615 Selva Lakes Cir 2014 roof CITY OF ATLANTIC BEACH
r 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
° INSPECTION PHONE LINE 247-5814
Application Number . . . 14-00001013 Date 6/24/14
Property Address . . . . . . 615 SELVA LAKES CIR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
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Application desc
REROOF
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Owner Contractor
-
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TINNEY, JAN A COASTAL IMPROVEMENT CORP.
615 SELVA LAKES CIR 1215 N 9TH ST
ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32250
(904) 458-3747
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Permit ROOF PERMIT
Additional desc . .
Permit Fee 80 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6000
Expiration Date . . 12/21/14
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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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904)247-5845
Job Address: � Permi Numb
er:
Legal Descriptionq3f1 .ZS-Zjp �ff *9 �AkrSPa �l#T :Z
17ZCk2 7- SSSo
-Floor ea of 5q-Tt-. ) o
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Valuation of Work$,� b�e Proposed Work heated/cooled J�.—�� nn-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 Residential
If an existing structure,is a fire spruakler syste nstalled9 (Circle one): Yes No N/A
Florida Product Approval# FZ_ 10 1 2-
For multiple products use product approval form n
Describe in detail the type of work to be performed: �� yr o,r C 4o »e w G®d
Property Owner Information: nn
Nam . A TI a w0 -Address:/015 3elkA
City e: StateFUip��_Phone '10q-
E-Mail or Fax#(Optional)
Contractor Information: Co�P �-•
C(54!? »�>�b✓eme» Qualifying Agent:
Company Name: X3.e.W State 'L Zip Z-
Address: � Z )5 �'� A 7- JVCity 3-&49Y,
Office Phone �„Z 2 ^ D gbb Site/Contact Number Sir rye Fax#
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone# -------�
Fee Simple Title Holder Name and Address -%T,09 JOL) -r),A »le
Bonding Company Name and Address l 1 S 221.- ,
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 a permit and that all woin s
rk will be performed to meet the standards of all laws rpegulating construction in thpis jurisdiction(. months at This permit becomeimes null
work is�ommenced.ot 1 understand trhat separate per
mjus be se er
,tied for Electrical Workd Plumbtng,Sig sr aWells,P eriod ols,XFu)aces,Boilers,Healers,
Tanks and Air Conditioners,etc-
WARNING
tcWARNING 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 BEFR ENTE RECORDING YOUR NOTICE OF
I here b certify that 1 have read and examined this plication and know the same to be true and correct. All provisions flaws and ordinances governing this
type of work will be complied with whether t his red herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions ofany other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
C=
f f�. �j Print Name TU -r
PrintName _ '.( flat��.`�....................................................................................................
Sworn to and subscribgd before me / Sworn to and subscribed before me 2014
this 19 Day of cJ u-nf ,20 `f this ay
,a r No Pu is D.CHRISTOPHER WARD
Notary Public' `�`= Commission#FF 029375Y ��
• a.- Expires June 20,2017 Notary Pu 1,�stete of F 2 ,10
Commis �l�
4•' Bonded Th u Tray Fe n In�u anc�B00-385-7019 My comm.expires May 20,2016
NOTICE OF COMMENCEMENT
State of a.
Tax Folio No.
County of �{V7Z
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 is stated in this NOTICE OF CO ENCE ENT. L
Legal Description of property being improved: >-2 —
vaV T
12,
Address of property being improved: YL V1.4 �-. S G
General description of improvements:
Owner: Address: kit'� !moi
Owner's interest in site of the improvement: G G S 21�-
Fee Simple Titleholder(if other than owner):
Name:
Contractor: Oji 5 1�4 ^r^ �Q�ayZ/�-�G✓� Ge �'�
Address: Z 5 5 r
Telephone No.: �Z2- l-J O Z�$ Fax No: �
Surety(if any)
Amount of Bond$
Address:
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: Doc#20'14140034,OR 6K 16822 Page 1806,
Number Pages:1
Address: Recorded-06 24/2014 at 0215 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
Phone No: Fax No: COUNTY
Name of person within the State of Florida, other than himself, designated
RECORDING$10.00
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.b(Fil wner'stiv 4�e S
Name: ••,,,, r�
Address- Yd I&cpX
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 OW?rja,
SigDate: Y "
Beday of C in the County of Duval.State
,�Y':''% NANCY J0 SMITH Of personally appeared Q M 'lri "
Commission#FF 029375
tea• a Expires June 20,2017 Not Large,State of Florida,County oDuval.
� �•' BoMeaThmTroy Fain Inamm-OW-�-7o,a My commission expires: J L�N.�Z_l
�'P`�•• Personally Known: or
Produced Identification: L- L —L42 L'" "-121—