660 Aquatic Dr RERF21-0104 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH R E R F 21-0104ISSUED: 4/7/2021
800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 10/4/2021
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:
660 AQUATIC DR REROOF SHINGLE Shingle: FL10624.1, FL2533 $8575.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171818 5220 AQUATIC GARDENS
COMPANY: ADDRESS: CITY: STATE: ZIP:
BIG FISH ROOFING INC 6821 N SOUTHPOINT DR APT 114 JACKSONVILLE FL 32216
OWNER: ADDRESS: CITY: STATE: ZIP:
Anthony Pooley 660 AQUATIC DR ATLANTIC BEACH FL 32233-3841
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.
p . p 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
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$99.00
Issued Date:4/7/2021 1 of 2
rs REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF21-0104
800 SEMINOLE ROAD ISSUED: 4/7/2021
ATLANTIC BEACH, FL 32233 EXPIRES: 10/4/2021
Issued Date:4/7/2021 2 of 2
'' '', Building Permit Application Updated 10/9/18
r4City of Atlantic Beach Building Department **ALL INFORMATION
,/ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
'.:axsi�s-
�rPhone: (904) 247-5826 Email:CBuilding-Dept@coab.us •y ) IS REQUIRED.
�vtr 6 AV Or. 0141 4 FL 32233 Permit Number: '�� e1 F `( v l 0 '1
Job Address: � �� ��
i
Legal Description 364/- /7-2s-.2') , qvc,c Cardtro L4 /J 13 RE# /7/ 8I8-- 5'22 0
Valuation of Work(Replacement Cost)$ X.) C S- Heated/Cooled SF !/ 32 1 Non-Heated/Cooled /3reo i c iz
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move [Memo ElPool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial 4Aesidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes Lk7No
• Will tree(s) be removed in association with proposed project? EYes (must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed:
Tear o i1-c old v'o-r and pa on /la() vim' : 1- !\G3\ e_
k Florida Product Approval# F L /(' (/• / , ft Z S33 - 2 for multiple products use product approval form
Property Owner Information
Name /v77/oWY fOO LE)' Address G((J 1j Q(/s477C b k l 1/C
City 47-en 4J7'/(' /3E. C/-( State Z.-----;e- Zip 3 q 233 Phone 727- SYS` 'ii Ga
E-Mail '7'"POOt 67 CP/!ij(-- , (") '?
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Cpmpany ' (iticdS" tah" dk`oc'kr�1( //nQualifying Agent J
ie✓t.. 2C4,e i )
Address 6 bZ1 , `�,
J•1 k 1): N //`/ City .�C,c/C1o,w,ltt State IL Zip 3 LL /l.
Office Phone 261G
Li i/ - fr- !' 33 `/ Job Site Contpct Number ;„,o-(G, 5)1r — `�34
State Certification/Registration# eC C• / '3r4'/ E-Mail CCi/ri•,1 a 6,3 .cl, !'u c:, ell t' ),"t
Architect Name&Phone# J
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
RECORDI YOUR NOE F COMMENCEMENT.
(Signat re f caner or nt) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this )( day of Signed and sworn to(or �
affirmed)before me this ii day of
not , 101I ,byt_130hti PobIt<2 Matth , 7.f�L/ , by 5C(l�/1 (X,i7['S
o
'+ STACY SI '• ' 1;K+: STACY' MMONS
;, v., Commission#GG 182461 : Commission f GO 182482
i 1 Personally Known OR ,'.�;:' Expires March 3,2022 Personally Known OR ':)`'''` Expires 3,2622
E or ryc; Bonded Thu Troy Fain hsonneec ik i.?�' Bonded Thu Troy Fain Insurance 800-3854019
[Produced Identification Produced Identification 411111.11...
Type of Identification: cc, b Type of Identification:
Doc # 2021085667, OR BK 19662 Page 1963, Number Pages : 1 ,
Recorded 04/05/2021 04 : 11 PM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
PREPARE IN DUPLICATE)
Permit No Tax Folio No
State of County of
To whom It may concern:
The undersigned hereby Informs you that improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT. //,
Legal description of property being improved. �� / 2 �C,� `A`C ` e�`���
Cir icB
Address of property being improved 6 l d ('),t i'Gr1" t b' ,44I6.n h( &Al ri 3 123 3
General description of improvements. AA f (e ft
Owner AA-72.104)7' DO -€Y'
Address COG /T6 i.);47-/c' �J,et✓( i4t'-sf 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Big Fish Roofing and Waterproofing,LLC
Address 6821 Southpoint Dr N Suite 114
Phone No.904.685-8334 Fax No. NA
Surety(if any)
Address Amount of bond$
Phone 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
Phone No. Fax No.
In addition to himself.owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06(2)(b).Florida Statutes (Fill in at Owner's option)
Name
Address
Phone No Fax No.
ver
Expiration date of Notice of Commencement(the expiration date Is one i 1)year from the date of recording unless a t"
different date is specified): itre
THIS SPACE FOR RECORDER'S USE ONLY W+ R
/
Wed A U ' 34/ 2( m,n y
g � . �!. J DATE � � y
Before me this I da or 4R.CITN" f?].-$ n tho 3 Ct
CD
C unt;o Duvai.Stat�of upqt G qnee.1183s pe y appeared
h7tr,
Yerein by e T.
;
himse:U herself t affrms that if statements and declarations herein - t
aro true and accurate w
Notary Public at Large.State of Ft� County of t U A_ f
My commission expires t.- -. �2 __. ...
Personally Known A` cc o
Produced Identlecatron F` �L �a L‘l r _L.c, fpr e
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