263 2ND ST - ROOF CITY OF ATLANTIC BEACH
3"' ;? 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
!INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0160
Description: SHINGLE
Estimated Value: 5850
Issue Date: 10/31/2017
Expiration Date: 4/29/2018
PROPERTY ADDRESS:
Address: 263 2ND ST
RE Number: 172544 0000
PROPERTY OWNER:
Name: FARZIN DARABI REVOCABLE TRUST
Address: 63 BEACH AVE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: AMERICAN ROOFING OF JACKSONVILLE
Address: 1720 Wildwood Creek LN
JACKSONVILLE, FL 32246
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500..For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
rj1�
-. f" ` ' BuildingPermit A lication
City of Atlantic Beach
tn.
800 Seminole Road,Atlantic Beach,FL 32233
"� Phone:(904)247-5826 Fax: (904)247-5845
Job Address: t0 ?V\CEAV (: . " ;.')FL322 Permit Number:
Legal Descrip ion, I Ce'311 (6-25-2. 1411 Lj,1er S ''7 ®. RE# 1 42 5 ' 1 lawn
Valuation o orke(Replacement Cost)$ dl'aso 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:
Comoett.,:recir-oC-C- ap6re r - -- s k. ‘,,,c1(
Florida Product Approval# FL ( d35-s 17-1- ((D a 4' for multiple products use product approval form
Property Owner Information .
Name: ?r A r �(. _Address: (es?i Betar
City `.rt . .It '" -'__ - pate Q Ai, Zip ei�Phone L( - 7.9 LI -(r 't
• Ir-
E-Mail a • @ rrta) tee
Owner or Agent(If Agent,Power o Attney or Agency Letter Required)
Contractor Information
Name of Company: American Roofing of Jacksonville Qualifying Agent: Daniel P.Kinkel
Address 3047 St Johns Bluff Road S,Ste 7 City Jacksonville State FL Zip 32246
Office Phone 904-385-4375 Job Site/Contact Number Chris Dennis,904-626-4636
State Certification/Registration# RC90227546 E-Mail dan@americanroofingjax.com
Architect Name&Phone# NA
Engineer's Name&Phone# NA
Workers Compensation Plymouth Insurance Agency,WC71949,expires 01/01/201.8
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. .
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
REC•RDIN ." 0 I • 1 •TICE OF COMMENCEMENT.
4,./; % F ( .. _f
(Signatu'•wner or Agent including Contra o4_ "-Signature of Contractor)
Sig�-d and sworn to(or affirm-•)before m-this day of Signed and sworn to(or affirmed)before me this I L day of
Sreter Ilii 2.011 , •y . kir l`tiL , r. Cx ivbte , 201') .b 13,3%n.
k.►4/Ws-i1
I (Signature notary) (Signature of Notary)
. ,14', SARA STREET
JESSICA A CLARK 0 :State of Florida-Notary Public
[ ersonally Known OR I.: .r My copelms910N#030842 rsonally Known OR Commission#GG 110141
oduced Identification o�• My Commission Expires
[ ]Produced Identification EXPIRESMay��2021 �''�+• °.�i.�`` June 01, 2021
Type of Identification: Typ of Identification:
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 172544-0000
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): x 0 m x z o
m002g8
C)Czo � ��
15-34 16-25-29E ATLANTIC BEACH TERR S/D PT OF LOT 18 oo z o a
m o
263 2nd St, Atlantic Beach FL 32233 E -1 W N P
(n p.. J
2. General Description of improvements: 4 m NUl
Complete Tear-Off and Re-Roof o r-o
o 0vO
m�
133
3. Owner Information: t
a)Name and Address: Farzin Darabi 63 Beach Ave, Atlantic Beach FL 32233 0-0 8
Tri_ J
b)Interest in 100% c
;I?c)Name and address of simple titleholder(if other than owner): 13NA co r)
m
c
14 4. Contractor Information: o
f �� a)Name and Address: American Roofing of Jacksonville
r
3047 St Johns Bluff Rd, Ste 7, Jacksonville, FL 32246
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 fmal payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified:
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 I,
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 SITE 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 penal of.- '-ry, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are et. '•-/best of
mm owledge and belief. Mr7/7 Abill 1
Sign:re of Owner or Owner s Authorized Officer/Director/Partner/Manager Signatory's Printed Na/Aar:'/'
/Office
Ai' bee
The foregoing instrument was acknowledged before me this L4 day of Sep-64bee ,20 '"7,
by'_: 0126/I1-XtreobL as OW rine, for CO-NIMP.K- + .'r
ame of Person) (Type of Authority,i.e.Officer/Attoiney) (Name of Party Instrument was Executed for)
I" ,, N•i ' ' ' P Lj
OF FLORIDA
;;r ..b' JESSICA A CLARK I
„; "; MY COMMISSION#030080246 Prf Name: S SLS i UtoLf 4L0
�'�-, EXPIRES May 07,2021
-- Personally Known
""` IE IdentificationiType:
(Affix Notary Seal Above)
Revised 2/01/16