311 10th St RERF19-0176 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
, � RERF19-0176
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 12/4/2019
ATLANTIC BEACH. FL 32233
EXPIRES: 6/1/2020
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: j PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
311 10TH ST REROOF SHINGLE SHINGLE ROOF $27000.00
TYPE OF REAL ESTATE j ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170065 0010 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
HAMMER TIME ROOFING 14286 Beach Blvd JACKSONVILLE FL 32250
OWNER: ADDRESS: CITY: STATE: ZIP:
PERSONS ROBERT B JR 311 10TH ST ATLANTIC BEACH FL 32233-5529
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 $190.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.85
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $194.85
Issued Date: 12/4/2019 1 of 1
NOTICE OF F COMMENCEMENT
tPREPA.RE IN DUPLICATE
Permit No Tax Folio No. , 7066 S (
State of j-//S rJ de- Count'-!of .CJ1
- vgJ�.
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.
Leda(description of property being improved: - , /6 -- 3 S a
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Address of property beim;improved: < < ,
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General description of improvements: R e—j9,00c
Owner 5:'4r',-+ ),S Pe!,j�.�C \r 12...rso-, S
Address 3 11 /08- -f c..
Owners interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Addre.ss
Contractor Nc-„ A� ( Rrto
Address ZI 4 )Z��:l "•• y I l c,
Phone No. (901-9 7.4; 5� 9 -Fax No. 1/1
Surety(if an i
Address
Amount of bond S
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. V y v other than himself,desi_nated by owner upon whom notices or other
documents may be set:ped:
Name
Address
Phone No. Fax No.
In addition to himself,owner desiionatee the foilo:•:inc person to receive a copy of the Lienor's Notice as provided in
Section 713.00(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone i•lo. F
*Hot
Fax
date of Notice of Commencement(the expiration •
date is one(1)year from the date of recording unless a O '�
r
different date is specified):
THIS SPACE •04/ !0,te
FOR RECORDER'S USE ONLY 1 OWNER
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Doc#2019973813,OR BK 19019 Page 1742, 0 ..{ Kt j e(h(�I � ! �'� i 3 3
Number Pa es.1 h eet+hese'end a i.-s -_allnand nd a=_c!ara!ions he=i n 3 • (J.) Z
Recorded 11/27/2019 10:39 AM, ler_tr_=and accurate -
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL vi p o
COUNTY
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RECORDING $10.00 :::C1"-&H-1/((( r
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1 icola _diit at Large.State o; !�%1/ il
PrudInitation re -.
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s _ Building Permit Application Updated 10/9/18
; '`" r) City of Atlantic Beach Building Department **ALL INFORMATION
``J`3})r 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 3iI /C•1-, s� i is-. .,_ > r.A / G �a, ;7)3 RE1F 1. 9- Ot7CP
,� , � Permit Number:
Legal Description -bej i 0 :),S -0 ci L.--.37yy i.fu 13..`.,J L f 6. k gi ! 3 RE# f/006 - «/C
L_.
Valuation of Work(Replacement Cost)$ _7 cic)� Heated/Cooled SF Non- Heated/Cooled
• Class of Work: flew DAddition ❑Alteration ❑Repair EMove :Memo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial .ldential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes I
• Will tree(s) be removed in association with proposed project? ❑Yes (must submit separate Tree Removal Permit) 21Vo
Describe in detail the type of work to be performed:
� - ' S�'�j�e -- S�i ns fe L r-t-��
Florida Product Approval#1/ ) 7� �I , "^&- lcr- -� I
!� _ i S a i 6 - e 3 for multiple products use product approval form
Property Owner Information S 1"'N" t
Name ke1"—,/--8 4-1,,-Ir/r ir)"-4.k. /u Pc./. .-,, _ Address 3// /7 f( S r
City /4He,P( /3/'c_ c� State /1 Zip 3a ? 3 Phone (icy ) SC`i4) - 1,i'?
E-Mail i per 3ci,-1 - G4CI ,j • Cc, u
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
r�Name of Company �,, ,,;, J e Qualifying Agent �1-,,,,,, /2 r tr <1,,,,r TAddress/ 1,� ? /.., //./ C/� /9 -?yr City 14c.tt,„,. J) f?L, stale `!_ Zip -.
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aOffice Phone l9�1/ ��/ 7/get Job Site Contact Number f�Jj�(1 02'://;- a j�r%
State Certification/Registration#01:./3:1q 5 j' 3 E-Mail j--, ,,,.,,C 4....._,. ,1-,r P ,�.*, / ,...,.....----
Architect Name& Phone#
Engineer's Name& Phone# 1
Workers Compensation Insurer g(,cise.G.e I &A t- b,l'� // OR Exempt❑ Expiration Date 9 p -top
Application is hereby made to obtain a permit to do the worand installations as indicated. I certify that no work of stat lation 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
RE ILT IN YOUR PAYING TWICE FOR IMPROVEMENTSTO YOUR PROPERTY. IF YOU INTEIt1D 4'
P
TO§NEIN FINANCING, CONSULT WITH YOU ' Ej ' OR AN ATTORNEY BEFORE
Dip,.0(`
cm 0134 ING YOUR TICS OF CO_MMENCEME} � � zi...,._3/4_,_
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o eo (Signa re of Owner or Agent) �/ (Signature of Contractor)
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g.j 2 - d— i sworn to(or affirrt/�)ed)before me thig�d da of Signed and sworn to(or affirmed)beforef` me this �0'cv�_ pa w
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