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458 Sargo Rd RERF21-0087 Shingle r,�Uf:; REROOF SHINGLE PERMIT PERMIT NUMBER �, RERF21-0087 CITY OF ATLANTIC BEACH �,,�, V~ 800 SEMINOLE ROAD ISSUED: 3/23/2021 �`.nil9% ATLANTIC BEACH, FL 32233 EXPIRES: 9/19/2021 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: 458 SARGO RD REROOF SHINGLE Shingle: FL10124R20 $9000.00 TYPE OF 1 REAL ESTATE I BUILDING USE ZONING: i SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171540 0000 ROYAL PALMS UNIT 02A3.00 COMPANY: ADDRESS: CITY: STATE: ZIP: A CROWN ROOFING INC 9791 Old St Augustine Rd JACKSONVILLE FL 32257 OWNER: ADDRESS: CITY: i STATE: ZIP: JACKSON JOHN T 458 SARGO RD ATLANTIC BEACH FL 32233-3816 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 $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: 3/23/2021 1 of 2 Yf„' , Building Permit Application Updated 10/9/18 e ; 1 City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY II 91” IS REQUIRED. Phh(one: (904)0247-5826 E mail: Building-Dept@coab.us /� Job Address: (-I5 U c r V 1`L` 1 � � -3 m Permit Number: fEJ_FZI - ol0g 7 Legal Description -Si` l IO -1 S ' 2 / -- I� I-T V IaiINS�n1-\ 2 RE# 1 7�, 3 `0- 0000 Valuation of Work (Replacement Cost) $ 9) HeatedrCooledVk% l-lQA Non-Heated/Cooled 1M • Class of Work: ❑New ❑Addition ❑AlterationRepair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial iu•esidential • If an existing structure, is a fire sprinkler system installed?: ❑Yes iNo • Will tree(s) be removed in association with proposed rolect? ❑Yes(must submit separate Tree Removal Permit) No Describe in detail the type of work to be performed: .�_ G)-(I 7 6 SOGat'tS / 6 I Z p:-it A 450- S/ h,(ps 7 n4 1-1tf C U hStY 10•.\1lm to t Florida Product Approval# F L 101Zc 1`�D for multiple products use product approval form Property Owner Information I Q. \ Z Name ,(kf�h 1G�(,���.5�h Address Lk 510 1\ A40,-nt\C 1)�u�'`'\\i-L 3 71'J City A+1GVl )1('( 8(GGi-, State Ft_ Zip 3223 3 Phone -1- U2 ^ 6-19 D Z E-Mail L Quk(ntsc\-0*PI\,COM Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information 1 1 (� \ Name of Company i (, G k 1,, C Qualifying Agent W��\1O-� \ 1C 1\\(\ Address t9 5 i (n , ('N, ' City 10-C1I/ (I L State kr.- Zip 37-7,S `7 Office Phone L�}'( - •i- JLkSGV le - : 7 Job Site Contact Number State Certification/Registration# CCC 13 z 95 Z( E-Mail W k\-Nn P./ A C fr JYk WiVi(11 r n Architect Name& Phone# J Engineer's Name& Phone# Workers Compensation Insurer 13rCU/VI cc (SYOW V- OR Exempt 0 Expiration Date l/// 2/ 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 REC RDING YOUR OTIC OF OMMENCEMENT. / (Si ature of Owner or Agent) (Signatu - of Contractor) Signed and sworn to(or affirmed) before me this 2-3 day of Sign•• and sworn to(or affirmed) before me this 23 day of /lis"rra. , 2.621 , by q ro h 2: ,7z.714-,7 /173.^4 ti , _Z , by li0//l Giy A07 (Signature of Notary) rt,rtAtw.c 1_11wui3 e. a... 'i.PAV: DON MICHAEL WATERS,JR. ,,01:14;;;:,,"•.. DON MICHAEL WATERS,JR. • ,a. •;,• MY COMMISSION k GG 319490 PersonallyKnown OR +; '. ;.: MYCOMMISSIONkGG31 pE onall Known OR �''Os EXPIRES:August3,2023 [ ) _ Y �'•.:?f d ., Bonded TAN Not Public Underwflers [ -; -`. edThni S:Iypust U, er, 4r uced Identification roduced Identification^^ '•;tp•«,�;= �ndedThruNotyyPubticUnde Type of Identification: }.,/...— Identification: eps, i40 g-,ri tarts Doc #I 2021071212 , OR BK 19638 Page 837 , Number Pages: 1 , Recorded 03/18/2021 03:25 PM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10. 00 NOTICE OF COMMENCEMENT Ir fy.X MnrRKAT►) Porth No Folio No ` S Li O Wsaved \ il . Courtly of To whore h may coa!•m: -— ac ortuncenT4 Lnwil+1,4CoNd horT4N kifd y tmProve me will M made to cM100 poverty I 1ty,moo so eomme etiw[MT. urea,the 1o11owi np Inlamefbn Ie elae.d In MN N'ICI 01 Legol7wreten re ,, a) n Orox, O. 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No. r\ t Expiration Gale d Noticed Cortvrbnoement(tile espintbn date Is one l l)Vim avid the date et teecordlnp uMesa a Mensal date Is wedlbd)' rwa aPAc!FOR RECONDen USE ONLY / owNa ! . z-/ f=oIrA� . Niro Ns ' fa , In et earey tom, daO �.tome and ti ._ MIf,HAE'_WATERS,JR. N rw ire loan Wr.Pi -• DON j° .. =. MYCOMMISSION#GG319190 rti FJ(P1RES:A�qust3 2023 � - � eoneee core Notary NuWk unaervr'Jan 4:c., - WileyPIMC al laps ttstr. f. d F1 k✓, t wry s._..stbs eine; !}„) ?a l or Produosd Krow�Kwl l_Ji— Scanned with CamScanner