303 10th St RERF19-0177 Shingle rt'-"'Jr REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0177
ISSUED: 12/4/2019
800 SEMINOLE ROAD
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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
303 10TH ST REROOF SHINGLE SHINGLE ROOF $16850.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170063 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
Arica Construction LLC 3983 Kaden Dr E Jacksonville Fl 32277
OWNER: ADDRESS: CITY: STATE: I ZIP:
BOUY KIM L 303 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.
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DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $135.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2 03
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $139.031
Issued Date: 12/4/2019 1 of 1
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
"on vT IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us Q
Job Address: _30_3 ��lh -5 / �� Permit Number: `` \. G��1 ( -0 1 l /
Legal Description ,5--.4`i /r/ .5 ,,1-g�Z.�'io4lhp/ c/X4 RE# /7P,r,,:"!7et78
d'/r.' Ii_47-�le.r--55X
Valuation of Work(Replacement Cost)$/ / Jiit ,A+' 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 project? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of wokto be performed: '6', "�'-i7- = ,c__ /�v—�dQrC' "> I
"'.1ze/c/27 e'�`e".— cam;,7��r 6_7 ,9A-
Florida Product Approval# f...'1 J1--g7, I (, Ft.-' 101Q4-1. ( for multiple products use product approval form
Property Owner Information
Name LaCr1' c'
8 .dy Address 3z,3 /c7 S,*rad
City d7/04...)17,e7
, je' 't State rr Zip X13.33 Phone a5/1• --;/- -1176`
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information ,,[�
Name of Company �✓i 7 �Rw. -✓ 117' Qualifying Agent "2-' , rE d
Address -`j<'3 K.01)47,-, f -5, City-)-- .4'71ciiState Zip B...-.-4,-27Office Phone (%Dy) ‘, .3....)- t'f.2 ' Job Site Contact Number el-ii,- -2P1-15."4.,.,
State Certification/Registration# E-Mail
Architect Name& Phone# ci/#7
Engineer's Name&Phone# " Ir' �y
Workers Compensation Insurer yirlDc!/!'j OR Exempt❑ Expiration Date--o__L-__ P✓
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 TORNEY BEFORE
REC• ' DIN SUR N• 'E OF COMMENCEMENT.
(Signature of Owner or •gent) (Sig ture of Contractor)
r <4,_
. nned and sworn to r affirm-d)before me thi day of S'j d and sworn to( aff' -, before me his , day f n1-_ ec ,2 1Li, b, 18SC f i V l� �s�, 1�, l ,t` • O �'C��O -I-:QS C
MIIIIISTAI
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w" % TONI GINDLESPERGER TC"o E G'
'. ;t MY COMMISSION#GG 353178 .: ' •.: COMMISSION#GG 353178
n,a •
'' [ I t''-+teriowrr IRES:October6,2023
.*o Flo,] 'e r .� rQSGf3eD6�2023 of I Notary f'ub6c lhrderwllars
C7 ' ba-c -U e of Identification: - .V-CS -2-49 o
Type of Identification: _ �� ��-� -0
Doc # 2019276930 , OR BK 19024 Page 1471 , Number Pages: 1 ,
Recorded 12/04/2019 12 : 13 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 170063-0000
State of Florida County of Atlantic Beach
To whom It may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following information Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:5-69 16-2S-29E-ATLANTIC BEACH-PT LOTS 2&4 RECD 0/R 10357-378-BLK'
Address of property being improved:303 10TH ST-Atlantic Beach FL 32233
General description of improvements:Tear-off&Re-roof using GAF Architectural Shingles
Owner BODY KIM L
Address 303 10TH ST-Atlantic Beach FL 32233
Owner's interest in site of the improvement Ownership
Fee Simple Titleholder(if other than owner)N/A
Name N/A
Address N/A
Contractor Ricardo Ravelo ARICA Construction LLC.
Address 3983 Kaden Drive East
Phone No.904-232-8475 Fax No.
Surety(if any)N/A
Address N/A Amount of bond$N/A
Phone No. N/A Fax No.N/A
Name and address of any person making a loan for the construction of the improvements.
Name N/A
Address N/A
Phone No. N/A Fax No.N/A
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Name N/A
Address N/A
Phone No.N/A Fax No.N/A
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 Statutes.(Fill in at Owner's option).
Name N/A
Address N/A
Phone No. N/A Fax No.N/A
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 . — 0• - J / / 9
51. _ ..0r./-4-,..00" _ DATE j' Y'/'
B,.• - this • day of �e _ in the
Coynty of Duval•-t leFloriid has person, appeared —
Casty
�,� a r�-
Mmsel her3b11 and affirms th- all statements and decia•'IoJ lTONI GINDLESPERGER
ere tru andaccurate .
1.7.7.:n".
s.
j. ;., MYCOMMISSION#GG353178
;o EXPIRES:October 6,2023
r ,!, -I tee: .• .-•7tvu Notary Peak Underwriter:
Notary Public at Large.State of Florida i Co ty of •'CA;
My commission expires:
PersonallyKnown _ I_Q
Producedltlenllficationpri eisC se _
ri 1�
/ CITY OF ATLANTIC BEACH BUILDING DEPARTMENT
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
CERTIFICATE OF COMPLETION
RERF19-0177
REROOF SHINGLE
ISSUED: JOB ADDRESS: REAL ESTATE NUMBER: ZONING:
12/10/2019 303 10TH ST 170063 0000
DESCRIPTION OF WORK:
SHINGLE ROOF
OWNER: CONTRACTOR:
BOUY KIM L Arica Construction LLC
303 10TH ST 3983 Kaden Dr E
ATLANTIC BEACH, FL 32233-5529 Jacksonville, Fl 32277
APPROVED: TT Acerb
CHIEF BUILDING OFFICIAL
VOID UNLESS SIGNED BY BUILDING OFFICIAL