388 4th St RERF19-0160 Shingle ;.11,J-'''�fr;S REROOF SHINGLE PERMIT PERMIT NUMBER
` CITY OF ATLANTIC BEACH RERF19-0160
M ~
ISSUED: 11/12/2019
800 SEMINOLE ROAD
Diu9''r ATLANTIC BEACH. FL 32233 EXPIRES: 5/10/2020
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:
388 4TH ST REROOF SHINGLE SHINGLE ROOF $7200.00
TYPE OF I REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169826 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN ROOFING OF
JACKSONVILLE 2117 University Blvd. S JACKSONVILLE FL 32216
OWNER: ADDRESS: CITY: STATE: ZIP:
AYCOCK THOMAS J III 388 4TH 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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $90.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
IssuedDate: 11/12/2019 1 of 2
Sr. l' REROOF SHINGLE PERMIT PERMIT NUMBER
izrJs: /J
` ` .` CITY OF ATLANTIC BEACH RERF19-0160
' ISSUED: 11/12/2019
r It , � 800 SEMINOLE ROAD EXPIRES: 5/10/2020
ATLANTIC BEACH. FL 32233
Issued Date: 11/12/2019 2 of 2
4e� ra: Building Permit Application Updated 12/8/17
A
City of Atlantic Beach
N 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 L ��I + ��� � T
/L/�
Job Address: 388 4th Street,Atlantic Beach,FL 32233 Permit Number: (�1
Legal Description 5-69 16-2S-29E ATLANTIC BEACH W1/2 LOT 31 BLK 5 RE# 169826.0000
Valuation of Work (Replacement Cost)$7,200.00 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 Residential
• 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:
Complete roof replacement. Install Complete Atlas Roofing System with Summit 60 synthetic underlayment and Pinnacle Pristine Architectural Shingles.
Florida Product Approval#shingles FL16305 and Summit 60 underlayment FL21350 for multiple products use product approval form
Property Owner Information
Name: Mary Ann and Thomas Aycock Address: 388 4th Street
City Atlantic Beach State FL zip 32233 Phone (904)728-4251
E Mail TomJa3racomcast.net
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) NA
Contractor Information
Name of Company: American Roofing of Jacksonville,LLC. Qualifying Agent: Dan Kinkel
Address 2117 University Blvd S City Jacksonville State FL Zip 32216
Office Phone 904-385-4375 Job Site/Contact Number 904-385-4374
State Certification/Registration# RC29027546 E-Mail admin@americanroofingiax.com
Architect Name&Phone# NA
Engineer's Name&Phone# NA
Workers Compensation Builder's Mutal Insurance#WCP1052393,expiration 5/3/2020
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. 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.
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.
'99110e-
)C. 42124)4Z- —
6 � -
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me thisYIA day of Signed and sworn to(or affirmed)before me this (% day of
Q(I.171 , Nei,by Idth f c-OcIC rla►crMb.t' , 2o� , b e6fACN K.v k j
""e JULIE KUPERINSK t (Signature of Notary) (Signature of Nota
MY COMMISSION M GG912202
°� R�Fcc SSe tuber I 12023 Nebry Pudic Sub o�Florkb
"+ars' ] riffl llylrno 1 e• [ ] Personally Known OR Christopher Chasse
►`� •roDuce. Identification t 7�p �Q [ ]Produced Identification • MyCommiss�•nGG273130
Type of Identification: Ft,
v f//�-I V�' \ Type of Identification: VMevii Expires 10/31/2022
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Doc # 2019260505, OR BK 19000 Page 215, Number Pages: 1 ,
Recorded 11/12/2019 12:08 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
cl;)
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 169826-0000
State of Florida,County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance
with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legal description of property and address if available):
5-69 16-2S-29E ATLANTIC BEACH W1/2 LOT 31 BLK 5
388 4th ST Atlantic Beach FL 32233
2. General Description of improvements:
Complete Tear-Off and Re-Roof
3. Owner Information:
a)Name and Address:Aycock, MaryAnne &Thomas 388 4th ST Atlantic Beach, FL 32233
b)Interest in 100%
c)Name and address of simple titleholder(if other than owner):
NA •
4. Contractor Information:
a)Name and Address: American Roofing of Jacksonville
2117 University Blvd S, Jacksonville, FL 32216
b)Phone Number: (904)385-4375
5. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified:100%
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated
therein are' -.- o the •est of my knowledge and belief.
)G 400j, r m A:coc/< � ato e<
Signa .-- of• .er or�'/ .er's Authorized Officer/Director/Partner/Manager Signatoory'ss.Printed Name&TitIe/Office
The foregoing instrument was acknowledged before me this .?a day of v ,20 1
by 'Mtn COCA
(Name of lierion making statement)
PERI
1JULIE KU NSKY NOTARY PUBLIC,STATE OF FLORIDA
46MY COMMISSION 0 00917202
EXPIRES:September II,2023 Print Name: i€.. is a j
Personally Known r„L b
Identification'Type:
(Affix Notary Seal Above) j� G 2 �-
hI' ✓ aa-b ~ 6 3 6 v1/3 —3Rev sed0 1/18
Doc # 2016074182, OR BK 17514 Page 162, Number Pages: 2, Recorded 04/04/2016
at 02:05 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $18.50
DEED DOC ST $3145.10
RECORD AND RETURN TO:GRANTEE
Prepared by:
Katrina McKinney,Employee of
Jacksonville Title and Trust,LLC
8785 Perimeter Park Boulevard,Suite 200
Jacksonville,Florida 32216
S449,250.00
File Number: 16-018
General Warranty Deed
Made this March 28,2016 A.D.By Sarah N Adams,a single woman,whose address is:3339 Shelley Dr,Green Cove Springs,Florida,
hereinafter called the grantor,to Thomas J Aycock,111 and Mary Anne Aycock,a married couple,whose post office address is: 1632
Park Terrace W,Atlantic Beach,Florida 32233,hereinafter called the grantee:
(Whenever used herein the term"grantor"and"grantee'include all the parties to this instrument and the heirs,legal representatives and assigns of
individuals. and the successors and assigns of corporations)
Witnesseth,that the grantor,for and in consideration of the sum of Ten Dollars,($10.00)and other valuable considerations,
receipt whereof is hereby acknowledged,hereby grants,bargains,sells,aliens,remises,releases,conveys and confirms unto the grantee,
all that certain land situate in Duval County,Florida,viz:
The Westerly 1/2 of Lot 31,Block 5,Plat No 1,Subdivision"A"Atlantic Beach,according to the map or
plat thereof,as recorded in Plat Book 5,Page(s)6,of the Public Records of Duval County,Florida.
Parcel ID Number:169826-0000
Together with all the tenements,hereditaments and appurtenances thereto belonging or in anywise appertaining.
To Have and to Hold, the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple;that the grantor
has good right and lawful authority to sell and convey said land;that the grantor hereby fully warrants the title to said land and will defend
the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances except taxes accruing
subsequent to December 31,2015.
OR BK 17514 PAGE 163
In Witness Whereof, the said grantor has signed and sealed these presents the day and year first above written.
Signed, ••ai.•and delivered in our presence:
II I JARS SgtLiA A1iU^L- (Seal)
,. Sarah N Adam
Witness Printed Name '�1_.d. .�_ aia' ✓l i Address: 3339 Shelley Dr,Green Cove Springs,Florida
Witness Printed Name
State of Florida
County of Duval
The foregoing instrument was acknowledged before - :th r ar 6,by Sarah N Adams,a single woman,who is/are
personally known to me or who has produced / r I 01 YI as identification.
KATRINA MCKINNEY 1
MY COMMISSION*EE 63121 1
Pritarynt Name:
e:lc
EXPIRES August 29.2016 NrPrintFame: lYZI
8DrOet Th,U Budget Nolo Sown mom titan 09n%1'41 whin 1Attie
My Commissi8Nltifiii4v S3likR3
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ANNUM vNRi1V)I ,,y
DEED Individual Warranty Deed-Legal on Face