332 8th St RERF19-0171 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
Yom. RERF19-0171 s, ISSUED: 11/26/2019
r
800 SEMINOLE ROAD
..610 ATLANTIC BEACH, FL 32233 EXPIRES: 5/24/2020
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:
332 8TH ST REROOF SHINGLE SHINGLE ROOF $11900.00
TYPE OF REAL ESTATE 1 BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
169925 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
EQUITY BUILDERS OF
FLORIDA LLC 2650-2 ROSSELLE STREET JACKSONVILLE FL 32204
OWNER: ADDRESS: CITY: STATE: I ZIP:
ENNIS GAILYA G 332 8TH ST ATLANTIC BEACH FL 32233-5436
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.
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 $110.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$114.00
Issued Date: 11/26/2019 1 of 2
51-51REROOF SHINGLE PERMIT PERMIT NUMBER
��isifi� `�
� � CITY OF ATLANTIC BEACH RERF19-0171
uv ~
800 SEMINOLE ROAD ISSUED: 11/26/2019
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ATLANTIC BEACH. FL 32233 EXPIRES: 5/24/2020
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Issued Date: 11/26/2019 2 of 2
.''..-LJrir Building Permit Application Updated 10/9/18
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\' Cityof Atlantic Beach Building Department **ALL INFORMATION
\ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us f
Job Address: 33.1, cite.a Permit Number: R GRF 1(1 - Oft (
Legal Description 5-G4 Ifo-D.5 -aqs . 11' A 1'.& 4A.c\., Lot is Rik 9 RE# If5,99�5-OOdO
Valuation of Work(Replacement Cost)$ 11000 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration DRepair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s)be removed in association with proposed proiect? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describepin detail the1 type of work1to beperformed:Gc' AAA4.:,_ vrderInb,.. - 41N4 ArcW caiural St►ivtq)GS
C"-move- ^4 1eQ‘'LL e-X.ST,/vq cD W J
Florida Product Approval1 # VI- 4N`I.I }tel- i 041 5 U —RII (� for multiple products use product approval form
Property Owner Information
NameG'►,\u�A EnMS Address 33a eV 5�,
City A-tlr& $ State Ft- Zip 3x233 Phone vii- 3D7-..77
E-Mail [910arAab6 ovisAA.cov \
Owner or Agent(If Agen , Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company E4:^ 5+t\ry S b' Vlor -Cc, Qualifying Agent S" IAdIC.)(, �
Address a.(o5(�- ? QssLlle, Si• City 3,1csm ilc State FL Zip 3.7aoc!
Office Phone 9Oc(-3°16-joHH Job Site Contact Number
State Certification/Registration# GyG/S//7(e 5- E-Mail jiAatiolo efRL4 rLt�i pl.(O1.A
Architect Name&Phone# AI/A
Engineer's Name&Phone# AL/A. /
Workers Compensation Insurer tom;46,-s /if 1/".44;-• OR Exempt o Expiration Date 1. 7
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 regulating
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 NpTICE QF COMMENCEMENT.
\
(sigRature of Owner or Agent) ' ! re of Contractor)
igned a d sworn to(or affirmed)before me this day of Signe. a,. �;,047o(or affirmed befo a m- this t 6 day of
� ,.tory 2°1a by G -Aba- 6nn is iA. .:iv . by 30.m. Mc V D(
`,
iri(Signature of Notary) _ li:aturre of N•tary)
Denise A.Ennis ?o�a_:1/46.:.1
P�� STANTON HUDMON
NOTARY PUBLIC [ ersonally Known OR c, ,.`. Notary Public -State 01 Florida
\.,]Personally Known OR _'�_ ;y �� �- Commission 0 FF 937739
STATE OF FLORIDA [ )Produced Identification ;,r�� p,=
[ ]Produced Identification �.:�,�=Comm#FF966426 Type of Identification: ',,f 0 ;,; ''s My Comm.Expires Mar 16,2020
Type of Identification: ' �'
rt* txpires 3/1/2020
NOTICE OF COMMENCEMENT
State of FloAo\ Tax Folio No. \(&1f5 -06OO
County of Qvv#A
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 COMMMENCEEMEN1D
T. p
Legal Description of property being improved: 5-,q 1G- as-a9 E . 1149 f tilaA 4, CqcA\ �� 5
Blk Q
Address of property being improved: 33a a�� S�• ��0.+�Z, IUc' FL 3aa33 I _
General description of improvements: Remove, AAd (tetkc.c.--. cdkicAin, Cook twiitn Peel C4 s -L
lyAblickur& and &Jc\n;li'..c*u 1_ _ Sln;v1 I c
Owner: Gc i1 T. LINA Address: 33^. 0h Si. IT IANC-_Btac\1) Fz- 3..233
Owner's interest in site of the improvement: 10% -
Fee Simple Titleholder(if other than owner):
Name: A —Contractor: Ef�+ v��Idd� of V101;64t
Address: a.(osv' ROSseIUC
Telephone No.: 70L)-3qg- PIM _ _ Fax No:
Surety(if any) _ —
Address: _ Amount of Bond $ _
Telephone 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,designated by owner upon whom notices or other documents may
be served: Name:
Address: A _
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone 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 OWNER
Doc#2019272433,OR BK 19017 Page 1758, Signed: � d Date: il't
12s I�
Number Pages:1
Recorded 11/26/2019 08:48 AM, Before me this as-vinday of Nab h.9-1. '!`(in the County of Duval,State
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Of Florida,has personally appearedGa^‘nt6 _
COUNTY Notary Public at Large,State of Flori <<'{ ::y, Nis C�/�rrYu�J
RECORDING $10.00 My commission expires:
'STATE--OF-FLORIDA
Personally Known: iii:`.-.iF Comm#FF366426 or
Produced Identification: �.•
. e -Expires3H12020