1775 Selva Marina Dr 2014 roof CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
J N� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
f 1'3��►
Application Number . . 14-00001019 Date 6/25/14
Property Address . . . . . . 1775 SELVA MARINA DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 11000
---------------------------------------------------
Application desc
Reroof FPA #101 . 2416
--------------------------------------------------
Owner Contractor
-
------------------------
-----------------------
STALEY JR, HENRY B GREAT WHITE CONSTRUCTION INC
1775 SELVA MARINA DR 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
(904) 838-1659
-------------------------------------------------
Permit ROOF PERMIT
Additional desc REROOF 10124 . 16 . 00
Permit Fee . . . . 105 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 11000
Expiration Date . . 12/22/14
-------------------------------------------------------------
Special Notes and Comments
need updated BTR for COJ
-------------------------------
Other Fees .
. STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
Fee summary Charged Paid Credited Due
--------- ---------- ----------
Permit Fee Total 105 . 00 105 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 109 . 00 109 . 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
�n(� 'Q+( Q l Permit Number: ' N1
Job Address: �� lyW _ L\
Legal Description ' X156 - '2�1� � 1W 1 S
Parcel# t
oor Area of Sq. t.
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Re Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval# � k• Vu
For multiple products use product approva orm
Describe in detail the type of work to be performed:
Property Owner Information: ,, ���� ,,����Address: MS Sfx�� \ffl
Name:
City State CL Zip 5 733 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: C jiN; Qualifying Agent:
Address:A City AJ)C State U Zip Z IU
Office Phone Job Sit Contact Number 9'115- Fax# (`4KAp(c
State Certification/Registration# EL 00
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 inas indicated. I certify that no work th 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 is not commenced within six(6)months,or if construction or work is susppended or abandoned for a period of six 16)months at any time after
work is commenced. I understand that separate permits must be secured for EledricaCWork,Plumbing,Signs, Wells,Pools, urnaces,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
COMMENCEMENT.
1 herebf certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
provisionsrk any be othero ederal,state,with whether ocal lww regulating construction od herein or not. 1he�the pe�foormance of constructioermit does not nresume to give authority to violate or cancel the
p f Y f
Signature of Owner 7� 13 <S>,+le-- Signature of Contractor J�I`
/, Print Name l.f. _vt. ............� 1,1C�.i'` �r
Print Name rlGn ... SFa�y ..................................................................
............ . .. ........ ............ .
Sword to and subscribed before me Sworn to and subscribedlbef me 20 f
this I Day of J VAC 20 1 L4 this _J1 Day of �J
AY .
LEY RIDGEWAY
�� •�,,�, ? Not y ublic State of Florida
Notary Public : ' y public State of Florida
1C •
Notal is' ' My .Ex,ppires Jun 20,2017
�=My Comm.Expires Jun 20,6 !+.E ed �bn#F FF 29966
Commission N FF 29966
Doc # 2014138368, OR BK 16820 Page 1011, Number Pages: 1, Recorded
06/23/2014 at 10:17 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
1000M OF CONMENCBMNT
�-ARE �7P33c R'Ej
f'eem�t 3k1. ,; `Tex��NO•�.�... .,..,...r. ._._._
To WhM it may concerti:._
Tiara unitearsigned tFM eby loft 110d. ra WOVMents wid be made to kmrtaw i( dy'vo in
accordance with�+afln�i�sf�tit+lF c U**.&Ming Information to StWWd in tii?is ffA OF
< i
0fw*pwtyq =<cwovee 1775 ova Marina lira Atlantic 8ch.Fla 32233 .._
Ge"a'erai desctip"p:tat'imprr Veme,•�.
, a Heng dale
Addre"`gym Sefv i Marina Dr.A4ieW Fla 32233
0*#W'5 gest 1h gale d he anproveftv. at -
fiee i t ie Ttlei idea iif attserpri�;a� + r3
WA
Name
AdWess
ucriilRGi cacbm �Mifw W0811d Schonfeid
Addles'. 4 !W" FL=3
arty)N0
? !1l15s
P ir?a'NQ. _.. Pax€ u.
tooto $of an: �wsm Wkirv, a!"n Yt2#"the consvuctIt'kn of the
Fox No3+fett tsi p so:. .:est<.tt $ paFrid . t +er f tom,rie ;trsatei by ter�3pxrs ; i Q=.aus z e 3"Y
him-Self, 7u i$r°t s t e foiiiowing}^'omw to recei,v'e 3 yC� Li�!'�C1`�NOWas i>:''tMt4*4 in
;, cn T 13.06 i2?t ?>Fbads motes.€Fitt in,&toMrNDf'ii .
ome
'
ids
Fax ray;
watwa data of Noiire of Gam am exXp atii?r'da:e s ossa:t t ye*.*yrs:ice date of go:Rt*ng UP�ie'w a
**w.*061A!SISwified A"3011
i8 8 115 i
14WWOEWS IKOILY ! OMER
W*tna
Awl
ado
V