Permit Roof 1913 Selva Marina 2012 fj1 ' l CITY OF ATLANTIC BEACH
T � J 800 SEMINOLE ROAD
- ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
013
Application Number 12- 00000255 Date 3/07/12
Property Address 1913 SELVA MARINA DR
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 8300
Application desc
reroof
Owner Contractor
LITTON DS KILLIAN ROOFING
1913 SELVA MARINA DR. 3898 DUPONT CIRCLE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32254
Permit ROOF PERMIT
Additional desc .
Permit Fee . . 95.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 8300
Expiration Date . 9/03/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 95.00 95.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 99.00 99.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII 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: INS spJoe /04111a b&. A Ia t '-emit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 1?3Oc) Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration Repai Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial 461 -siden i..
If an existing structure, is a fire sprinkler system installed? (Circle one): • es N /A
Florida Product Approval #
For multiple products use pro uct approval form n
Describe in detail the type of work to be performed: 74e. '9OT2 .s L 7/4j.
Property Owner Information: r `-
Name: '4.1 rm
' T/ / i'' Address: IRj'3 Sek4 • MBA.. ilk.
City ;,Arris, Q- •G. ' StateF Zip 32233 Phone '0 - =1-
E -Mail or Fax # (Optional)
Contractor Information: .
Company Name DS Killian Roof & General Contractors Inc. Qualifying Agent: David Scott Killian
Address: 3948 South Third St Suite 122 City Jacksonville Beach State Fl Zip: 32250
Office Phone 904 246 7663 Job Site/ Contact Number 904 509 8470 Fax # 904 339 9233
State Certification/Registration #: CGC 1504656 CCC 1328203
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. 1 certify that no work or installation has commenced prior to the
issuance of 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 �f 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. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, 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
COMMENCEM
1 hereb certify that 1 have read and : • • fined th'• a placation and know the same to be t and correct. All provisions of laws an• . ordinances governing this
type of work will be complied with er sppel i led herein or not. The granting of a perm does not presume to give aut .r ty to violate or cancel the
provisions of any other federal, stat, • ■cal Is regulating construction or the performance of construction.
Signature of Owner " / *- Signature of Contract. _ T --•
Print Name 6 (i -e..... � t 1� � �6.. 6.. Print Name DIV ( 0 5 "%f l
`' � P A4.1
Sworn to and subscribed before me Sworn t• ant sub , i' >,� �f e 20
this Co Day of aaa���a► ���► t — I
A P 1 0 ary Public - State o1 Florida ( , I ;° ,� �7AlriVirli I
f� fi r . �. ,a;; �.�. ...' ...ry �� I
N • a • • he a 'Al I d Thru No Pubf
ry + Commission • EE 34559 �efrr �`� •
, <,1-: ,...
a ^ • Bonded Tiro* National Notary Man. ► • eve sed 01.26.10
•
Doc # 2012048211, OR BK 15870 Page 934, Number Pages: 1, Recorded 03/06/2012
at 03:56 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
DUPLICATE)
Tax Folio No.
County of
To sitcom i may concern=
The raedersigraed beret/ rffortns you that improvements will be made to certain real property, and in
accordance sill S•esaon 713 of the Florida Statutes, the following information is stated in this NOTICE OF
COMMENCEMENT. �y /1
-� desatpoce _ • o i O Z4' ' It, din , ! ,
# - 7P /.. /.i I I:
Address of property being improved r _4 / • AL' r • ri ..lt r�l 0 .
General desorption of improvements Re = oof
Owner 1 /�. •
Address L
�'. eL� >>? �/ i , MUM [L�� =MT N! 2 cw.
Owner's interest in site of the improvement !O 0
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor DS Killian Roofing & General Contractors Inc.
Address39 S. Third st Suite 122 Jacksonville Beach F1 32250
Phone No. 904 246 7663 FaxNo.904 339 9233
Surety (if any) N/A
Address Amount of bond $
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name N/A
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 N/A
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 N/A
Address
Phone No. Fax No.
Expiration date of Notice of Commencement (the expiration date is on year ffr the date of recording unless a
different date is specified): '
THIS SPACE FOR RECORDER'S USE ONLY .wNER
Signed: DATE„) ' (i !
Before me this , day of kA& rCJr- ' T in the
Counl oQf Duvel,Stete of Wide, has p rsonally appeared
ClINK `\ P_ l ,s C Jr f \ herein by
himself/ herself and affirms that all statements and declarations herein
are true and accurate
_� •
p MIRIAM GRIFFIN
.t,,, ti: Notary Public , State at Florida i
!f • tir ': ■ Co . Expires Ott 14, 2014
No -"' .lie . t_arge, Stat . tl• ' t`7FL .. mission it EE 34559
My commission expires. AJWA.rli� 7Li>M Notary Ana. Personally Known "" ' '
Produced Identification ... A - a -