512 N Nautical Blvd RERF21-0166 Shingle REROOF SHINGLE PERMIT PERMIT N1-0166 UMBER
( -_---•-•__. �i
,. � CITY AL
800OF SEMINOLETANTIC ROAD BEACH
ISSUED: 6/22/2021
'71"'T`-7'riATLANTIC BEACH. FL 32233 EXPIRES: 12/19/2021 j
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:
512 N NAUTICAL BLVD REROOF SHINGLE Shingle: FL10674 R15, $8500.00
Underlayment: FL15216-R8
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170703 0364 SEASPRAY
COMPANY: ADDRESS: CITY: STATE: ZIP:
Ready Roofing
OWNER: ADDRESS: CITY: STATE: ZIP:
MOTES JENIFER A ET AL 512 NAUTICAL BLVD N ATLANTIC BEACH FL 32233-4119
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.
1 BUILDING ROOF IN-PROGRESS INSPECTION REQUIRED INFORMATIONAL
Notes:
a.The roof sheathing for all new construction must remain uncovered until the Roof Sheathing Inspection is approved.
b.All roofing projects require an In-Progress Inspection.
c.Sheathing installation and replacement guidelines per APA.
d.Underlayment must conform to FBC-R Table905.1.1
e.Shingles must conform to ASTM D3161 G or H,or ASTM D7158 F
Issued Date:6/22/2021 1 of 2
+S' r REROOF SHINGLE PERMIT PERMIT NUMBER
-- A...-.
. �P RERF21-0166
CITY OF ATLANTIC BEACH
)r ISSUED: 6/22/2021
800 SEMINOLE ROAD
° }~ ATLANTIC BEACH. FL 32233 EXPIRES: 12/19/2021
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:6/22/2021 2 of 2
NO'T'ICE OF CO11MENCEl11ENT
fermil No. I as Folio No.
State of Florida.Counts of I)ut al
TT IL I.NDLRSIGNI I)hereby pise notice that the Unpins merit%sill he made to certain real property in accordance tsith
Chapter 713.Florida Statutes.the fi+ll(m inp information is pros idcxl in this Notice of('omnrcncemenl.
1. Description of pro x its(Iepal description of properly and address if available):
35-64 17-2S-29E SEASPF AY LOT 10 BLK 3
2 General Description of intprosements:
REROOF
3. Ossmer Information:
a)Kann and Address: JENIFER MOTES • 512 NAUTICAL BLVD N ATLANTIC BEACH FL 32233
h)Interest in pmpeny:PRIMARY RESIDENCE
cl Name and address of simple titleholder(limber than canner):
NA
4, Contractor Information:
a)Nam and Address:REAM ROOFING LIC-3035 POWERS AVE STE.4 JACKSONVILLE FL 32217
1. •':ane Number.(90.11_40•1425.49
3. S...rct
n)Nahme n6i:c^, N t
t t Pt.re'•
..
c)Amo..-:: ftcrst.
6. :.cr:Jer Infunnyi5:n:
a)?Dant::d,J Address•i l y
L•)i'horrc Number:___7. ['mon within:t;a tits::,f I Fri Al designated by owner upon whom notices or other documents may be served as
provided by 7:" 1 l(I YS)7,:'r,:ida Statutes:
a)Name and ... .._ _
b)Phone Nm::-.t> D..••.ie.nated
8. In additi• a '- _•':m:::-alt(`vtrer designates of to receive a
copy of sire L:er:O '.,::a:as provided in Section 713.13(I)(b),Florida Statutes.
a)Name and Address:
b)Phone Number of person or entity designated by ossner: o
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction a c,
and final payment to the contractor.but will be one(I)year from the dale of recording unless a different dale is n
specified: rm a a
WARNING TO OWNER:ANY PAYMENTS MADE BY TI IE OWNER AFTER TI1E EXPIRATION OF THE NOTICE m
OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER Cl IAPTER 713,PART I.SECTION o °I
713.13.FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR v o
PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON TTiE JOB SITE �r^ "'
�•-a C7
BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITI( YOUR �, Z
LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF .a. a it
COMMENCEMENT. u k a}Z p
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated c)Z C 0 re
therein are true to the best of my knowledge and belief.
4 .A • Y`(\cr,k-e s
iprre of Oss er or Owner's Authorized 0 icer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The foregoing instrument was acknowledged before me by means of@physical presence orOonline notarization,
this\day of '"\MN—C. ,207\.by --Z-Let' c'( ‘NNO r'S who is personally known to
(Name of Person)
me or produced as identification,as
(Type of Authority,e.g..officer,attorney in fact,etc.)
for --exNY� , V r O e
(Name of Party Instrument was Executed for)
NOTARY P ELIC SIGNATUR —STATE OF FLPR
COLLEEN A.1�ElIkGComm t ss io Notary Name: tao l�-G•e tt JA. •e,es
P•' �;Corruairsion 4 GG 165631 •
lAfGx Notary Seal'way
•'�'rr Lof SM1r';,•°.. &deErpir(eteTlmfbeunr 6hSunro.2021
600`36+4
09
Revised 1/1/2020
Scanned with CamScanner
Building Permit Application
City of Atlantic Beach Building Department "ALL INFORMATION
,`.}
t t,/1 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
•
Phone: (904) 247-5826 Email: Building-Deptcoab,us IS REQUIRED.
(cU
Job Address: J \\ s\U--�\ i � V CI -1,2_,3-3 Permit Number: RERF21-0166
Legal Description 3 _11�
4___L. s��� St1.S?( \-0T \ 5i3oc-3 REP
Valuation of Work(Replacement Cost)$b- _ Heated/Cooled SF D Non-Heated/Cooled
• Class of Work: CJNew OAddition ❑Alteration f iepair LJMove ODemo [Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ZResidential
• If an existing structure,is a fire sprinkler system installed?: DYes ❑No
• Will tree(s) be removed in association with proposed project? fives(must submit separate Tree Removal Permit) ENo
Describe In detail the type of work to be performed:
V-ZCV13& 1 \nq GVvehS CbVhtng -NruAc1OC,tLWO ' ' cc)
c2.,hvwtn6 syvnT- t is xtrdev1Gt\Ir t-Ata
Florida Product Approval 4-ELOW-V-VA2-G - PLt472-t tp- for multiple products use product approval form
Property Owner Information +,
Name sJ� _i k J _ — Address_G tz aUt,1 tC-Q Ivo
't
City `QLJ s -,j L..1 State Ft_ Zip �'�.."3.7? Phone � - �(}� W
E-Mail Jexl YYl • • AP..cn uczY1c GYa-t s C.C)YYt
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of CompanV l � l t.-�< Qualifying Agent �)\. (� O SSU t\
Address P 1,p� * t�... City J c,1c- r\k re State-EC- Zi 7-`
Office Phone_• 1 1.. Job Site Contact Number • $ 2- 1 Z*,
State Certification/Registration If v2 , F-Mail F CPV'`a f C . OA, , 1 • •X
Architect Name&Phone h _\k
Engineer's Name&Phone h N
Workers Compensation Insurer OR Exempt/ Expiration Date 31 6 12025
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 entitles 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 LENDERAN ATTORNEY BEFORE
RECORDIN YOU N TI OF COMMENCEMENT / -
(Si,nature of Owner or Age)t) (Signature of Contractor)
SigneVand sworn to(or affirmed)before me this 1V‘y of Signed and sworn to(or affirmed)beforea this 'y day of
D' 1 ,byE-Q • `M co -J JNA Z� by _• Y`7��St/
_ ? �t�i
(Signature of Notary ` (Signature of Notary)
..r .�
;F.
fu GARTH M.GREER
,
( rsenally Known ;.',' COLLEEN A.KEELING )aersonally KnuHn OH 4 �.
Notary Pi is Slate of Fion OJ
''• ` rc Commission=GG 30.451
( J Produced Identifica iOa}' C n t GG 165631 1/Produced Identificati n t •�
Y'•.,,r�t. ,>.-F•*• 1 ?dr n° ray Comm.E x.fres Feb
1 t, 2023
Type of Identification. F�,r December 7,2021 rype of identification: ( �/ + Nauora'Notary Assn
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