654 SELVA LAKES CIR - ROOF I. �
-
`i CITY OF ATLANTIC BEACH
SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
J131J`"
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2388
Job Type: ROOF PERMIT
Description: ROOF - RE ROOF SHINGLES
Estimated Value: $5,670.00
Issue Date: 10/8/2015
Expiration Date: 4/5/2016
PROPERTY ADDRESS:
Address: 654 SELVA LAKES CIR
RE Number: 172027-5806
PROPERTY OWNER:
Name: RAVI, DILEEP C
Address: 101 S OEAN DR APT 405
GENERAL CONTRACTOR INFORMATION:
Name: SHORE ROOFING COMPANY
Address: 914 7TH AVENUE S QA THOMAS LOUIS SHORE
Phone: - -
FEES:
BUILDING PERMIT FEE $78.35
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $82.35
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904)247-5845 1 5 ROO F_e-6
Job Address: la f9 ‘ 100,_.Z
c`A 45 _.C.✓ ._ ._ _ ___._ .__ __.Permit Number:
Legal Description 2, 1?vof
-�i� t'�'-Floor Arca o a/t� �' I'arccl #
Valuation of Work$ j` Proposed Work heated/cooled t
9 '
S6 74 ... non-heated/cooled
Class of Work(circle one): C, N� 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 system installed? (Circle one): Residential N/A
Florida Product Approval II /�lJ,e Z. /0.1)21) /
For multiple products use procf�app va-i`cn•m •r 3
Describe in detail the type of work to be performed:_-fie i'''SOke r, a, s� r t.r/mot ti /95-Z.
Property Owner Information:
Name.RAVI, � / ltdre .. /
o t . °CM/✓ 1Zy Am eos, �J State i!, ' ,. , ne 90 c s7( -07 td
E-Mail or Fax # (Optional)
Contractor Information: l't)r;'I'RA('I OR EM ADDRESS: —_ -_-
Company Name: SL o a , .,•f,
Address: eS/y , �hLc _. .f Qualifying Agent:
—.__ —___ - .____.. _._ _- _..Cif' i. . /i .
Office Phone y� J Job Site/Contact Number -- tit`' FL___ Zip _3.2,z p
.�!_ Y� 1.:. YJ__ (22e-airs Fax#
State Certification/Registration#__ C C!' 0 t 4�' Fax �/� Q 8'y2
Architect Name&Phone#
Engineer's Name&Phone# _ _ •
Fee Simple Title Holder Name and Address
Ilonding Company Name and Address
Mortgage Lender Name and Address Address..
�tioicnti,nr is hereby grade to obtain a permit to d„1/,'uor•A and installations,rx br,lierrted I.r,illy rho,,.,,n orA nr ius/u//ahnn has •o _ -- - -
iseuunce it.nl,erurit anti.that all work will he lie r aruee,l to ease,the stan(Grrtls of,,/1 lows r,.gul;rring r ou,•r�',won in this/rn•i.cdi,•tion. %h
is void if worA is not commenced within vii IN months. or i/ronstrnct/an or work is strvlu+n,h•,I or abon i n:rd ft,, t ,mod o v'. ,commenced nt red y tun toter
wank is coitpuenee,l 1 ranirmstantl Thal.,'karat,'Permits mast I', second•,/ J 1 ee.�permit I If it rs, !he'd fell.
Tanks and Air Condi/innrrs,etc.
fete Electrical►rink, Plumbing..Clh;nc, Belk I't�,/sr��inveutcal�ltnileii,flle•rr/stn;
WARNiNG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY.i Y. iF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here/a,certif3•drat/hove re•tn/and examined this epnlication and knmr the same to be tru and swiss/. All p revisions of laws and ordinances governing this
tlpc rfwork will he complied with whether specified herein or not. the grouting o/a pernul dues put presume to give authority to violate or cancel the
', ovieions plant,otter federal.state, or local law regulating construction or/h, 1,, '/arnluf,C t f epns/m(1,m.
signature of Owner ` Signature of Contractor *X------
'riot Name �
�i Ieep 2Ct i, . . Print Name //! vrA s'it d✓C.
iefore j � "
Zis 'gray of �, p�t� if—
this t,e
,,�' �w%/ ' this ! Day of t' ,'O�Q2. . 20 I
. •. ANNUM L BETTY wt (� „
otary •t c 4 Notary PubI1C,f3bb of Florida "l' w °., DAYNA H.WIWAMS
�.� Votary 'u lie ;tv MY COMMISSION#FF217841•;,w CommissbM FF 159728 =r', 'F EXPIRES:August 7,2019
My Comm.expires Sept 14,2018 •..•, `,
� � �bagged Notary Pubic UMerwriMn
-11
•
NOTICE OF COMMENCEMENT
State of FL- County of 60(00 Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements ,ill be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is :�:, i ie ';i/�OT1 1 r)1-CO M•frNCEM1;. F.
Legal Description of property being improved: IN-6.0 �y� _5 i vg ,Util 'yC �3 G /0 7
Address of property being improved: 6:-CT Se/t/p-( /q/ of Cr ✓ a t f 1l r✓pi L ?e1. FL -7222 .33
General description of improvements: /IC O
Address: /0/ O'CCq n/ tV
Owner: _ / -"f �'' 1))/* /q e j
Owner's interest in site of the improvement: _
Fee Simple Titleholder(if other than owner): .
Name: tt
C
•
ontractor: ,S I1 Uf,L ,.4�)0V i
b �5
Address: gt, % G u
ft.Wt. atA x 1,r✓A 2/0
Telephone No.. `/ ' , . .— cy2 Fax No.
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the constriction 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
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax Nu:
•
Expiration date of Notice of Commencement(the ekpiration date is one (I)year fi•oin the date of rccordinv unless a different date is
specified): . _._ _
THIS SPACE FOR RECORDER'S USE ONLY OWNER
X Signed: AO" (Tate: ro0/ !
ANNETTE L BETTY i3efot•c me t us y/y�y ] /
INotary Public,Stato of Florida Of Florida,has Personally crppea
■ .a, ^ Commisslont FF 159728 ersonally Known: r`
ply oomm.expires Sept 14,2018 'roduced Cdentiliceti n: "
'otary Public: VAIp l• .1YJ
\Qy canmissiun expii c s ) a1y0�
Doc#2015232197,OR BK 17330 Page 621, ;ot/�
Number Pages:1
Recorded 10/08/2015 at 03:27 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00