1972 Beachside Ct RERF20-0057 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
mss, CITY OF ATLANTIC BEACH RERF20-0057
800 SEMINOLE ROAD ISSUED: 3/18/2020
ATLANTIC BEACH. FL 32233 EXPIRES: 9/14/2020
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:
1972 BEACHSIDE CT REROOF SHINGLE SHINGLE ROOF $8500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169542 0584 BEACHSIDE
COMPANY: ADDRESS: CITY: STATE: ZIP:
BENTON INTEGRITY 5570 FLORIDA MINING BOULEVARD, JACKSONVILLE FL 32257
ROOFING & WINDOWS #310
OWNER: ADDRESS: CITY: STATE: ZIP:
HAINES KENT M 1972 BEACHSIDE CT JACKSONVILLE FL 32233-5955
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 $95.00
it
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $99.00
Issued Date: 3/18/2020 1 of 2
f.s
t'L�' REROOF SHINGLE PERMIT PERMIT NUMBER
J ' RERF20-0057
CITY OF ATLANTIC BEACH
�� 800 SEMINOLE ROAD ISSUED: 3/18/2020
moult ! ATLANTIC BEACH. FL 32233 EXPIRES: 9/14/2020
Issued Date: 3/18/2020 2 of 2
(c-:si...1-iis.p.,
°; Cash Register Receipt Receipt Number
r City of Atlantic Beach - R12010
J�`�,i319i-
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $99.00
RERF20-0057 Address: 1972 BEACHSIDE CT APN: 169542 0584 $99.00
BUILDING $95.00
BUILDING PERMIT 1 455-0000-322-1000 0 $95.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R12010 $99.00
Date Paid: Wednesday, March 18, 2020
Paid By: BENTON INTEGRITY ROOFING & WINDOWS
Cashier: FJ
Pay Method: CREDIT CARD 3
Printed:Wednesday, March 18,2020 10:12 AM 1 of 1 t
ervoyirit
INSPECTIONS REQUIRED FOR BUILDING PERMITS
2 To verify compliance with building codes,inspections of the work authorized are required at various points of the construction.
�4 The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
Power Pole Final Plumbing
Silt Fence Final Electrical
Piers/Stem Walls Final HVAC
Underground Plumbing CC Final
Underground Electric Final Building*
Foundation/Footing *For new living space:When all construction work including electrical,plumbing,
mechanical,exterior finish,grading,required paving and landscaping is complete
Slab** and the building is ready for occupancy,but before being occupied
**FORM BOARD ELEVATION CERTIFICATE MUST BEON-SITE FOR SLAB INSPECTION Swimming Pool Steel
Retaining Wall Footing Swimming Pool Safety
Driveway Electrical Grounding&Bonding
Sewer(Building Dept) Swimming Pool Final(Bldg)
Sewer Tap(Utilities Dept) Swimming Pool Final (PW)
* Additional inspections may apply to your project if your project
Rough Electric
contains these elements:
Rough Plumbing/Top Out* Formed Columns/Beams*
Rough Mechanical* Masonry Cell Fill
*When all rough electric,plumbing,mechanical are complete but before any work is *When forms and reinforcing steel,anchor bolts,sleeves and inserts,and all
covered up. electrical,plumbing and mechanical work is in place,but before concrete is poured.
House Wrap Structural Steel*
Wall Sheathing *When all structural steel members are in place and all connections are complete,
but before such work is covered or concealed.
Roof Sheathing
OTHER:
Tie-down Framing Connections
OTHER:
Rough Framing
OTHER:
Roofing In Progress
OTHER:
Window/Door In-Progress
OTHER:
Insulation Ceiling
Insulation Wall S lr I NaL
i\.�r
RoQ
Exterior Lath
Permit Type
Stucco Scratch Coat RE
� 11Z Co)
Exterior Siding In-Progress S
4.7
Brick Flashing&Ties Permit No.
Early Power Z I ,� A
Gas Rough /`'►o�'L1'(�.r
Job Address
Gas Final* ^
rrr
*When all gas piping is complete and wallboard is installed but before gas is G N1 Q i rE G V
///���
try
attached to any appliance.All outlets must be capped and pipe pressurized ata
minimum of 15 lbs. Contractor
POST THIS CARD WITH PERMITS AND PERMIT
Building Department Public Works/Utilities Fire Department DOCUMENTATION IN FRONT OF BUILDING
Phone:904-247-5826 Phone:904-247-5834 Phone:904-630-4789
Fax:904-247-5845 Fax:904-247-5843 Fax:904-630-4203 INSPECTION LINE: 904-247-5814
MUST CALL BY 4PM PREVIOUS DAY FOR NEXT DAY INSPECTION
Construction Hours per City Code:7am-7pm Weekdays;9am-7pm Weekends
ir--- '''.; Building Permit Application
City of Atlantic Beach
,_!s'i 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 c - /�c
Job Address: 1'72R�GI15iCkc. egN.t'+ , Ai-1 .MBawl,LaCh Permit Number: RG R f O OS 7
Legal Description 41,2-14 09-.2S- 5 BEAChi5 Dr LD7'2 . 131-k ( RE# (471•52/2-OSS-4
Valuation of Work(Replacement Cost)$B,StO Heated/Cooled SF.- -1-.4<g" Non-Heated/Cooled 3,3 -6'
• Class of Work(Circle one): Ne Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Reside
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No dn`
• 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: ex-1?-41;C t u pyt_;las 3.$'J 1112 p:4-01--
(vAF r-,. rr,ei-tD FL to124;bAF F€f#Pa►5+e.U n-(a.vrue r F L i 1,,(L;OFF Ways tictib FL I(o(coo•I
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: p,' ' 4 ' \L5 Address: lel/a '(3c h5icl rcx-Lri-
City A4k&fic State 'L Zip 32253 Phone '(011-3811-f4 42
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Cx.,>eNte
Contractor Information
Name of Company:Qr\-VAI --ecelQualifying Agent:
Addresses jn 7(orldta .nt'iNe ,(e►rlyd RAI 4e3RCity.7OuC, St Wilie_ State rl Zip 32'21'1
Office Phone 4:415+;tar R tclo5 1 Job Site/Contact Number 904-Alia'31.06‘1
State Certification/Registration# ('C.0 I37-'t(pb E-Mail etd,r+oNinitt 11N'5e.04e.s113•4,rir-
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation D(F-RSA se.l f yASL*($5 0..4Asi,silt./N0,0"./r213i,/2020 ^
Exempt/Insurer/Lease Employees/Expiration Date r,��`(6 D
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify t at k owtn EaNe onth a
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 ripiym1ntf o
permit,there may be additional restrictions applicable to this property that may be found in the public records dT' co n4(y, �+�I
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
Str1; ��^r1�
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done In riipl��n�e`ftiithiall'rtmefi
applicable laws regulating construction and zoning. City of Atlantic Beach, FL
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
RECO NG YOUR NOTICE OF COMMENCEMENT.
/—(Slgnatu4e of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this I7 ay of Site and sworn to(or affirmed)before me this (o" day of
Eehruanj 2020,by ICenf- . Hain eS March , 2o20,b 3. • . : 1 d ■fe,11
(Signature of Notary) ( i•n. e•f ota )
.„r+r KR'�STAL K'ALK
[ ]Personally Known OR [ ersonally Known OR � ' Nnta y Kutlic-State of Florida
[{eroduced Identification [ [Produced Identification ?, Comrissl pi a GG 90A969
.or r}.. My Con-fn Expires Sep 15,2027
Type of l e ti 'c ti n: 2— Type of Identification: sordes t7ircu5h 4t14)nal Nota Assn,
I1i+` KRYSTAL K SALM 1
1 '?,1""• `. Notary tUtliC-State of Florida
Commission I GG 908969
, ' or r,. My Comm.Expires Sep IS,2023 I
I Bonded tnra.th National Notary Assn. 9
Doc # 2020057702, OR BK 19135 Page 2310, Number Pages: 1,
Recorded 03/11/2020 03:30 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
Stateof FIOr'Idel Tax Folio No. IV?52/2" 4-{
County of DLiVdl
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:1/2-14 171-,2,4- IE
---- Ar N5IDE 1.877 22 134-k-1
Address of properly being Improved:612. fide,, r} ,R4Lb144,G Beads,FL 3=33
General description of improvements:_ _2,g2c___Z)[ltt L __3 VII/ _ T
Owner: K441,el.Pet,`f1CI -_ Address:/41-2 8resZ4 s54 Ca+r+, L ti-HC MI-v4c1-3t2233
Owner's interest in site of the improvement: c1Ce,Fee Simple Titleholder(if other than owner):
Name:
Contractor. &_near, 1r3trp-ify Rooftop (Ind Windnws
Address: S5 f1Dr!> n3in'I8111d.S.,Ste3iD _iD.CksOri lle,-Fx_322,57 --
Telephone No.:itioq)21 2-71,4)3 Fax No: (q09) 2&O-1355
Surety lir any) ,
Address. Amount of Bond S
Telephone 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,designated by owner upon whom notices or other documents may be
served: Name:
Address: _
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Licnor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(t)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: L-4-4( / Doe. /j �/ILC1O
Before r(ie this t`T day of Fels u&nu in the Cou(jry fAn'al,State
Of Florida,has personally appeartxl ken} M 44 ai n eS
Notary Public at Large.State of Florida, ounty of Duval.
My commission expires: 9/l5 12_0z3
Personally Known: or
Produced Identification:FL PL. 1.4820•50•53 ..,1144.-.0
I41'• lictiVyNeat•5t eelPanda
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