727 Selva Lakes Cir - ReRoof , fr l '" a ` s 1 CITY OF ATLANTIC BEACH
-- ;) 800 SEMINOLE ROAD
J �' 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: 16- ROOF -280
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $4,000.00
Issue Date: 2/4/2016
Expiration Date: 8/2/2016
PROPERTY ADDRESS:
Address: 727 SELVA LAKES CIR
RE Number: 172027 -5860
PROPERTY OWNER:
Name: HOOD, BOLD R III
Address: 14529 MARSH VIEW DR
GENERAL CONTRACTOR INFORMATION:
Name: DAVID MERRITT CONST. CO.(ROOF)
Address: 108 FLORIDA BLVD QA: MELISSA MICHELLE MERRITT
Phone: - -
FEES:
BUILDING PERMIT FEE $70.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $74.00
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: 7a,7 Sel Vu 1-(4 KS (q. (GIG M iGhfc. &Wi - ermit Number:
Legal Description 1/Ce- C6/ ---t l/3 till c 3 (-04— 1 3 l
Floor Area of Sq.Ft. arcel #
Valuation of Work $ `CV'
Proposed Work heated /cooled t
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 Residential
If an existing structure, is a fire sprinkler s stem installed? (Circle one): Yes No N /A
Florida Product Approval # a_ /o /?'i /
For multiple products use product approval form
Describe in detail the type of work to be performed: kettcoP
Property Owner Information:
Name: Fj & b' Address: Se1Vc La a 'c e
City -A c o i r h ` c , 6 e L . State Zip 3 ( W - 33(f —9
�3 Phone � ,21 O zZ 3
E -Mail or Fax # (Optional) w - ( 5* ,-e.1-
Contractor Information: , / CONTRACTOR EMAIL ADDRESS:
Company Name: V i /� k � 7.-7t-C_ Agent (r ° �t S J`Q e t &1
Address: l —Q Cr / ✓V( Vt City 1/4"-i GEC. State l'( Zip 3?? 5T
Office Phone '7 -/ C '1 Job Site/ Contact Number — I
State Certification /Registration # C.C.C.--/ 3 Z _ ) / � � 2,1 Fax # �' —7 .-"/
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
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
and void if woJ k is cot and nced within bx performed 6) onths, or f construction or w work is sus regulating ded or abandoned for a this
period of ix jurisdiction.
months at any time after
work is commenced. I understand that separate permits must be secured for Electrical !Fork, 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 NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this a placation and kno , tl,, .,,,,,,, t., e true and correct. All provisions of laws and ordinances governing t$i.� ,+'` -� •"o;
type of work will be complied with whether specified herein or not. Iv, e v° 'utX ig ,f a permit does notpresue e to give authority to violate or cancee
provisions of any other federal, state, or local law regulating construct, a Di a � mance of construction. r
Signature of Owner �`� , ,, m R
` 1 , ` m `i gnature of Contrac or x .., T 'rint Name �LE7 CA .S,/ x { -n Q/ T
n . ... m 0 'rint Name �l L SA, 3efo e.me � d �' o o 6 c
hiss Day of J . b _ 20 ° ci (o C is me d $ o c
A Pr N 3 z Z t is 3 Day of FiPR1 20 2 Z,
-.�, ice` �° / j n rn otar ' i•li 1 3 N o i!Ir:ry 17 is o 8 c
o .5 w u
0', . § Revised 01.26.10
NOTICE OF C•MMENCFMFNT
State of County of
To Whom It May Concern: Tax Folio No.
The undersigned hereby informs you that improvements will be made to certain real ro ert
the Florida Statutes, the following information is s • ted in this NOTICE OF CO p p'' and in accordance with Section 713 of
Legal Description of property being improved: "" te 0 M I CEMENT.
Address of property being improved: /
�U! '
General description of improvements: i V C
r ,-
/
Owner: OLD ♦ 0 0
Address: ge 4 S
Owner's interest in site of the improvement: —` 'e Aif 0 act,
Fee Simple Titleholder (if other than owner): • 3a
p/ 19 4 9
' ' t
ontractor: t
Address: A C 1 f-1t n Y1 ak tik - CX1 h.
it i
Telephone No.:
—__ Fax No:
Surety (if any)
Address:
Telephone No: .. Amount of Bond $
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 Name: Y be
Address:
Telephone No:
Fax No:
In addition to himself, owner designates - the following person to receive a co >
713.06(2)(b), Florida Statues. (Fill in at Owner's option) PY of the Lienor s Notice as provided in Section
Name:
Address:
Telephone No:
Fax No:
Expiration date of Notice of Conunencement (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
Signed: / ' , \ i► i
Before me is `' Date: J -Wrb 1
t day of in the County of Du val, State
Doc r# 2016026656, OR BK 17451 Page 867, Of Florida, has personally appeared c -
Number Pages. 1 Personally Known: k ` �
Recorded 0'2'042016 at 10:36 AM, Produced Identification: or
Ronnie ANT, Fussell CLERK CIRCUIT COURT DUVAL Notary Public: i �.
RP CORDING $10.00 My commission expires: _ 1 3 2 ,
,.v.,. ........
ir. ,. JEFFERY SCOTT REYNOLDS
f‘. 4y
� j a i MY COMMISSION #FF180913
(.._ I
'ides EXPIRES December 3, 2018