675 Selva Lakes Cir 2012 roof CITY OF ATLANTIC BEACH
s
800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
" INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-d;0001150 Date 8/31/12
Property Address . . . . . . 675 'SELVA LAKES CIR
Application type description ROOD PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 7325
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Application desc
reroof
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Owner Contractor
GRANT, THOMAS HANSON ROOFING INC
679 SELVA LAKES CIR 2714 CORTEZ RD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32246
(904) 641-6328
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Permit . . . . . . ROOF PERMIT
Additional desc
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 7325
Expiration Date 2/27/13
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Other Fees . . . . . . . . . STAE DCA SURCHARGE 2 . 00
'
STA E DBPR SURCHARGE 2 . 00
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Fee summary Charged ,aid Credited Due
----------------- ---------- --- ------ ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF AI LANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
V�
NOTICE OF COMMENCEMENT
P
)
Permit No. Tax Folie No.
state of County if
To whom it may concern:
The undersigned humby Irirvi mu you that:Improvements' will bo made,to certain real property,and in
accordance with Section 713 of the Florida Statutes,the fol owing information Is stated In this NOTICE OF
COMMENCEMENT, /_ d
Le ai description of propetty being Improved: 67(5` F'
Address of property being improved: 0075r
General description of improvementsc
Tuner _.
Arldrr..ca � � c'i7 �9 j''i"1CC_r d"'tu'tY�,A!�v; vs �—:
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor r
Address � J `
f'hono No. FaX P,9 y4(— W ~ Z�7
^2W-
Surety(if any)
Address Amount of bond$
Phone No. Fax 1 o.
Name and addrees of any person making a loan for tho con>:tru tion of the 1mProveem?nts.
Name
Address
Phone No. Feu l^
Doc#2012188757,OR BK 16054 Page 2050,
Name of per-nn within the Rtate of Florida other than hitnAe Number Pages:1
documents,may be servetl; Recorded 08/31,12012 at 02:29 PM,
Name JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
Address RECORDING$10.00
Phone No, F,
In addition to himself,owner designates the following person to eceive a copy of the Lienor's Notice as provided in
Seetlon 713,06(2)(b),Florida Statutes.(Fill in at Owner's optio l).
Name
Addraa55
Noone No. Fax No,
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
difrarant date Is speciricd).
THIS SPACE FOR RECORDER'S USE ONL ti WNER
h t 3v Lt Z
31ynn�, DATE
Barer,me this a day of e
COunty of tate of Ranee,hperaostaily appgAr9d
T r" es heretn by
hlmaolff norsolf nil Im"..thnl nil arrtwm WQ and dt rlaratlnnt Wain
ENOTARY
ORGE PORTOC.ARRERC are
true and acc', ate
PUB!IC-LOUISIANA
DDO-BOSSIER PARISHy�
ARY ID NUMBER 056297 Commission is For Life y
�o✓a.+.�m+lv+ea�..A,r+� NO��rf PubRr,at Argo,Siete er County Of
My mmmisslan xpires:
Personally Knv _..... ,,,,, _or
Produced Identl aeon W r
(BUILDING PERMIT A PLICATION
'
Cn,y OF ATLAINTI� BEACH
800 Seminole Road,Atlantic',Beach, PL 32233
f
Oice (904)247-5826 Fa (904)247-5845
Job Address �rLy 4 � f, _ri7Z _ Periuit Number:
Legal Description Parcel#
a oor Area o.. q. t. q• t
Valuation of Work 2 Proposed Work heated poled� non-hutted/cooled
Class of`V'Vork(circle one): New Addition teratio Repo'ir Move Demolition pool/spa window/door
Use of existing/pruused structures) circle one),. Commercial
If an existing structure,is a fire sprinkler system installed? (Circic 4110EYes No . N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed:
Pruuerty Owner Information
Kame: G'rCAVrt -
City tiN vi Ile _ _State 1AZip - 0f A-1 —Phone ° + l 35
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: K. +fi. Quali'Fyin8 Agent: _SA
Address: L City uw lk SYa.ce_ /� Zip .3ZZ-94;
Office Phone Job Site/Contact Numberql- 3 910 � Fax#
state Certification/Registration #.. _Oj —
Architect Name& Phone#
Engineer's Name&Phone# -
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
:9pplicatian is hereby made to obtain a permit to do the work and installations as indi'ated. 1 certify that nrr work or installation has commenced prior to the
issuance of a permit and 0,0
t all work wild he perforn:cd to meet the standards of all la',,r regulating construction in this jurlsdictzon. This permit becomes nut(
unci vutd tjwvrk ia'nut�:Vrn,r,ertc eel within six(G)n+onths, or f j;a?zvtruef,'(),t or tiuork is us ended or-abandonedfora rzpL1 of rL�((6)naonthr al am rr»tn ne�ar
,.work is rammancea' 1 u+Tde+stand that separate permits must he secured for Electrl a�ll'nrk,Plumbing, Signs, T�e is,Pools, Ttir»ares,boilers.,hfeafers,
Tanks and Air Conditioners,eta
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR P YING TWICE FO IMPROVEMENTS
TO YOUR PROPERTY- IF YOU INTENT] TO 011TAIN FINANCTNI CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFOT E RECORDING Y QTR NOTICE OF
COMMENCEMENT.
1 hereby certify that I have read and examined this application and know rhe same to b true and correct. 411 provision of taws and ordinances governing this
type of work it ill he eom 'ed with whether specii& herein or not. The granting o a permit does not presume to ive authority to violate or cancel the
t>r n,n.rrnn.c nfnr�v ntt,ar jrz
P. n .alt egulating construction or the ve?fo Lance nfconstr:tctlon.
Signature of Ow r Si'' nature of Contractor
r
Print Name 6 m�� rc1 h P int Name fir HCt�So cc
.................................................................... ............ .._.._.._....... .,.,.,,..,..,., ,.............................................,......,....,..,.,.,........................
Sworn to and subscribed before me S orn to and subscribed before me
this Day of- 1 K aw e, s^ .20 / th s -LL!�Da of
Notary Pu lic N
JEFF OHLRICH
GEORGE PORTOCARRERO _•. .`_. Commission#EE !!ed 01.26,10
NOTARY PUBLIC- LOUISIANA `i Expires January 3 ,CADDO-BOSSIER PARISH „�cg` BondedThmT Fain Man
NOTARY ID NUMBER 056297
My Commission Is For Life