683 Selva Lakes Cir re-roof permit CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
- - ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOBINFORMATION:
Job ID: 16-ROOF-2565
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated Value: $7,952.00
Issue Date: 11/23/2016
Expiration Date: 5/22/2017
PROPERTY ADDRESS:
Address: 683 SELVA LAKES CIR
RE Number: 172027-5882
PROPERTY OWNER:
Name: BROST, MICHAEL J
Address: 683 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN ROOFING OF JACKSONVILLE
AMERCIAN ROOFING OF JAX DANIAL KINKEL, RC29027546
Address: 1720 Wildwood Creek LN
Phone: 904-385-4375
FEES:
BUILDING PERMIT FEE $89.76
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $93.76
PERMIT IS APPROVED ONLY W 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, _��F,ZS/b�5 FL 32233 / C
Office(904)247-5826 Fax(904)247-5845 ` lD
Legal Address: 683 Salve Lakesh.Atlantic ATLANTIC
FL 2233 Permit Number:
Legal Description 8-34 38-33-398 0.138 SEC a ANTIC BeACa LOT 5 ELK 223 Parcel#171050-0000
Floor Atea o q. t. q.
Valuation of Work$7,952.00 Proposed Work heated/cooled 1812 ppu-heated/cooled 2430
Class of Work(circle one): New Addition Alteration Repair Move Demolition pooFspa window/door
Use of eristing/proposed structure(s) circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida ProductA proval# Atlas Shingles FL16503 Atlas Undedayment, FL16226
For multiple products use pro uc pp
arova orm
Describe in detail the type of work to be performed: Complete tear off and Re-Roof
Property Owner Information:
Name: Micahel J. Brost Address: 683 Selva Lakes Circle
City Atlantic each State ELZip 32233 Phone 90486&5838
E-Mail or Fax#(Optional) mibrost@bellsouth.net
Contractor Information:
Company Name:American Roofing of Jacksonville Qualifying Agent: Daniel P. Kinkel
Address: 1015 Atlantic Blvd, #352 city Atlantic Beac State FL zip32233
Office Phone 904-385-4375 lob Site/Contact Number 904.226.1205 Fax# 904.853.5318
State Certification/Registration# RC29027546
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 4 hereby made m obtain a perms to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuaxe ofaperina Sdded all work will beper armedto meet the standards of all laws regulating rovavefion in thojerisdlalon Thispermitbecomesmll
ant void fwork is tat commenced wahin eix(@Jlmondu,or iJconsnuction or work is awpe deit or abasdeardjor a tad ofsa/6)mowhe ai may time alter
work is cammereed. /understand that separate permits must be secmedJor E/ectAcat Work,Plumbdg,S/gns, la,Pools, umacrz,Boilers,Men ns,
anko andA/r Casedidoners,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.
There by orththal haveed with ddus�plierein ordbm wsameto be aveand corrects pressvistoeuaflawseray tosmtces governing t1
type o work will be complied with whether epMen red herein or not. The granting of a permit does not yrcsume ro give mahartry to vin/ate or cancel shy
play
ojany other federal,state,or local law regulating construction or the performance ojconsamction.
Signature of Owner 1-,Y� Signature of Contracto
Print Name Print
Sworn to and subscribed before me Swo ands sc ' ed befo me
thisLL Dayof /lrwl.vLl,r/ 201E Day 20
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NOTICE OF COMMENCEMENT
Permit No. I=Folio No. 172027-5882
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.
1. Description of property(legal description of property and address if available):
44-60 16-2S-29E SELVA LAKES UNIT 3 LOT 145
683 Selva Lakes Circle,Atlantic Beach, FL 32233
2. General Desction of improvements:
Complete lar-Off and Re-Roof
3. owner information:
a)Name and Address: Michael J. Brost, 683 Selva Lakes Cir,Atlantic Beach, FL
b)Interest in 100%
c)Name and address of simple titleholder(if other than owner):
NA
4. Contractor Information:
a)Name and Address: American Roofing of Jacksonville -
1015 Atlantic Blvd, Suite 352,Atlantic Beach, FL 32233
b)Phone Number. (904) 385.4375
5. 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 L
SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
110PROVEMENTS 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 the best of my knowledge and belief.
�— nAu � Nl(cPrimedN ros�
3tgnalure of Owner or er's Authorize Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office
oPhe foregoing instrument was acknowledged before me this 4r day of #-)D 4&.6/ ,201f,
ry IVl( v. )y1. I'rAr1t Vas t^�''t � v for Mi/V,c. l f�mc4—
D (Name or rerson /' (Type ofA 'ty,i.e. ,cer//Mmol/meY (N arh Instrument'— t was F,ucukd for)
' Jct
NOTARY PUBLIC,STATE OF FLORI A
5 m w 8 ¢ a `` `y a ,� p' Print Name: Me 11:SYn. M. r kw-liM V
® Personally Known
`p R Identificatiodrype:
St `oow °l lf�f FLO���•`•a -' Revised 2/01/16