘ State FL. ttZip 31ZZE
Office Phone ley- L'15-Ss37 Job Site/Contact Number 'I'C-i- 4 72-- `fLe7`)
State Certification/Registration# Cu.-13160m E-Mail L-1s e-i It.w�+>,h d C-6 0 (�•h1. 4.,..-4
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Iii.:k t•-- wyhas' Sc'►1';c•+5 12i CI/al
Exempt J insurer/Lease Employees/Expiration Date l c a
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify thCtno work r ids t� h
commenced prior to the issuance of a permit and that all work will be performed to meet the standar of.altihe • io
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 comini Ietlt.e"Pith a112019
applicable laws regulating cnnctruction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCE�}M�{E,�NT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE TYNP'"f480 Qilhar'lent
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORN I4E9antic r-.: ach, FL
RECORDING YOUR N•TICE * COMMENCEMENT. --- ------2
(Signature of Owner or Agent) (-- (Signature of Cont •c .
(including contractor) 4— Fs
Sign d and swor (Qc affirmed)beforeme this i day of Signed and sworn to(dor aa'gme.)betore -• y of
C laQ ,c90/7,by rel et. (es, — _cl,, t, GV " ' }, 1,,,...,„... :-
.
i - ,1I Oal-/Uk_ it I - -
(Signature of Notary) 011 tgnature of Notary)
W— — — a— — —I — — •• •f / MARSIN .tELLAND
;'+' :4.., JANE MARION RAINER `s�� •iNC'xy pud;c S ate ei no•:da
" WW RINK:-Slate of Florida
` • .' Y ) a. •; CCTn�iSfAn r GG 101031
/14 Personally Known 0 •; :fit,,1• • CornrniscuN St GG 159866 ` [>Personally Known OR 't,�; My comm trans may lc.?Ott
; MyCoe'rn EauaesNnv'3 t1'lAw, •::?•-.
( )Produced Identificat�sro ( 1 Produced identification I e«vr•Itm•y�►+v wlaunAw
Type of Identification: _ Type of Identification:
Doc # 2019242080, OR BK 18974 Page 1237, Number Pages : 1 ,
Recorded 10/21/2019 10:50 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
(PREPARE N DUPLICATE)
Permit No. Tax Folio No.169904-0000
State of non* County of OtAat
To whom It may concern.
The undersigned hereby informs you that improvements will be made to certain real property,and In
accordance with Section 713 of the Fturida Statutes,the following Information Is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:5-69 16-2S-29E ATLANTIC BEACH W 25FT LOT 30,
E 40FT LOT 32 BLK a
Address of property being Improved.373 6TH ST.Atlantic Beach,FL 32233
General description of improvements. Roof Replacement
Owner Barks,Brenda _
Address 5Rf 34thAve South.Jacksonville Beach, FL 32250
Owner's interest in site of the improvement
Fee Sirnpie Titleholder(if other than owner)
Name
Address
Contractor Townsend Roofing and Construction Services,Inc.
Address 10418 New Berlin Rd#115 Jacksonville,FL 32.226
Phone No.M845 7 Fax No.904"645-5442
Surety(if any) _
Address _Amount of bond$. - __ __-
Phone
__—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 herset owner designates the following person to receive a copy of the Lienors Notice as
provided in Section 713.06(2)(0),Florida Statutes.(Fit in at Owner's option).
Name
Address
Phone No._ Fax No.
Expiration date of Notice of Commencement(the expirat%on date i5 one(1)year from the dale of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY i OWi--
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�TE !c t"( 1
IBeta� •. - • nrait f — h Sit
ttn-ile(.,
Sok_ F�jrle.has personally app ral_ I0
himself;hemelf end alarms thai all statemen"s ani onperrpri th reln JANF MARION RAINER I
are hue and accurate t"`' Nalaty Public-Stale of Ronda
r i `'•. � Commission#GG 159866
01-14-6.
��j � -.a at4 ,M Comm.Expires Nov 13.2921 )
Cp�n `•"!!!.1,,‘,".!.:1 aonded puoyll Natuna Nahnry tit,
11±671
1 Notary rubric at Large.sj^_or o)C7 a°
hwnr1 , a,
Produced Identification