477 Helmsman Ln RERF20-0047 Shingle /� Jr%)` REROOF SHINGLE PERMIT PERMIT NUMBER
�� , __ � RERF20-0047
r, CITY OF ATLANTIC BEACH
" �" ISSUED: 3/6/2020
800 SEMINOLE ROAD
inti>r ATLANTIC BEACH, FL 32233 EXPIRES: 9/2/2020
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:
477 HELMSMAN LN REROOF SHINGLE shingle re roof FL10124 $10500.00
R20, FL15487
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP: I
170703 0414 SEASPRAY
COMPANY: ADDRESS: CITY: STATE: ZIP:
FLORIDA ROOFING 4320 DEERWOOD LAKE PARKWAY
EXPERTS 1001-403 JACKSONVILLE FL 32216
OWNER: I ADDRESS: CITY: STATE: ZIP:
TOLBERT CAROL T 477 HELMSMAN LN 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.
�_ � r 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 $105.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$109.00
Issued Date: 3/6/2020 1 of 2
I
%'s- ''''`f' REROOF SHINGLE PERMIT PERMIT NUMBER
: RERF20-0047
CITY OF ATLANTIC BEACH
''° �" ISSUED: 3/6/2020
800 SEMINOLE ROAD
";�;i >r EXPIRES: 9/2/2020 .
ATLANTIC BEACH, FL 32233
Issued Date:3/6/2020 2 of 2
,„'-41%,, Building Permit Application Updated 10/9/18
gr-
City of Atlantic Beach Building Department **ALL INFORMATION
r�, 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us 1
Job Address: 477 Helmsman Lane ; Atlantic Beach, FL 32233 Permit Number: Fad LXX T
Legal Description Qc�
Sc.t.i \ VA R)VC- y RE#
Valuation of Work(Replacement Cost)$ I D I SZ)O Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition CAlteration Rgepair ❑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 .ro.osed •ro.ect? ❑Yes must submit se.arate Tree Removal Permit El No
Describe in detail the type of work to be performed: Re-roof 2"1 S� 311
Florida Product Approval# ( - R?-t FL t Sktt1 for multiple products use product approval form
Property Owner Information
Name Carol Tolbert Address 477 Helmsman Lane
City Atlantic Beach State FL Zip 32233 Phone 904-422-1802
E-Mail Caroltolbert@me.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company emtcla Linc PALM
lCwl LM Qualifying Agent T cr V1S �laucr'f e1(AddressL}37 f) D CP.Yi l Gt tom. l City State JJ Zip 3 u\lp
Office Phone 01by - 32 -(o(y(P J Job Site Contact Numper1 &S 91 U4 - -1‘.(71
State Certification/Registration# (CC (,212gD'—I E-Mail ft0n(a[AY06 (�P cpt Q (?I li1(�IL-( 'w
Architect Name& Phone# J
Engineer's Name& Phone#
Workers Compensation Insurer 131kt ICU-VS Mill-Utak OR Exempt ❑ Expiration Date I-I - 2021
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
RECORDI J OF COMMENCEMENT.
(Signature of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this 28th day of Signed and sworn to(or affirmed)before me this 2 day of
February , 2020 , by Caroll T er M0YCi0 , U ,As)/ _ _Gil tck
1Si�nature o�Nsta�r) _ L'I'El "1r' •.
lrRV pU
I ;
Doc # 2020051362, OR BK 19126 Page 2490, Number Pages: 1 ,
Recorded 03/04/2020 09:20 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
IPnMP.we ad ouPI JCATel
Permit No. Tax Folio No.
State of _ County of
To whom It may concern;
The underslened hereby Informs you that Improvements will be made to Certain real property,and In
accordance with Section 713 of the Florida Statutes,the folbwing Information Is stated In this NOTICE OF
COMMENCEMENT,
Legal desa1ption of property being Improved: •r c:A- Z.y k`
Addressor property being improved: 477 Helmsman Lane;Atlantic Beach,FL 32233
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•
General desaiption of improvements: Re•roof
•
p„ Card Tolbert
Address 477 Helmsman Lane;Atlantic Beach,FL 32233
Owner's interest In site of the improvement Owner
Fee Simple Titleholder(If other than owner)
Name
Address
Contractor l 0:14'S r�n c;nc Fav c\-5
Address ?2b �ePr it c JLHtcX 1r,„r Lim v221(p
Phone No. CVA)
3Z$'coI Ll LrFax No. (D'I'I1-I(a- 1(6.4-10
Suety(If any)
—
Address Amount of bond S
Phone No. Fax No.
;.� Name and address of any person making a an 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 whm onotices or other
documents may be served:
Name
Address
Ppb No. Fax No.
In addition to himself.owner designates the following person to receive a copy of the Lienor's Notice es provided in
Section 113.06(2)(b),Florda Statutes.(Fill in at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date cf Nonce of Commencement(the expiration date is one(1)year from the date of recording unless e
1 different date is Specified):
THIS SPACE FOR RECORDER'S USE ONLY ER
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