1969 Selva marina Dr roof 2012 CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
jj ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001683 Date 11/13/12
Property Address . . . . . . 1969 SELVA MARINA DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 23960
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Application desc
roof
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Owner Contractor
-
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STULL, CHARLES W TAYLOR CONSTRUCTION CO
1969 SELVA MARINA DR. 3617 CAPPER RD
ATLANTIC BEACH FL 322334519 JACKSONVILLE FL 32218
(904) 710-8946
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Permit . . . . . . ROOF PERMIT
Additional desc . . . 00
Permit Fee . . . . 170 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 23960
Expiration Date . . 5/12/13
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Other Fees STATE DCA SURCHARGE 2 . 55
STATE DBPR SURCHARGE 2 . 55
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Fee summary Charged Paid Credited Due
--------- ---------- ----------
Permit Fee Total 170 . 00 170 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 5 . 10 5 . 10 . 00 . 00
Grand Total 175 . 10 175 . 10 . 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: �CI S��V �ity 4 7D Permit Number:
Legal Description Parcel#
Floor Area of Sq. t. q. t
Valuation of Work$2 3,6)&b,a Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one):. Commercial
If an existing structure,is a fire sprinkler
(circle
sy tem installed? Circle'on!: Yes No N/A
Florida Product Approval# 5- M
For multiple products use pro uct approve orm V49__
�
Describe in detail the type of work to be performed: 49__
Property Owner Information: n'' nn
Name:t^l 4'l Address: I`"I>r<T! -) Kk
City State Muzip &3Phone
E-Mai or Fax#(Optional
Contractor Information:
Company Name: 5 QM!IAgent:Address: Ci � State /1- Zip
Office Phon - Job Site/ ontact Numbe d Fax#
State Certification/Registration
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 Isnot
commenced within six(6)months,or if construction or work is suspended or abandoned for aerrod of stx1ti)months at any time after
work is commenced. I understand that separate per
must be secured for Electrical Work,Plumbing,Signs, ells,Pools, rurnaces,Boilers,Heaters,
Tanks and Air Conditioners,eta
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.
I hereby certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complie with whether sped ed herein or not. The granting of a permit does not presume to gave autho violate or cancel the
provisions of any other fele tate,or local law re ladng construction or the performance of construction.
Signature of Owner `�'� Signature of Contractor
F� 1 F� )
Print Name �C J l� ^Y� Print Name UA f
....tJ'... -c�,................................. .. ............................... ........ j1 .........................................................
Sworn to and subscribed before me Sworn to and subscribed before Te
this 13 Day ov / 20( �' this IS Day of OAW 20 —
Notary Public + STEPHEN T.PUTNAMI Notary Public
Notary Public,State of PaW Notary Public,State of
FloridaF
Coneor*DDW1l40 .RM i#DD998148 omm.expves July 20,0011sm.epes Juy 20,204
2014
Doc#2012254396,OR BK 16141 Page 568,
Number Pages: 1
Recorded 11x13'2012 at 10:11 AM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
This Instrument Prepared By: COUNTY
Name:TAYI QR CONSTRI ICTlnN CC)QF.IACKSC�NVII LE RECD RDRdG$10.00
INC.
Address:3617 CAPPER RD JACKSONVILLE, FLORIDA 32218 Tax Folio No: 169506-1004
Permit No.:
NOTICE OF COMMENCEMENT
State Of FLORIDA
County of DUVAL
THE UNDERSIGNED hereby gives notice that improvement(s)will be made to certain real property,and in accordance
with Chapter 713, Florida Statutes,the following information is provided in this Notice of Commencement.
Descdption of property(legal description of property and street 39-94 08-2S-29E SELVA NORTE UNIT ONE
1. o�
03907 SELVA NORTE UNIT 01
2 General description of improvement: REROOF
3. Owner Information:
a)Name and complete address:CHARLES W STULL 1969 SELVA MARINA DR ATLANTIC BEACH FLORIDA 32233
b) Interest in property:OWNER(100%)
c)Name and address ot Fee Simple I ftle Holder(it ofner than owner
Contractor Information:
4. a)Company name and complete address:TAYLOR CONSTRUCTION CO. OF JACKSONVILLE INC.3617
CAPPER RD JACKSONVILLE, FLORIDA 32218
b)Phone number: (904)710-8946 Fax Number:(904)924-8267
5. Surety:
a) Name and complete address: N/A
b)Amount of Bond: $
c)Phone number: Fax Number-
6. Lender:
a)Name and complete address: N/A
b) Phone number: Fax Nurnber-
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by in Section 713.13(1)(a)7., Florida Statutes:
a)Name and complete address:N/A
b)Phone number:Fax Number:
8. In addition to himself,Owner designates the following person(s)to receive a copy of the Lienor's Notice as
provided in Section 713.13(1)(b), Florida Statutes:
a)Name and complete address:N/A
b) Phone number:Fax Number:
9. Expiration date of Notice of Commencement(the expiration date is 1-year from the date of recording,unless a
different date is specified): N/A
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHPATER 713,PART 1,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 WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE 1�OMMENCEMENT.
Signature of Owner or Owner's Authorized
Officer/Director/Partner/Manager
Signatory's Title/Office
The foregoing instrument was acknowledged before me this day of (type
b .� �i �I ! �
y
of authority,..e.g.officer,trustee,attorney in fact)for of of party on behalf of
whom instrument was executed)
EN T'PU' r. Signature of Notary Public—State of Florida
fd State of{ra;i,a Print,Type, or Stamp Commissioned Name of Notary
'f �, a3998'43 Public/Commission Number
�:�,y 20:2414
Personally Known or Produced IDS
Verification Pursuant to Section 92.525,Florida Statutes
Under penalties of perjury, I declare that I have read the foregoing that the facts stated in it Are true to the best of my
knowledge and belief.
Signature of Owner or Owner's Authorized
Officer/DirectorlPartner/Manager