591 SELVA LAKE CIR ROOF PERMIT Sk f) % --
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J =" ATLANTIC BEACH, FL 32233
r F INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-1332
Job Type: ROOF PERMIT
Description: RE-ROOF , SHINGLES
Estimated Value: $5,750.00
Issue Date: 6/10/2016
Expiration Date: 12/7/2016
PROPERTY ADDRESS:
Address: 591 SELVA LAKES CIR
RE Number: 172027-5538
PROPERTY OWNER:
Name: HARDWICK, BARBARA J
Address: 591 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: SOUTHERN COAST ROOFING & CONS
Address: 4557 EAST SENECA DR QA MEHMET ORS
Phone: - -
FEES:
BUILDING PERMIT FEE $78.75
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $82.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of FLORIDA County of DUVAL
To whom it may concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: R E#172027-5538
LEGAL DESC. 43-11 17-2S-29ESELVA LAKES UNIT 2LOT 71
Address of property being improved: 591 SELVA LAKES CI R Atlantic Beach FL 32233
General description of improvements: RE ROOFING
owner SAND VALLEY EQUITY LLC
Address 4745 SUTTON FART:CT#60 i jACKSONViLLE, FL 32224
Owners interest in site of the improvement 100%
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor SOUTHERN COAST ROOFING&CONSTRUCTION INC.
Address 3616 GALLION ROAD JACKSONVILLE,FL 32207
Phone No.904-305-8887 Fax No. 904-330-0836
Surety(if any)
Address Amount of bond$
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 Owner's option).
Name
Address
Phone No. Fax No_ Q
g
Expiration date of Notice of Commencement( e expiration date is one(1)year from the date of recordin unless a
WL
different date is specified): of
THIS SPACE FOR RECORDER'S USE ONLY O Z dI
Signed: DATE,' i t b N
Before me this of o n he
County of Du 1,St Florijj�� as ally appeared
�IAn�V� l'7Ot t herein by W X
himself/herself and affirms that all statements and declarations herein V W
Doc#2016131527,OR BK 17593 Page 409, are true and accurate d 3
Number Pages: 1
Recorded 06/10/2016 at 09:21 AM, v
Ronnie Fussell CLERK CIRCUIT COURT DUVALT&J 0, b�11/
COUNTY 4
No ry Public at Large.State County of 'J., • S
RECORDING$10.00 my commission expires: 0
i Personally Known yor
Produced Identification
(0-ROOF _ 133z
CITY OF ATLANTIC BEACH t 09—
SOL'SEMINOLE ROAD.ATLA.NitC BEACHr
. _°.2'233
OFFICE 1900247-5826 0 FAX NO i944)24?584.§
` BU;LDiNG.DEPI OCOAE;LIS
BUILDING PERMIT APPLICATION DUVAL COUNTY
'{."ADDRESS 2.VAL'.kATiON OF WORK 3.SO :T LINDCR ROOF
4.LEGAL DESCRIPTION 5,CLASS OF WORK: S_U �t>F STREiC'TUREI
'56 TVA �,. t{ i;}J°*} T i-• 11 EVA'6-Li<stvG C3 -DEM iT>ON RESIt_'TIAL
.I.. b�:C.. St3 tilYlS:vF. L ct T" d Q ADDITION C7 CON4ERT,NG USE ❑c MNtFRCIA_
7..DEESC'RIPTION jOF"K,i.( Q ALTERATION 11 ACCESSORY SLD. H.ERE SPRINKLER
KcV CJ 'f 3�}C...' [D4 [3POOL t SPA Q
Q MCVE Q C-HER ❑N.? r�
PROPERTY OWNER: CONTRACTOR: ARCI,TELT t ENGiNI Ell �J
8 \AME t';.a;ClfvfPA'r'NA44r
1,
23 COMPANY rv,4M?=
�aO'DV4 rn41, "ry IN
1E NAME t 24 L;CENSEE NAME_s
Gw�~ rS Lel
10_ADDRiEESS'S. 17.STATE OF FLORIDA SE,140. � 25 STATE OF FLORID LICENSE NO
..DDRGCS•/S D r) 211.ADDRESS.
�Yt
11.OFFICE PfiONE. 1".FAX N.0, 14 C=FI �-1— 2, FAX NO 27 OFFICE PHONE: 29.FAX 'I
04473115W
13.CELL PHONE.q�4. ��'. 21 CELLPHONE-q04'��yV��� 25.CELL PHONE: g
1 EMAt-ADDSS= 22 EMAi ADDRESS: VV,O L4901 30 F.Wd tADDRESS:
t Q1 t C& u 60 .G Arh �I f'Yy)FEE S
E Tt E R. SONDING COMPANY: MOF TGAGE LENDER:
3-. -'DAME pr aTr�a rru+ar a'+ Rt 33 NAME 35 NAME t,
32 ADDRESS, 34 ADORESS 36 ADDRESS Q
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 pearit 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 Constructonor work is suspended or
abandoned for a period of six (ti) months at any time after work is commenced I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Bolters,Heaters,Tanks, Air Conditioners,etc.
OWNER'S AFFIDAVIT-1 Certify that all the foregoing information is accurate and that all work will be done in Clmpliance with all applicable
laws regulating construction and zoning I will not occupy or use the referenced building or any part therof,until a inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law
** WARNING TO OWNER: *
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE 0
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT%ITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COPIMENCEMENT.
(14"OWNER or AGENT CONTRAOTC R
, 9raIAruna AWxy,L RsquWed) (Quil4worityi
Signed. Dates-�l / o Signed: �� _Cate —
Befo a me th�s_,j_day of:-TVALed•�.-��.4"O in the county of Before me this day of V 0 I b,2009 in the county of
Duval.State of Florida,has personally appeared Guvai,,eta fF1-11,
� h� nilly appeared
,61mn Fa4ic l,`�n Ir r 7
herrn by himself!herself and affirms that ail statements and deciarations are herin by himself!herself and affirms that all statements and declarations are
true and accuratetrue and accurate
P;ary P ibiic at Large,State of__ai_,.__.-_.Gounty of L Nota Public at Large,State of� ,County of
�/r'wsarsally In., 116 Personalty Known
Cf P-oduced Ident�cati _ _ —.__...... Cl Produced ldenhfcaton- ni
Notary Signature. 0. Notary Signature-
PAMELA SOMPHONPHAKDY PAMELA SOMPHONPHAKDY
:prF :
6Lcco1 PemnAe'l ;�$FQIYJBpMAIt$SK)N#FF221913 =': MY COMMISSION#FF221913 '
EXPIRES April/9.2019 EXPIRES April 19.2019
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