63 W 4th St RERF20-0015 Shingle 1d -------'
'"`''`Jf4' REROOF SHINGLE PERMIT PERMIT NUMBER
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. CITY OF ATLANTIC BEACH RERF20-0015
yr 800 SEMINOLE ROAD ISSUED: 1/23/2020
) -t!•0;11>r EXPIRES: 7/21/2020
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:
63 W 4TH ST REROOF SHINGLE SHINGLE ROOF $10539.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170823 0010 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
BIG FISH ROOFING INC 6821 N SOUTHPOINT DR APT 114 JACKSONVILLE FL 32216
OWNER: ADDRESS: CITY: STATE: ZIP:
GARCIA GUADALUPE 63 W 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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $105.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $109.00
Issued Date: 1/23/2020 1 of 1
.0-.'''.4 Building Permit Application Updated 10/9/18
' City of Atlantic Beach Building Department **ALL INFORMATION
''41.•_ HIGHLIGHTED IN GRAY
800 Seminole Road, Atlantic Beach, FL 32233
°Tir_i • IS REQUIRED.
Phone:/2 (904) 247-5826 Email: Building-Dept@coab.us
Job Address: l3 W4-41 54jrle1A-f1 r`e g<4ctiIp 3Number-. I� C—`��"zD 0015
Legal Description id-31 11-2S-216. l i i iii ict,147( 6 0`if )C c I'j S//� RE#
, Lt / f3LK77 'lie'�,
Valuation of Work(Replacement Cost)$ j0)556
1 Heated/Cooled SF /f 2 `/C Non-Heated/Cooled
• Class of Work: ❑New [Addition ❑Alteration ❑Repair✓✓❑Move ❑Demo ❑Pool ❑Window/Door /Lt-v��F
• Use of existing/proposed structure(s): ❑Commercial I�Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes Ilflo
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed:
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Florida Product Approval# L kr I. 711, 1 r/ �C 2S 33._ l Z for multiple products use product approval form
Property Ownert? [Tees(mu11
Name f�at /,'4i i2/ S V Address (03 W h�Jrtcr;✓/t/4►9-Lft &telt/g. -3- ..>-53
city_ #46-I/C reeacek State > Zip 30-e-31 Phone 904' rg 6573Y
E-Mail cjohnNark'iS 7'J C rhe, 1.raft
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information / � tt i (} ,
Name of C r17p ny S Sh !( n O thdtr'rt:F' Qualifying Agent J ��f'° e�4�f�
Address 6 t 4/ 'DU 11.109" i),- *//t City Jack is ✓ilk State t(.- Zip 3 LZ/6
Office Phone ® S/- 6, e ..„pc3 7 Job Site Contact Number '� G " ' 7 ''t,
State Certification/Registration# C / 3 .3 5/4-P•i/ E-Mail 6//.,y 1 0 .i_ci :A et-L.)1'401 r� . ('c,mn
Architect Name&Phone# ✓
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt o 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 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 YO R PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN Fl AN ING, CONSULT WITH YOUR LENDER OR ATTORNEY BEFORE
RECORDING Y I U NOTICE OF COMMENCEMENT.
i
� ,2i� •:.v3 (.ignature of Owner or Agent) (Signature of Contractor) a'• ��
ri"��'•y i;.ned and •wo to(or affirmed)before me this 2 0 day of Signed and sworn to(or affirmed)before me this Z�' day of ^°",.,,,•'•
al 5 n '04,,,,,‘, Zito ,by J o hv1 v 7- S 7C.'nccc. , Zu2( ,by S Gr',1 SCoq�S Ei f n
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[ ' Produced Identification _ [ ]Produced Identification E
T'pe of Identification: c1 L ID Type of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of F f County of 1)t/V6 l
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. �? /7-2,5 ( /
Legal c iption of pr�}party being Unproved:
/" -� `2 /`�� l/ 7
s �dn- &cA S9C /f 579 47-7- f3%k '77
Address of property being improved: ( 3 Gt/ V<h ,Q do 4. /e,.4% / -
J
3227]
General description of improvements: !`
e- /11.
Owner J11'Vlib� S
LO Gr(/ t / r
Address (�3 L(J 'I- J1% 4+1Gut�'I . 6/,4 FL 5! -22-3 3
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor 6,9 is.DA 6é, r011��, pJ„d �� /
Address tJ Z l COU1a'i,PZ- .QT /v 2 -// ' G GASoo7� tGL 312/(
Phone No. QU'r/-� 'S" 9J3 ' Fax No. `V/14
Surety(if any)
Address Amount of bond$
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 herself,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
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1) "••.•
different date is specified): Year from the date of recording unless a ;;+t•••..�,r;
THIS SPACE FOR RECORDER'S USE ONLY OWNER I :i
+.al
Slgneyl DATE i'20-ZO ZV
Before ne this day of _Tari ua Lc, 7 a? O In the
Doc#2020018239,OR BK 19079 Page 2321, County of Duv .St to of Fl9rida,has erso Ily, appeared
7tS 't v[�i 5 herein by
Number Pages. 1 himself/her •If an•affirms that all statements and declarations herein
Recorded 01/23/2020 03:39 PM, are true and=cc =te Rle
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL ,�
COUNTY
it
RECORDING $10.00 C K rGet
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Notary Public at Large,State of (C County of h4
My commission expires: 3.3 - Zo Z Z
Personally Known or
Prnrinrorl blenaa..eun.. ,' r..•
S� Ly\,
frail.,y ',\ CITY OF ATLANTIC BEACH BUILDING DEPARTMENT
800 SEMINOLE ROAD
�r ATLANTIC BEACH, FL 32233
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CERTIFICATE OF COMPLETION
RERF20-0015
REROOF SHINGLE
ISSUED: JOB ADDRESS: REAL ESTATE NUMBER: ZONING:
3/4/2020 63 W 4TH ST 170823 0010
DESCRIPTION OF WORK:
SHINGLE ROOF
OWNER: CONTRACTOR:
GARCIA GUADALUPE BIG FISH ROOFING INC
63 W 4TH ST 6821 N SOUTHPOINT DR APT 114
ATLANTIC BEACH, FL 32233 JACKSONVILLE, FL 32216
APPROVED: ' k---....„Ace vA
CHIEF BUILDING OFFICIAL
VOID UNLESS SIGNED BY BUILDING OFFICIAL