1645 Selva Marina Dr - ReRoof (----
J J ,>
-` �s A CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ��
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 -443
Job Type: ROOF PERMIT
Description: reroof
Estimated Value: $26,098.00
Issue Date: 2/22/2016
Expiration Date: 8/20/2016
PROPERTY ADDRESS:
Address: 1645 SELVA MARINA DR
RE Number: 171994 -0000
PROPERTY OWNER:
Name: LOCKWOOD, TRUST
Address: 1645 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: ROBERT ROBERTS FIRST COAST ROOFING
Address: 5151 SUNBEAM RD SUITE 23 QA ROBERT EARL ROBERTS,
JR
Phone: 904 - 287 -7756
FEES:
BUILDING PERMIT FEE $180.49
STATE DCA SURCHARGE $2.71
STATE DBPR SURCHARGE $2.71
Total Payments: $185.91
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 1 . -VY._ • ∎ . u,... II . m . .An 3 • s Permit Number:
Legal Description 30-as 0$- a3- 39 E ' 11c1. ' . iota. t S 'a el# 1419 S 4 - ooco
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ oQ(o1 9&'Proposed Work heated /cooled 41,x22. non- heated/cooled
Class of Work (cire on ): N ew Addition Alteration Repair Move Demolition pool /spa
window /door c' p scs -exiao -7'a- Pi- area,
d ss ruone): - -- `�
Use of existing/prop sectur (cit?le Commercial esidentia
If an existing tucture, is a structure, sprinkler C kler syste installed? (Circle one : es N /A l /
Florida Product Approval # 1'� 101 `d5 , G k = ivlor,,„4, \ en l 1 �1 a IA to r` al For multiple products use product approva form
Describe in detail the type of work to be performed: aemoute, exis - kic5 eirooJ '04n,atei-u-3 ck t ')ns att 1Seui ti,irnstes
Property Owner Information: 46
Name: ,a r or-e.4 ock wo od Address: S cp4c Se i v& M g.*'i n0. r
City ? k \el c_ NeacQ. \ State t Zip 3aag3 Phone %y Q- 319'4 A 91,4 - a4L- 3„Sgb
E -Mail or Fax # (Optional) i ockwoad a &met.t.c.or
Contractor Information: ,-- `- KeWet tZ +I. rQU
Company Name: olnc. kobec� -V t� f.
s ius Coati 1 tort � liC Qualifying Age tit: 1rer � Q P�2)r e• n .() Zes1.s
Address: '\ S3� Su."Noe -Oc �cl Su2re. $' CitZZAQ530kNIA.Lb State ;'►.ort&
Zip 3 aaS Eck 3e.as
Office Phone et 04. Qtt1 - '4=+,S (, Job Site/ Contact Number qd,4 -4 - 5- E'50( Fax # 9a4's` 5 - 3 c 0- —
State Certification/Registration # C C.C. $ S C. q "4
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. 1 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 fbr 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, ells Pools, Furnaces, Boilers Heaters, Tanks and Air Conditioners, etc.
WARNING TO OWNER: YO FAI 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 application and know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not resume to
give authority to violate or cancel the provisions of any other federal, state, or local law regulating construction or the performance of
construction.
Signature of Owner 1 AaR 9 Acktevcd li( /2-b- /l 5
•
Prin Narne ..zQ[, ' - c,kv ...._...._.__.— _.._..._.-- ALBERT MORENO t.
■ WO i to an' subscribed before the _ , . Public S tate of Florida
is I ! 0 . y of _ r- e = - 20 1 ° • " �•U < • Notary Commission # FF 239295
). I I I c My Comm. Expires Jun 9, 2019
I A 1 ' t;i' O C,J o r, ,
, Bonded through National Notary Assn.
`I o : Public
! 7
Signature of Contractor, eze.,_7
::.' "(
: ; r o ,: - " .".< RICHARD K DOROUGH se, Print Name o
---- °- °•--- --•• °• °-••° -' ' i MY COMMISSION #FF166400
Sworn t, and subscrib before me =' „ EXPIRES October 7, 2018
this Day of -i P.) . 20 1 (407) 398 -0153 FloridallotaryService.com
4)�
Notary ublic
Doc # 2016023156, OR BK 17446 Page 408, Number Pages: 1, Recorded 02/01/2016
at 03:51 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
n (
State of .__ loc. i Ot1. Tax Folio No. - 4 4 . 1ggq -p .) _ -_
County of _ .. [ a c nije
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. ��
Legal Description of property being improved: _ =a9 Oft - GS - E &(ya )42.611
Address of property being improved: 14 Setvqjvttttyno.. Or y AtInmyko.,Puan.&.?._ 3Qa'L�
General iYl description of improvements: -` R a GiDe+r
Owner. nr Q �- , [ick Address: 1 4 4S p .�I?lvrZ. srAZ
Owner's interest in site of the improvement: * i jne MM,,,, i —
Fee Simple Titleholder (if other than owner): �
Name: — - -- --
Contractor. Q e } q3 -. ra 4- roas4 e a csql:p
Address: LAS :V2. St.A,be.am C l r - : ! ► b. J. t 1i . - VA- •i
Telephone N o.: 9 Dq- a$.- 4 Is'(a._ Fax No: a a •-• 39 tit
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
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone 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 SPACF. FOR RECORDER'S USE ONLY OWNER
Signed: �
�r ti.. i iii v `'C- I4 Vic( Date: /-52c Lt'>'
Before me this _ 1.j't" day of ? r: c t m lS,_ 1 .< in th cou of Duval. State
` � �R Pw., ALBERT MORENO Of Florida, Noss 11
:° `� Notary Public - State of Honda at y d d aunty E r pNr . � Z .c . : :
- Notary Public at Large, State of hl rids, panty of Duval.
cif .:' Commission # FF 239295 , My commission expires: U i e c,
= , _ My Comm. Expires Jun 9. 2019 l 5
t F � .1` o o- ' . P K Pet9nnatly Known: or
Bonded through National Nctary Assn _t! Produced ifica — e , V_!
>t ? L 1 c - i r
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