662 SELVA LAKES CIR ROOF & NOC I r j 1,;\J`1r
\mss '' s, CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ijlet ;� 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 -1045
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $6,200.00
Issue Date: 5/4/2016
Expiration Date: 11/2/2016
PROPERTY ADDRESS:
Address: 662 SELVA LAKES CIR
RE Number: 172027 -5810
PROPERTY OWNER:
Name: HICKS III ET AL, STUART K
Address: 662 SELVA LAKES CIR 662 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN ROOFING OF JACKSONVILLE
Address: 1720 Wildwood Creek LN
Phone: - -
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $81.00
Total Payments: $85.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
T LDING PERMIT APPLICATIO
ITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 662 Selva Lakes Cir Permit Number:
44 - 60 16 2S - 29E .076 SELVA LAKES UNIT 3 E 1.5 FT LOT 108 Parcel # 172027 - 5810
Legal Description LOT 109 E 3.1 FT)
Fl oor A rea of Sq.Ft. o n - heated /cooled 2,414.00
Valuation of Work $ 6,200.00 Proposed Work heated /cooled 1,775 00 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 system installed? (Circle one): Yes No N /A
Florida Product Approval # FL1956.3, M States Peel & Stick Underlayment, FL 13857
For multiple products use product approval form
Describe in detail the type of work to be performed: Complete tear off and Re - Roof
Property Owner Information:
Name: Stuart K. Hicks Address: _a62 Selva Lakes Cir
City Atlantic Beach State FLZip 32233 Phone 678.520.3365
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: American Roofing of Jacksonville Qualifying Agent: Daniel P. Kinkel
Address: 1015 Atlantic Blvd, # 352 City Atlantic Beach State FL Zip 32233
Office Phone 904 - 385 -4375 Job Site/ Contact Number 904.226.1205 Fax # 904.853.5318
State Certification/Registration # RC2P02754A
Architect Name & Phone # NA _
Engineer's Name & Phone # NA
Fee Simple Title Holder Name and Address NA
Bonding Company Name and Address NA
Mortgage Lender Name and Address NA
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certibr 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
w ork isc ommenced.ot1 commenced within six understand that separate permits or must be secured for Electrical Work, suspended Plumbing, Sig a Wells, P o months Bo at s, Hea after
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
I hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with wh'ther specified herein or not. The granting of a permit does not presume to give authority to violate or ca c•1 the
provisions of any other federal, state, s f. •1 law regulating construction or the performance of construction. j/
/ /
Signature of Owner �(L Signature of Contract. �l , mo o ice=
Print Name 5 Ja-rc \\\C'' , ` ' Print Name ,,�i .jt. /./ 4/ /
Swo and sus • - ' • . 4 • me Sw • . d subset • - • • - >• re me /A
this / • . . f fV a � :
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P TICE OF COMMENCEML,1+1T
Permit No. / 6- Roo( to VS. Tax Folio No. 172027 -5810
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
tion of roe (legal description of property and address if available): 662 Selva Lakes Cir, 32233
1. Description property g p p pm'
44 -60 16- 2S -29E .076 SELVA LAKES UNIT 3 E 1.5 FT LOT 108, LOT 109(EX E 3.1 FT)
2. General Description of improvements:
Re -Roof
3. Owner Information: Stuart K. Hicks ,
a) Name and Address: 662 Selva Lakes Cir, Atlantic Beach, FL 32233
b) Interest in property: 100%
c) Name and address of simple titleholder (if other than owner):
4. Contractor Information: American Roofing of Jacksonville
a) Name and Address: 1015 Atlantic: B:vci # 352, Atlantic: Beanh, Fl 3223
b) Phone Number: (904) 385 -4375
5. Surety Information:
a) Name and Address: NA
b) Phone Number:
c) Amount of Bond: $
6. Lender Information:
a) Name and Address: NA
b) Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a) 7, Florida Statutes:
a) Name and Address: NA
b) Phone Numbers of Designated Person:
8. In addition to himself/herself, Owner designates NA of to receive a
copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
a) Name and Address:
b) Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement (the expiration date may not be before the completion of construction
and final payment to the contractor, but will be one (1) year from the date of recording unless a different date is
specified: _
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true to thy, best of m knowledge and belief.
I' / t v� 0:\6\644/v
Signature of Owner Owner's Authorized Officer/Director /Partner/Manager Signatory's Printed Name & Title /Office
The foregoing instrument was acknowledged before me this day of / 2/ , 20
b as r for
(Name of Person) (Type of Authori , i.e. O • icer/ ' ttorney e of Party Instru i cuted for)
I ja ,
Doc # 2016100885, OR BK 17551 Page 133,
Number Pages: 1 NOTARY PUBL C, S OF FLORIDA •7 3
Recorded 05/04/2016 at 03:42 PM, N 3. r
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Print Name: " G� r ;
COUNTY o T
RECORDING $10.00 ❑ Personally Known
o 0
III • entificatioraype:
(Affix Notary Seal Above)
; d 3/15/1: