2049 SELVA MARINA DR - ROOF PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2111
Job Type: ROOF PERMIT
Description: reroof 10124.16
Estimated Value: $8,560.00
Issue Date: 9/4/2015
Expiration Date: 3/2/2016
PROPERTY ADDRESS:
Address: 2049 SELVA MARINA DR
RE Number: 169506-1074
PROPERTY OWNER:
Name: SCHOLL, HARVEY H
Address: 2049 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: GREAT WHITE CONSTRUCTION INC
Address: 4320 DEERWOOD TRAVIS SLAUGHTER
Phone: - -
FEES:
BUILDING PERMIT FEE $92.80
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $96.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BUILDING('ODES.
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: egOM s d aq wM# %IJ p
�tk Permit Number:
Legal Description 31-'lk OS-ZS-Z. Sek J&t, NOt•e, t�1 Parcel #
09 Floor Area of Sq.Ft. t
Valuation of Work$ ?1LO0 . 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 R: dente.
If an existing structure,is a fire sprinkler system installed? (Circle one): es No /A
Florida Product Approval # VA'-
For multiple products use product a p p$13TraT form
Describe in detail the type of work to be performed: 0.0.7.-0.) ' ZCICI ke(li-
Property Owner Information:
Name: qtk 'O k I Address: 20461 eNkl(A. 1,A0,,6 C1a. DV
City tai . ..t C■ State-Vt.-Zip SZZSS Phone
E-Mail or Fax# (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS: qJW C()Of f ? QUI\IOA.- C b Y '
Company Name:GT if Whit Consit rt1c n Qualifying Agent:
TrcAvl5 510 hte r
Address:43a{ DP.erwooel LaV e 32-�-I(P City \lay State FL Zip 3a-c l o
Office Phonegbd- (1L(1 - '11 . Job Site Contact Number- ( AS .3$-I(,S'( Fax# I-Mslt- ?4(p-I iLi o
State Certification/Registration# C . 132e1 o -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
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 is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)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, 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 NOTIC S E _ _
COMMENCEMENT.
I hereby certify that I have read and examined this Application an. -:•oi d ,f,,Sam. o be true and correct. All provisions of laws and ordinance °o+ F;:A&i
type of work will be complied with whether specified herein or ot.,; ' ::{n I g of a permit does not presume to give authority to viol, .i,.th.
provisions of any other federal,state, or local law regulating cons rni'c aj •� :rformance of construction. ',� . ,,,,
/ I:/
Signature of Owner , v "�� o 0
� o Signature of Contractor _ ESL- a � -� n
Print Name //2, V e of Z/ d L o a d —' •'
H rt, vr
K > Pant Name '^. x = m
F.1 N CI' `
Before)me o 9 :efore me „ = rn
T
this Day of ' / ' Il I ' 201 S N 22 ,hi ( Day of ' VI' SA- I * I
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Gary Publi ' ' s - otary Public
Zi °' Revised 01.26.10
Doc # 2015202571, OR BK 17289 Page 2284, Number Pages: 1, Recorded
09/02/2015 at 12:28 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT.
,late of _._ �N; L CountY of
Tax Folio NO. _
To Whom It May Concern: __. ...._
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated• t is NOTICE OF COMt1 .NCEM.FNT. \
Legal Description of property being improved: ;f:".1.2: a :`J'S " 24 5� �� ; i � '
Address of property being Unplowed:w. 0 �"' '�^^. �'"�'- 0(4-
r�
General description of improvements: ' . > • ""
t fl '�. mod' ` . .....�a� f..i. 3
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Owner: b.1s+ 5, _=Z t�f€dreCC:r ' S �a +a7'>° �'` i\.. co hl
f
Owner's interest in site of tt t€ne impri>vement: �+� n a
Fee Simple Titleholder(if other than owner):
Name:
Contractor: g S3/411.2.W
Address: " kd r - •}. r1,a1'1 � � .... ...2- a
Telephone No.: WA1 ; ; Fax zo:...._` # ;�t itt:_. . ...8 `.
Surety(if any) ,_-
Address: _.:. �._._.. Amount of Bond$............._..._... -- —..
Telephone No: Fax No:
Name and address of any person making 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
t 3.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:-
Telephone No: Fax No:
Expiration date of o' e Commencement(the expiration date is one(l)year from the date of recording unless a different date is
specified):..._ i� .....'` t/.t 2 '..
THIS SPACE FOR RECORDER'S USE ONLY OWNER ,# t
N1,0"
r f .
�
Signed: Date: I
Before me this 3 dattf,Wt in the County of Duval,State
r.
01 Florida,has personally appearedki <: .1
Personally Known: or
Produced Itleitifi•• ion p _
Notary Public: .... .:- 441+ a
My commission expires:
.Natay t »� , 2,„,,e• J .} // �
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