518 Selva Lakes Cir re-roof permit SSI
CITY OF ATLANTIC BEACH
T) 800 SEMINOLE ROAD
..., 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-2737
Job Type: ROOF PERMIT
Description: re-roof FL10674-R10 and FL15216
Estimated Value: $8,520.00
Issue Date: 12/8/2016
Expiration Date: 6/6/2017
PROPERTY ADDRESS:
Address: 518 SELVA LAKES CIR
RE Number: 172027-5600
PROPERTY OWNER:
Name: JOSEPHS, TARA HARRIS
Address: 4575 CARRARA CT
GENERAL CONTRACTOR INFORMATION:
Name: ROGERO &WILLIAMS ROOFING CONTRACTORS INC
Jeremey S. Rogero,CCC1330387
Address: 883 Lawhon Or ST
Phone: 904-518-5463
FEES:
BUILDING PERMIT FEE $92.60
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $96.60
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach,FL 32233
I
Office(904) 247-5826 Fax (904)247-5845
eAb :
(Ce- A-P� ISL 3' 3 Permit Number:
Legal Description q?-/1I� 39t. cP„/Va�d�laS fhak ). &rJD.Q Parcel# L2��a�� 2�n
.Floor Area or q. t. ,q•
Valuation of Work$ hX-- Proposed Work heated/cooled 163e nonheated/eooled.2)�S 17
('lass of Work(circle one): New Addition Alteration Repai Move Demolition pool/spa window/d<wr
Use of exisdng/proposed structure(s)(circle one): Commercial
If an existing structture,is a fire sprat er sys ey installed? Circle one): Yes
Florida Product Approval# I W4q-Q i,V t't ,(tagn.Q,f+f- FL/ Sell to
For multiple products use piroduct approval forin
Describe in detail the type of work to be performed:PQ f 0(?t% 3L) SQ UQire-
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Proneriv Owner Information:
'vuoiS $ Q Address:
l'itl } f1 ..- 2 --Stat�377-3
i-.-Matt or Fax i!(Optional)___ __. ___ —_-.
Contractor Inform
ation; n ^ � �� T Q�
Company Na1")'��lotr„ }-6Ch(Tb l,u7T' Qualifying Agent: ✓GfGIYA )&QV-
Address: ..� City � —�� Ziphone Job Site/Contact Number 90 2 77G 27 Fax# le 7/
State Certitication/Registration#y
Architect Name& Phone#
'r:nitineer's Name& Phone#
I-ee Simple Title Halder Name and Address—
Bonding Company Name and Address --------
Mortgage Lender Name and Address --- --------
{pplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commeneedpriw to
issuance of a permit and that all work will be performed to meet the standards afall laws regulating construction in this jurisdiction. This permit becomes
and void iJ'work is not commenced within six(6J months, or ifconsfruction or work v suspended or abartdonedfar a pe1so ime a
p s�/uttmaacesnths8ale t Neal
vork i.v commtmled. I understand that separate permits must be secured jor 6leddca/work, Plumbing,Signs, Wd P
Tanks and Air Candid....ere
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENT
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
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Signature of Owne Signature of Contractor (J������//���/
Print Name Print Name fef .- �-l'1,t(I(11...' , -- -
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ROBERT �l+Imts a,on'ii FF 381aa Nt .,A 21, 2017
o m mis s ion EsposSuiv 24, 2017 Revise OLA 6.10
Doc / 2016270817, OR BK 17789 Page 2278, Rumba- Pages: 1, Recorded
11/29/2016 at 09:15 AN, Ronnie FUSSell CLERK CIRCUIT COURT DUVA COUNTY
RECORDING $10.00
NOTICM OF COMMENCEMENT
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