650 SELVA LAKES CIR - ROOF .4:41.k. \�`S\ CITY OF ATLANTIC BEACH
- , r.) 800 SEMINOLE ROAD
J ` .. ATLANTIC BEACH, FL 32233
.Fi l 9%'
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-1557
Job Type: ROOF PERMIT
Description: RE ROOF - SHINGLES
Estimated Value: $10,785.00
Issue Date: 7/11/2016
Expiration Date: 1/7/2017
PROPERTY ADDRESS:
Address: 650 SELVA LAKES CIR
RE Number: 172027-5804
PROPERTY OWNER:
Name: SWARTZ, TERRY M
Address: 650 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: ROGERO & WILLIAMS ROOFING CONTRACTORS INC
Address: 883 Lawhon Dr ST
Phone: 904-518-5463
FEES: -- -- ---— ------
BUILDING PERMIT FEE $103.93
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $107.93
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 1 (, -f jc_ISE7
,Job Address: 050 $LI_.✓_.G._4- Lit5 l'C e Pe,YG 3,)a3.3 Permit Number: ._.. , / - - - -
Legal Description .01-ka 16--Z- r ' V .c_. ''t3ler J Parcel #11)0 9"56-0_ ..,_.w___.
oor ' rea o :q. t. q.Ft
Valuation of Work$/0 78$ D0 Proposed Work heated/cooled non-heated/cooled
lass of Work(circle one): New Addition Alteration epai- Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial Residential
If an existing structure, is a fire s ria r system installed? (Circle one): Yes No N /A
Florida Product Approval # F L -K 0 ildId(,ccj,w elf FL/11'/10 Pe o A2mOic.
For Multiple products use product approva orm
Describe in detail the type of work to be performed: A rU of 30 59 U0 JC 5
__ ____--___ 42- p% 1)%n0 s .______.
Properly
Owner liiforinati/on: c-
Nabil': /zo{/ 3GJ"a Ir/ - _ - -- Address:�, 5 .a �,�_pide-___----_ _...--_-cif; i.14t L&G _._ -Statc j Zip3))33 Phone 90g. �a _-_ e� �__.____—_.-_________ _.-
Contractor Information: 60-4445
! L' ,L/
Company Name/000 fa ms, ch (. 0- t'C��TG�-S Qualifyin Agent: ✓fi'(/�'iGt� �f.0D
Address: 311/S 0(1 0, J City 0tx / State FL Zip32257
Office Phone Eloy. 31r•5---0 3 Job Site/Contact Number 9Qy,,2S S'7 )00 Fax# /may PUG. tin/
State Certification/Registration # (GL' I33 0 3e."
Architect Name & Phone #
1-, ineer's Name& Phone#
Fee Simple -Title Holder Name and Addressor., kk .5 3fi ' [_A 3.A>L 3 Z-7,---572 _..-...---
Bonding Company Name and Address
Mort.:ai;e Lender Name and Address -----...--_---------.-- _ ..__.._
Application is hereby made to obtain a permit to do the work and installations as indicated. l certify that no work or installation has commenced prior to
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
and void i/work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time c
work is commenced l understand that separate permits must be secured for Electrical ;York, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heat
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.
:u rebr::eritft'that I have read and examined his application and blow the same to be true and correct. .111 provisions(?1-laws arid ordinance..,�o:-c:'tying,
..rr of work.will he c'.,nrplied with whether- f}ecijted herein or no/ The granting of a permit does not presume to,gtti'e authority to vtolatc or,.rarer
,q',01 0/11. irder4 sicrlc, or l•i;',n 11/rw regulating construction or the perlornzwsee nl construction.
y)�
` Signature of Contractor ��..�'��`!►
Signature of Owner '� A . _ .106.11,_ g
Print Name i e m S GO e 4 L • Print Name
------
teirt y........ .. G�.(..t (�, .
Swor 1 o and subscr. ed before me Sworn t and subscribedbeforeme/ ,20 /(�
this Day of_ 1�n� 20 1 w this �-� Day of c.73-1.,�e,
...... - . co,
. /�f�>d- :�:�'', PAUh ROBERT-CAS-ETTA} - ��. .,,ti ERT CIt3SETTA
Notary Public � Commission OFF 39155
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'• Commission 11 FF 39155 y ,/"_,� .?
IV, My Commission Expires
My Co, •TVI§t�!44*(0 U
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' July 24. 2017
July 24, tot
r
Doc # 2016154814, OR BK 17625 Page 1069, Number Pages: 1, Recorded
07/07/2016 at 09:59 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTTaE OF COMMENCEMENT
. IPREPoRE IN DUPUCATEI
Permit No.-_- Tax Folio No.
State of County of ZDV V t=1l_..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. / r l/
Legal description of property ba
'/ng improved. I- r -a E
Jt-L v,t L4-ic�S Un 113
to-r /t
Address of property being Improved' 5T) ,�2 V s Ci(acre.
P7i-k �t r /� at [o ri & 3.,a 3 3
General description of imprpvernents: V V- .
Address 2 r /�l',.nth &&r c 3
Owner's interest in site of the improvement 1)L,)/'L I
Fee Simple Titleholder(if other then owner
Name Rogers and WOlerro Bulldog and Roofing Coneaclor4
Address 3415 Kori Road Jacksonville Florida 32251
Contractor Jeremey S.Rogers
Address 3415 Kan Road.Jacksonville Florida 32257
Phone No.904-5'8.5463 Fax No.904.619.2400
Surety of anyl
Address Amount of bond S
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 then himself.designated by owner upon whom notices or other
documents may be served'
Name Jerernay s.Rowe
Address 3415 Kori Road.Jacksonville Florida 32257
2hone No.4043165463 Fax No.904-619-2400
in addition to himself,owner designates the following person to receive a copy of the Lienors Notice as provided in
Section 713.06(2)(b).Florida Statutes.(Fill in at Owner's option i.
Name
Address
Phone No. Fax No._
Expiration date of Notice of Commencement(the expiation date one(1) j'from the date of recording unless a
different date is specified'.
THIS SPACE FOR RECORDER'S USE ONLY ? f OWNER
fid.Mo • / d - DATE/ Lr��,L
Wont Ina 4 ae,_ ea
or. . r how ty appMW
rt (+s/ ��w . Mein Dy
1141,445 Mna and awn II MI and dScwrbrs MrNn
antnreancaccvrare
PAUL ROOERT CASSETTA
s`;'� Commission•FF 39155
Lt.' t My Commission Expires July
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July 24, 2017 • ,/ .
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