712 SELVA LAKES CIR - ROOF r-j r\,y r�,.
�`' �� CITY OF ATLANTIC BEACH
�`2 800 SEMINOLE ROAD
80
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ATLANTIC BEACH, FL 32233
>\ IN SPECTION PHONE LINE 247-5814
'�J,31!
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 15-ROOF-2183
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated Value: $5,690.00
Issue Date: 9/15/2015
Expiration Date: 3/13/2016
PROPERTY ADDRESS:
Address: 712 SELVA LAKES CIR
RE Number: 172027-5838
PROPERTY OWNER:
Name: MCCAULEY. BEVERLY JANINE
Address: 712 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: - - --
FEES:
BUILDING PERMIT FEE $78.45
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $82.45
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
t` BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233 �'Z3
Office (904) 247-5826 Fax(904)247-5845 1 S ; �
1a S Iva ,\ cL jr c 1 0 Per it Number:
Job Address: _ 1
Lid-lop i 1 a - S ` :3 A e kip lO I LtS Parcel# 5 .r't
Legal Description oor Area of Sq•l't
Proposed Work heated/cooled non-heated/cooled
Valuation of Work$ t�G Q P
Class of Work(circle one): New AdditionAlteration Repair Move Demolition pool/spa window/door •
Use of existing/proposed structure(s)(circle one):. Commercial Residential o N/A
If an existing structure,is a fire sprinkler system installed?circle one): t �� o
Florida Product Approval# \L cl 5l, '�
For multiple products use product approval folm
type in detail
the e of work to be performed:.e ,r
Property Owner Information:
1 1 \ 1 Lira_�
C ,�,� Address: Va a �e S
Came: n n Stat �Zip .`).33 Phone Olt L1 ....3_,.S _. -i�3
City
E-Mail or Fax#(Optional)
i
Contractor Inf r ation: �__-
` ) Qualifying Agent: A:.")(,.r)1 k bk-i c ,
Company Name: d� �-�c n� 5 ,r 4-„1 City State I Zip=-
Address: I`f - L�'v r ty Yl °
Office Phon `+ .1. .. S, t t Job Site/Contact Number Fax#
State Certification/Registration# s C'f' 1--7 ', c )-,
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
-- Mortgage Lender Name and Address
issuance hereby and that aobtain r will bet performed work of all indicated
aws regulatinthat struction in this installation jurisdiction. permit becomesonull
issuance of permit time after
and k void if ommencedot I commenced within six understand that separate permits or if must be secured for Electrical Work,Plumbing,Signs,a Wells,Pools,xFurnaces,Boilers,Healers,
work and Air Conditioners,etc.
WARNING TO OWNER: YOUR OUR�YIN RECORD OR IMPROVEMENTS
TO COMMENCEMENT MAY RESULT IN
TO YOUR PROPERTY. IF YOU INTEND
BEFORE O OBTAIN FINANCING' OSU WITH
YOUR LENDER OR AN ATTORNEY R U[7RNOTICE OF
M NCEMENT•
y. - ■ n d to violate or n his
I hereby work will ll be come 1 read d with examined specified this
lhertein or not.know The granting of true
a permit does correct.
not P provisions
sumet to . laws and iolat governing c e t this
type si work w P .
provisions of any other federal,state, or local law regulating construction or the performance of construction.
A //. _ .� Signature of Contractor.. '
. Signature of Owner _ 4 i I- .. t�
�C'1/ /l ? e Print Name (),-.,'.., ) r�o✓�^�`u ..._.___...._.__......_.
Print Name �(
e Swo , • . d subs 'bed before me 20 l�-
Sworn to and subset' ed before,m this • l ay of
this/ Day of c, u 1' ,20 l G
�i2��1 t � / .r: 'ub is 1� ,,... ,
Notary Public 'A07.. •"
;v� o BER I �0
.° ��, AMBER L HICKS j'' •; vv11gg
i MY COMMISSION#FF033216
�~ MY MVO# F033216
' ; ..Z.O,„,?! EXPIRES July 2.2017
° EXPIRES July 2,2017
3980• (407)39•••••_.-0153 FloridallolaryServiee.eom
(40�396O1fr7 FlondaNe�tarv$e+vice.com -.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE;
Permit No Tax Folio •.
State of � County of , •
C
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
COMMENCEMENT.
I
Le al d scription f property being improved: ., •
Iva ICW vs ur-
Address of property being improved: "A ( a , ]feYQ t fl 1 LeS eire LQ
q n 3
General description of improvements:
11 - Owner ! .4 C_
• •
�1-1 r)-1. A4-.Address_1S� ' C 1=11311111111111,0:. -
Owner's interest in site of the improvement alb . III. III=
Fee Simple Titleholder(if other than owner)
Name
Address `-,-
Contracto .� ' /7" _ � ���
Address J.� r -••• . I -
Phone No 111 t Q UL 5(6 q Fax No.
Surety(if any)
Address Amount of bond S
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No. L.
N N- E
Name of person within the State of Florida.other than himself,designated by owner upon,whom notices or other Y LL 5
U lL N
documents may be served: _ * c`i T 1
Z
Name -IO7 t
Address w 1 c z
co Phone No. Fax No. Q p
a
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 Statutes.(Fill in at Owner's option). .`-::-•�o•,. 2
Name i . t:
Address • o 74, R'
Phone No. Fax No.
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 OWNER
e
s-�_ /5
-signed: 1....L.■ A
Before me this day of/ in the
Co'y2 y_017tRyva.Sja Hof Flo •:'•Wally appeared `
•!Jc_ V C /// G ZLt Le l herein by pr't T
himself'herself and a)(mts that all statements and decla Lions herein
are true and accurst
Doc#2015184058,OR BK 17264 Page 1841.
Number Pages: 1
Recorded 08/11;2015 at 12:15 PM,
Ronnie Fussell CLERK CIRCUIT COURT 74, R'
(>1-4) 1/1 ksi___ '
COUNTY Notary Public at Large.sta . County of 4 v��
RECORDING$10.00 My cccnmlsslon expires: - ^ i` or
Personally dentific
Produced Identification