431 Selva Lakes Cir - ReRoof �' ` " ' z CITY OF ATLANTIC BEACH
�. 800 SEMINOLE ROAD
5111, ' =" 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 -285
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value:
Issue Date: 2/5/2016 1
Expiration Date: 8/3/2016
PROPERTY ADDRESS:
Address: 431 SELVA LAKES CIR
RE Number: 172027 -5004
PROPERTY OWNER:
Name: RAINES, KENDRA D
Address: 431 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: PRIME ROOF CONTRACTING LLC
Address: 13792 HERONS LANDING WAY APT 9 QA MARK ANDREW
YOUNG
Phone: - -
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
I
1
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 431 Selva Lakes Circle Permit Number:
Legal Description 41 -55 16- 2S -29E SELVA LAKES LOT 1 Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 5,550 Proposed Work heated/cooled 1437 non 195
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): ommercial ' esidentia -
Han existing structure, is a fire sprinkler system installed? (Circle one): o
Florida Product Approval # FL10674 -R7
For multiple products use product approval form
Describe in detail the type of work to be performed: Re - Roof
Property Owner Information:
Name: Kendra Raines -(j \ Ob Address: 431 Selva Lakes Dr
City Atlantic Beach State Zip 32233 Phone (904) 535 -6301
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: Prime Roof Contracting Qualifying Agent:
Address:372 Royal Palms Dr City Atlantic Beach State FL Zip 32233
Office Phone ( 452-8440 Job Site/ Contact Number (904) 625 -1446 Fax #
State Certification/Registration # CCC1329505
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 certifi that no work or installation has commenced prior to the
issuance of permu 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 constnuction or work is suspended or abandoned for a penod of six (6) months at any time after
work is commenced / understand that separate permits must be secured for Electrica! Work, Plrmbing, Signs, Welds, 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 plication and know the same to be true and correct. All provisions of and ordinances governing this
type o work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, local law re toting construction or the performance of construction.
Signature of Owner / b y, Signature of Con c r . / . �"
Print Name Y)1Ji, Print Name � 5" y/i�. _
Swo t n d subscribed . - fore me Swo . . and subsc . - • before me
this y o f (�}y ! 1( 20 • this 'S lay of U W` , 20
Notary Pub tc No ry Pu. lc
Revised 01.26.10
;. li70 Andrew D. Davis
?- SS ON X1 19 � kt, Andrew D. Davis
� • := EXPIRES: Sept 17, 2018 ,., "
� ' o� „ \ O • N WWW.AARONNOTARY•COM a l ii , COMMISSION # FF180849
' "°a -la :- EXPIRES: Sept 17, 20t
�, J `' wwW.AARONNOTARY,C(»4
so
NOTICE OF COMMENCEMENT
PREPARE IN DUPLICATE.
Permit No. Tax Folio No.
State of Florida County of Uuval
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.
Legal description of property being improved: 41 16 2S - 29E SELVA LAKES LOT 1
Address of property being improved: 431 Selva Lakes Circle Atlantic Beach, FL 32233
General description of improvements: Re - roof
Owner Kendra Raines .- L0 19
Address 431 Selva Lakes Circle Atlantic Beach, FL 32233
Owners interest in site of the improvement
Fee Simple Titleholder (if other than owner
Name
Address
g Contractor PRIME ROOF CONTRACTING, INC.
Address PO BOX 50247 JACKSONVILLE BEACH, FL 32240
(904)625 -1446
Phone No. Fax No
Surety (if any)
Address Amount of bond $
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.
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
Phone 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 Statutes. (Fill in at Owners option).
Name
Address
Phone No. Fax No.
Expiration 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 E
Signed: e::./4
DATE a Hike
Before me this _ in 1 e ,j
County f uva State ofAsincia. has ve A�j Hy ' � D Davis I C Doc # 20 160280266, OR BK 1 7453 Page 318, himself herseit and affirms that al statements and declaratio nu Number Pages: 1 are true and accurate _ ,A, L`QM$$� yn ff16084
Recorded 02'05,'2016 at 01:30 PM, EXPIRES�� Sept. . 17, 20
Ronnie Fussell CLERK CIRCUIT COURT DUVAL i0 r �.` `� WWW.AARONNOTARY.COM
:AUNTY RECORDING 810,00 Noabc
at Large. State of , . Courty cf Dvv ~ 1
My commission expires:
Personally Knoxn
Produced Identification t/ 1 '—