Permit Roof 1520 Selva Marina Dr 2011 JO
01 CITY OF ATLANTIC BEACH
: j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
4 J1.31
Application Number 11- 00001808 Date 3/18/11
Property Address 1520 SELVA MARINA DR
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 11440
Application desc
NEW ROOF
Owner Contractor
STRICKLAND, BRUCE W. BURGER ROOFING CO.
1520 SELVA MARINA DR. 134 -1 ERNEST STREET
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32204
(904) 355 -2756
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 110.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 11440
Expiration Date . 9/14/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 110.00 110.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 114.00 114.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 1520 SELVA MARINA DR Permit Number:
Legal Description 30 -028 16- 2S -29E SELVA MARINA UNIT NO 4 Parcel # 171984 - 0000
Floor Area of Sq.Ft. Sqq.Ft
Valuation of Work $ 11,440.00 Proposed Work heated/cooled 2313 non 817
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa 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
Florida Product Approval # FL10124
For multiple products use product approval form
Describe in detail the type of work to be performed: REMOVE EXISTING ROOFING AND REPLACE WITH A
PEAL & STICK UNDERLAYMENT AND 25 -YEAR 3 -TAB SHINGLES.
Property Owner Information:
Name: BRUCE STRICKLAND Address: 1520 SELVA MARINA DR
City ATLANTIC BEACH State FL Zip 32233 Phone 642 -5111
E -Mail or Fax # (Optional)
Contractor Information:
Company Name:BURGER ROOFING CO Qualifying Agent: GARY BURGER
Address:134 -1 ERNEST STREET City JACKSONVILLE State FL Zip 32204
Office Phone 904.355.2756 Job Site/ Contact Number 904.237.9664 Fax #: 904.358.0733
State Certification/Registration # CCCO32514
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six 6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, Bo Heaters,
Tanks and Air Conditioners, etc
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
COMME
I hereby certify that I have read and examined this a nd kno the same to be t ru e and co All provisions of laws and ordinances governing this
type of work will be complied with whet s.eci ie 1 . not. The grant of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or 1. .' : re,s ' co > ction or the performance of construction.
11911 Au,
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Signature of Owner �.,,� � Signature of Contracto �� .�, A _ ,
Print Name �" �
J G ° ip Name : ' 1 'I E ,►,. ; � �l' ,� -, q:-.10..ii � Print
Sworn to and subsc , : Y PUBLIC o •and subs , ibed before me i' ll this t Day o b . �'„ t S TATE OF F� • • 20 ( 1f'i' Da o,2414•2,0,„; " x
/ Erns 3129/2014 ` ► rr iGi �
otary 3 ' • . is � S1 "t. '!�� R. MERED(1H
* , , * MY COMMISSION # DD 900284
i " EXPIRES: July 14, 201R.evi
m sed 01.26.10
mr'TFo F e e Bonded Thu Budget Notary Services
NOTICE OF COMMENCEMENT N Number : U t br 5� age �;
ber Pages. 1
Recorded 03 'I 8 2011 at 01 10 PM
JIM 'RULE ER CLERK C'RCUIT COURT DUVAL
COUNTY
Permit No. RECORDING 510.00
Tax Folio No. 171984 -0000
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property (legal description): 30-028 16- 2S -29E SELVA MARINA UNIT NO 4
a) Street (job) Address: 1520 SELVA MARINA DR, ATLANTIC BEACH FL 32233
2.General description of improvements: REMOVE EXISTING ROOFING AND INSTALL PEAL & STICK UNDERLAYMENT
AND 25 -YEAR 3 -TAB SHINGLES.
3.Owner Information
a) Name and address: BRUCE STRICKLAND
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property FEE SIMPLE
,-74.Contractor Information
a) Name and address: BURGER ROOFING CO, 134 -1 ERNEST ST, JACKSONVILLE, FL 32204
b) Telephone No.: 904.355 .2756 Fax No. t. 904 .358.0733
5.Surety Information (� )
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6.Lender
a) Name and address:
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement (the expiration date is one 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 YOUR LE Ai _ .ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENC t,
STATE OF FLORIDA
COUNTY OF PINELLAS , , DENNIS J. A 10 a ��� „
NOTARY PUSUC Signature of Owner or Owner's A + oriz a ffi, dDirector/PartnerfManager
ip ,. STATE OF FLORIDA
011 t'
• '•' • - • Print Nam
Emirs* 5/29/2014
The foregoing instrument was acknowledged before me this 11 day of VIA A& , 20 1 , by
as (type of authority, ty, e.g. officer, trustee,
attorney in fact) for (name of party on be If of whom inst ument was executed).
Personally Known OR Produced Identification Notary Signature /1
Type of Identification Produced Name (print) N A 5 (7.5 (' ) /1
OR
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
FORMS/NOC,rvsd2010
Signature of Natural Person Signing (in line # 10.) Above
i 1