86 W 9th St RERF20-0053 Shingle (,;-5-1..w.,--;)„,iillV REROOF SHINGLE PERMIT PERMIT NUMBER
:.r- J' RERF20-0053
CITY OF ATLANTIC BEACH
\ ISSUED: 3/13/2020
\\\\ 800 SEMINOLE ROAD
x�o:; 9" ATLANTIC BEACH. FL 32233 EXPIRES: 9/9/2020
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:
86 W 9TH ST REROOF SHINGLE SHINGLE ROOF $9500.00
TYPE OF REAL ESTATE I BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
170814 0094 ATLANTIC BEACH SEC H
COMPANY: I ADDRESS: CITY: STATE: ZIP:
OWNER: ADDRESS: CITY: STATE: ZIP:
OFFEN SALLY BEATY 86 W 9TH ST ATLANTIC BEACH FL 32233-3465
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.
m
FEES etil
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $100.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$104.00
Issued Date: 3/13/2020 1 of 1
Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845RLRFzo y0053
Job Address: 8s West 9th street Atlantic Beach FL.32233 Permit Number:
Legal Description 18-34 17-2S-29E.121 ATLANTIC BEACH SEC H W 51.7FT LOT 6 BLK 68 RE# 170814-0094
Valuation of Work (Replacement Cost) $9500.00 Heated/Cooled SF Non- Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): Commercial Residential
• If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
Complete roof replacement. Install Complete Atlas Roofing System Summit 60 Synthetic Underlayment and Architectural Shingles.
Florida Product Approval#Shingles FL16305 and FL21350 Underlayment for multiple products use product approval form
Property Owner Information
Name: Peter Offen Address: 444 Maple Street
City Brevard State NC Zip 28712 Phone 703-268-3819
E-mail pboffen@roanoke.edu
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) NA
Contractor Information
Name of Company: American Roofing of Jacksonville, LLC. Qualifying Agent: Dan Kinkel
Address 2117 University Blvd S City Jacksonville State FL Zip 32216
Office Phone 904-385-4375 Job Site/Contact Number 904-385-4374
State Certification/Registration# RC29027546 E-Mail admin@americanroofingjax.com
Architect Name & Phone# NA
Engineer's Name& Phone# NA
Workers Compensation Builder's Mutal Insurance#WCP1052393, expiration 5/3/2020
Exempt/Insurer/Lease Employees/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 regulationg
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 I►.r END
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFOR
RECORDING YOUR NOTICE OF COMMENCEMENT.
L
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(S nature of Owner or Agent) (Sig - ure o ontractor)
(including contractor)
and sworn to(or affirme before me this day of Si ed a d sworn to(or affirm-.) before e thisr11-1--a-
Signed ay of
J WN ,! n��p ,by f L C� t c b '�1i7( 11ti1..__.4.. 4 ---L.. CCSa
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nature of Notary) ( gnature of Notary)
[ ]Personally Known OR P JULIE KUPERINSKY Personally Known OR i�r Nt, Notary Public State of Florida
`F Susie Ellen Green
Produced Identification MY COMMISSION#GGg12202 [ ] produced Identification My ie Elleson GG 942798,it
7e,I5r EXPIRES:September I I.2023 [ d ,p` Expires 12!2612029
Recorded 03/11/2020 03:53 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
Permit No._w `_ Tax Folio No. 170814-0094
State of Florida,County of duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance
with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legal description of property and address if available):
18-34 17-2S-29E .121 ATLANTIC BEACH SEC H W 51.7 FT LOT 6 BLK 68
86 W 9TH ST ATLANTIC BEACH FL 32233
2. General Description of improvements:
Complete Tear-Off and Re-Roof
3. Owner Information:
a)Name and Address: OFFEN PETER ET AL 444 MAPLE ST BREVARD, NC 28712
b)Interest in 100%
a)Name and address of simple titleholder(if other than owner):
NA
4. Contractor Information:
a)Name and Address: American Roofing of Jacksonville
2117 University Blvd S, Jacksonville, FL 32216
b)Phone Number. (904) 385-4375
5. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified: 100%
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,
SECTION 713.13 FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SI t h BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated
therein true to the best of my knowledge and belief.
Signature of lamer or Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The fo going instrument was acknowledged before me this m'`5- day of Rb r "� ,20 )49
by rerfA - 0 /
(Name of Person making statement)
P
40",,, JULIE KUPERINSKY ���
NOTARY PU�LLC, TATE OF FLORIDA
Ogt MYEX COMIRE - tON 11,2202
2023 1 i e �l2,) n , I S -Li
"4,,,,,,(1-1 EXl'iRFS September I I,21)23 Print Name: J l.. J/-/--/` � /
El Personally Known Cr 11 R.
13 Idcntificatiod'1'ype: I !-�
(Affix Notary Seal Above)
Revised I/01/18