555 Selva Lakes Cir roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
0INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-2184
Job Type: ROOF PERMIT
Description: Roof Repair. GAF Timberline HD Roof system replacement
Tiger Paw synthetic underlayment FL154487. FI product Approval # 10124.
Estimated Value: $5,875.00
Issue Date: 9/28/2016
Expiration Date: 3/27/2017
PROPERTY ADDRESS:
Address: 555 SELVA LAKES CIR
_ RE Number: 172027-5520
PROPERTY OWNER:
Name: CLAYTON ET AL, THEODORE
Address: 555 SEVLA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: TOWNSEND ROOFING & CONSTRUCTIONS SERVICES,
INC.
,CCC1326289
Address: 10418 NEW BERLIN RD APT 115 QA RANDY CRISS
TOWNSEND
Phone: 904-268-7310
FEES:
BUILDING PERMIT FEE $79.38
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $83.38
FERMI! IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDENANCES AND THE FLORMA
BCILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
// Office(904)247-5826 Fax(904)247-5845 1 �1
Job Address: 555 -54 vile Wee Dr-,Ie- Permit Number: ,1p-Rt al l
Legal Description "'II 17'752RE �? I� LAL6 W Z Lal dZ Parcel# 17Z07,7-5520
�k� loo 1 Sq.R. Ste'
Valuation of Work S S;g7 Proposed Work beated/cooled uon-heated/eooled
Class of Work(circle one): New Addition Alteration Move Demolition pool/spa window/door
Use of existing/proposed strucmre(s)((circle one): Commercial
If an existing structure,is a fire spnnkler system installed?(Circle one): Yes ® N/A
Florida Product Approval# (n Zy
For multiple products use product approval form //
Describe in detail the type of
llfwork to beperformed: L64-F T' +6 ��e HP C'oof SyS-lCk✓/ cTlacekwx4
Procerty owner Iotonoati^^on:
Name: &I ^f'wi. 7-ed Address: 371 P(Azs JU(
City AJi. act- Smtc FLZip3zz33 Phone /03-2-97-(741
E-Mail or Fax#(Optional)
Contractor Information: / L /� -�
Company Name: IOWrtSenrl P�wkiA 9¢6 yrtaA 9(0`(-`�Po aifving Agent: l Akjy (ot.,MuµY
Address:�D4�R Nm �cc ' IIS City Tgckrawu:/IQ_ State L zip 3uZ�
tlffcePhone '104-6q5--5%r7 Job Sittl Contact Number d n-s 472-4979 Fax# a)o 4-A 45-5`/'/Z.
State Certification/Registmtion# L-L I-4 GL 6 Z 89
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 tbe work and msml(attom as inifia ted Ice,*that no wok w irutallatim has commenced prior to the
issuake, apermitandthdalfwokwiflbep, oratedto meet the standards ofaf((aws regulatingcomhuction in thitjurisdiction. Thispermitbecomesnufi
aidvoidi wok is not commenced wahm six(4; monde, w ifcotutruction o work u sus ndedor abandoned fo a�s ad afatx//6)months m any time a{}er
wwk is commeked !understand that separate permits most be secured fo ElaYr(eoWork,Patmbing,Sfgns, Wtlis,Poa/a,Ftimaea, Boilers,Heaters,
Tanks and Air Can"oners,enc
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 WrM
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
!hereby certfythm/have reed ord examikdthis fication and know the same lobehae and cored. A(Iprwaiant of( (�wdinancea governing alis
type of wwk wB(be complied with whether speci herein w tate The grwairg oja permit does not presume to Rtwi o violate o cake!the
provisions ofany othu faders(stale,w lkd law regulatixg c gapvc(ion pr tke perfomake ojcovtrucHon.
Signature of Owner�l/1/1,_l fQ�/AV--- Signature of Coniracto
Print Name _/
Swom and subscri ed bef m me Swom to rd subs 1� -I
this Day of r c .20 1 b this a" ay of / utalwrn ten
rM nar
No lict!n, p9pSTOMMSEHI N rc
♦ MY COAMISSIOa t FF GMlass/ nasi Ya
Iar EXPIRES:M"25,2015 est
nvBaNNThrv&NMxoGrYSm'ius .
NOTICE OF COMMENCEMENT
PREPAREINDUFLMATE)
Permit No. Tax Folio No. 172027-5520
State of coma 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: 43-11 17-2S-29E SELVA LAKES UNIT 2 LOT 62
Address of property being Improved: 555 Selva Lakes Circle, Atlantic Beach, FL 32233
General desodpbon of improvements:Roof Replacement
...Clayton,Theodore
Address 371 Plaza Rd.Atlantic Beach,FL 32233
Owners interest in site of the Improvement
Fee Simple Titleholder(8 other Man owner)
Name
Address
y/ I Contractor Townsend Roogng and construction Services.Inc
r^„�I
Address lO 18 New Nerhn Rd X115,Jacksomgle,FL 32226
Phone No.ea'eaasea7 Fax No. 904-645-5442
Surety IN 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 Stale of Florida,Met than hlmseg,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself,owmer designates the following person le receive a copy of the Lienor's Notice as provided In
Section 713.06(2)(b),Florida Stables.(Fill in at Owners option).
Name
Address
Phone No. Fax No.
Expiration dam of Notice of Commencement(the expiration date is one(1)year from the data of recording unless a
different data is specified):
THIS SPACE FOR RECORDER'S USE ONLY �/// DyRIEJj _
C/V1i�DATE—
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Number Pages:i Mmsem and
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Recordetlssell CLERK
IRC PM, era true end accunb pr ser
+�...;%ere CMRISTON#FF09 ^�
Ronnie Fussell CLERK CIRCUIT COURT DUVAL a 1p( a MY COMMISSION kFF092854
WNSEND
COUNTY \
RECORDING$10.00 EXPIRES:March25,2018
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