448 OSPREY KEY - RERF21-0097 REROOF SHINGLE PERMIT PERMIT NUMBER
Jam.. CITY OF ATLANTIC BEACH RERF21-0097
vY800 SEMINOLE ROAD ISSUED: 4/1/2021
s ATLANTIC BEACH. FL 32233 EXPIRES: 9/28/2021
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:
448 OSPREY KEY REROOF SHINGLE SHINGLE ROOF $6000.00
TYPE OF REAL ESTATE BUILDING USE
CONSTRUCTION: I NUMBER: ZONING: I GROUP: § SUBDIVISION:
172027 5094 SELVA LAKES
COMPANY: I ADDRESS: CITY: STATE: ZIP:
MONAHAN ROOFING 2050 S KING CIR NEPTUNE BEACH FL 32266
OWNER: I ADDRESS: CITY: I STATE: ZIP:
REGAS LLOYD C 448 OSPREY KEY ATLANTIC BEACH FL 32233-4367
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.
I _
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $85.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$89.00
Issued Date:4/1/2021 1 of 1
iiii. Building Permit Application Updated 10/9/18
. ' City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
�;'
' 1,4- IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
j C-2-R r- 2- t . --'
Job Address: 4{�� �, Permit Number: 2)27-"' �[
comm
Legal Description it1 _9 ti^ZS-��291E— (v� 4.4.--/,- L
-S E# 1 7
Valuation of Work(Replacement Cost) $ a Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration Sir ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial l ential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes ENO
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describean detail the type of work to be performed:
COrneleh� Rer.io.r t,t,,..h C.,. F ---c-, ,,,,,/in .� Pr, -\ ,.,n d Fc II- 0k._,+ r
Florida Product Approval# F/ /0/2 ' - R a - for multiple products use product approval form
Property Owner Information 1...L- )L-( d R e c rc-
Name ..-4:51:::)F-'4 Tz')S• --Address '/ere c_,v_ __,-‘ t—'A
City ,4,Tt—Awt---rtl<— -- State Fi- Zip 32233 Phone 3.:::)S-8,3 t- (cc i
E-Mail r'5"n4-t,15Ca)�+nv 1•►. cowl
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) _-
Contractor Information
Name of Company (Y\or4;,t.c.. (Zc:., t r C I ru,i-,JJ Qualifying Agent N I (-
Address 2c}s & ti ns C,i c l .<._ 60,n4 h City 4)1p/v,..... yg,.c State Fi.- Zip 322E 4
Office Phone 22 ( -00 S S Job Site Contact Number v.,-N SG s--`-1 51 -
State Certification/Registration# R c c'u 11 3ti`'‘ E-Mail —1-4ri,-n A A,a,- C'sz G.-..a . c 1-
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt o 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 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
RECORDING YOUR NOTICE OF COMMENCEMENT.
,1AM
(Signature of Owner or Agent) (Signature of Cont actor)
Signed and sworn to(or affirmed)before me this Ci day of Signed and sworn to(or affirmed)before me this)Cf day of
Iltr..r-OrN , 2o21 , by 12.dr; . . Sc&r4o NM,\ ,2c , byp`0,(Qoot5g, ///�M�G nc vt.- )
,q;i i I►IARIAE SANTOS .. ..M4;�i . NAJEEPERRY
., . • MYCOMYSSKR i GG 2436E7
ah : Commission#GG 366354
4 Personally Known OR .. ,„`. o+ EXPIRES:September 21,2022 ( 1 P ally Known OR " .• ' %"�.<7: Expires August 15,1023
( )Produced Identificatio Lo'c°•' Bonded•71ruNotar.PPut4 UUMsr s roduced Identification "f.!... Bonded Thru Troy Fein Insurance 600-385-7019
Type of Identification: Type of Identification:
cc91rt 912\7j
NOTICE OF COMMENCEMENT
Permit No. C i I --C�C��i.� Parcel ID/Tax Folio No.
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.
�!vQ La.kQs
Xl. Description of property(legal description of property and address if available): Iii-95' 172$ 2q'E Lot'4-6,
4÷64a c-' -'1.---- --'-'j __.. .n.--c\-� "e"--ct— 6 -:-.6.G"-k-1,1 •"-t- 322:T-7'
l . General Description of improvements:
VerooF e`ci..1r.,4 .Ahijcte fou(- .
Owner Information:
a)Name and Address: -',C'S 1TLEts "'s j, alt cv,*re-&-:n( 1 -/-
b)Interest in property: ohx•J F''
c)Name and address of simple titleholder(if other than owner):
4. Contractor Information:
a)Name and Address: MOnc.hca., iL o. F't' eo,-.t r c.c._t-or 1 , 20 S o k_i n s G‘ r c( v. .50441-,
b)Phone Number: 2 z i -uo Sr __ u e p 1-c,,•,e (3 e -� , 3 22_6,c.
5: Surety Information: '
a)Name and Address: _
b)Phone Number: — NI ra- -
c)Amount of Bond: $
6. Lender Information:
a)Name and Address: /11 1
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a)7,Florida Statutes:
a)Name and Address: N( to
b)Phone Numbers of Designated Person:
8. In addition to himselfi"herself Owner designates fJ i Ca- of to receive a
copy of the Lienor's Notice as provided in Section 71. .13(1)(b), Florida Statutes.
a)Name and Address: w i 13
b) Phone Number of person or entity designated by owner:
9. 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:
WARNING TO OWNRR• alrsr__Ltexrvair 7 MADE BY THE OWNER AFTER THE EXPIRATION OF THE .
Doc#2021073296,OR BK 19642 Page 196, DERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,
Number Pages.1 AND CAN RESULT IN YOUR PAYING TWICE FOR
Recorded 03/22/2021 02.32 PM, NOTICE OF COMMENCEMENT MUST BE RECORDED AND
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL
COUNTY 'MST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
RECORDING $10.00 kTTORNEY BEFORE COMMENCING WORK OR RECORDING
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true to the best of my knowledge and belief.
\. -- > r� c S' c�3S'
J4Signature of Owner or Owner's Authorized Officer/Director/PartnertManager Signatory's Printed Name&Title/Office
•
The foregoing instrument w.s .c ►• a a .' • • - •_ M day of t10.ch ,2021 ,
i ,� :'+ ' yty;.. �!`.,e,�•, •, t for R�rp � .
(Name of Person) ii 1 _: ofjcpwiTalWiiiikulk „. i.o Otfcer/Attorney) (Name of Party Ifistriunent was Executed tor)
'',te$` Banded 1t1w NoD Pubic Under ers