Permit Roof 655 Selva Lakes Cir 2012 CITY OF ATLANTIC BEACH
t 800 SEMINOLE ROAD
J „r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . 12-00000851 Date 7/06/12
Property Address . . . . . . 655 SELVA LAKES CIR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5400
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Application desc
REROOF FPA #5444
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Owner Contractor
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MONTELEONE, PAM ET AL NORTHEAST FLORIDA ROOFING INC
655 SELVA LAKES CIRCLE 178 PINECREST CIR
ATLANTIC BEACH FL 322334379 SAN MATEO FL 32187
(386) 937-2598
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 80 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 5400
Expiration Date . . 1/02/13
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 80 . 00 80 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 84 . 00 84 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Doc # 2012141176, OR BK 15992 Page 1850, Number Pages: 1, Recorded
07/06/2012 at 12:30 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING
$10.00
NOTICE OF COMMENCEMENT
State of �� Tax Folio No.
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' stated in this NOTICE OF COMNIENCET.
i
Legal Description of property being improved: i U� ��'2 ���`� S (An�& a
Address of property being improved: &
General description of improvements: !�(p lydo
ownery MJL ,nl ess: 6 J r�a LA-AX r. N�k /-1-4661
Owner's interest in site of the improvement: o%A31'\er
Fee Simple Titleholder(if other than owner):
_ Name:
tractor: c( ` .
Address:
Telephone No.: Wk-a132- 4P►1 Fax No:
Surety(if any)
Address: Amount of Bond S
Telephone No: Fax No:
Name and address of any person maidng 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:
Telephone 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 Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
c.
Signed. _ Date: ' _
Before me s f the. ounty of Duval, tate
Of Florida,has p
Notary Public County of val.
My conunissi
Personally y' or
Produced Id H144fir '
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:al
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�� � .hIW"whit`dbC�OLk."�b(ca&6.Wa+:i...a.a,aS+'1.1.a.wr�;7t1i�mYi�zi a:.Ncrv.,a.w�w'n.i:�+,.,... •. . " :`•.'
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845
Job Address: '��yc 64 `1 fd .4Y�� � /.ir � � Permit Number:
G6 - a �c S�Pa cel#
Legal Description o
_ ` '-1,t
Valuation of Work$ S /00 Proposed Work heated/cooled t� non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s)(circle one):iCommercial Residential
If an existing structure,is a fire snr= r system installed? (Circle one): Yes No N /A
Florida Product Approval#
For multiple products use product approve orw
Describe in detail the type of work to be performed: /(r — t! D �—,y e (,..3j� S
Property Owner Information:
Name: Pe .K Address: G SS Sd✓A L-t k S (j r r l,-
City ewch StataR_Zip 3)a3 Phone ` 0 H_X1 - 10�f o
E-Mail or Fax# (Optional)
Contractor Information:
Company ame: N to f t- Qualifying Aw ent• .�4 [ 'r+S
Address: �Y1 e City 4�-X ft , I Statef'f Zip t S1
Office Phone 7- Job Site/Contact Number t- Fax#
State Certification/Registration#1'C.ty 13a 6-1
Architect Name& Phone#
Engineer's Name &Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
'IPP
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 7ais and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes nu!l
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for apertod of sixj6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Healers.
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
COMMENCEMENT.
1 hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
hype of work will be complied with whether speci re ein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state or local law r gulat g construction or the performance of construction.
L. b
Signature of Owne �C Signature of Contracto4/A_ _T1P__1
Print NamePrint Name
' Ie-- /c—I S 0n
. ......
�1 11111/
Swor and subscr' R/ 6�i���� Swor c$ ubscribed be re e
this Day of •••••� ! 20 1 this Day of 20
ary 13. 9
Oj
Not Public = � Notary
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