611 Selva Lakes Cir roof permit CITY OF ATLANTIC BEACH
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-2828
Job Type: ROOF PERMIT
Description: complete tear-off and re-roof FL 16503 & FL 16226
Estimated Value: $7,997.00
Issue Date: 12/19/2016
Expiration Date: 6/17/2017
PROPERTY ADDRESS:
Address: 611 SELVA LAKES CIR
RE Number: 172027-5548
PROPERTY OWNER:
Name: HARMON, DEBRAN L
Address: 611 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 $89.99
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $93.99
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845 -
Job Address: 611 Salva Lakes Cir Atlantic Beach FL 32233 Permit Number: b0- Q-00 r -aBa;g
Legal Description 43-11 17-2S-29E SELVA LAKES UNIT 2 LOT 76 Parcel# 172027-5548
riq, t
Valuation of Work$ 7,997or a.00 Proposed Work heated/cooled 2366 non-heated/cooled 1926
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval # Atlas Shingles FL103 Atlas Underlayment, FL16226
For multiple pro nets use product approve 65orm
Describe in detail the type of work to be performed: Complete tear off and Re-Roof
Property Owner Information:
Name: Debmn L. Harmon-O'Coa...r.r Address: 811 ¢Plea I akpc r.4rr.1p.
City Atlantic Beach StatFL Zi 2233 Phone 904 389 8900
E-Mail or Fax#(Optional) sunsender(a),gmat .c't-om
Contractor Information:
Company Name:American Roofing of Jacksonville Qualifying Agent: Daniel P. Kinkel
Address: 1015 Atlantic Blvd. # 352 City Atlantic Beach State FL Zip 233
Office Phone 904-385-4375 Job Site/Contact Number 904.226.1205 Fax# 904.853.5318
State Certification/Registmtion# 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
.spplieation u hereby made to obtain a permit to do the work and insmllalioni as indicated. I ceni/v that no work or installation has commenced prior to the
e seance ofa permitand that all work will be performed to meet the standards of all laws wgulatingconsiruction in aus jurisdiction This permit becomes null
aM void Jwork is not commenced within sir(6/months,ar rjconstruction or work is suspe dad ar abandoned for a penod ojsu/6)months at any time aper
work is commeued. I understand Jhal separate permits must be securedjor E(eebieal Work,Plumbing,Signs, WAiq Pools, Furnace,Bolleis,Healers,
Tonks and Air Condifiarters,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.
lherebvmrlifytharI have readandesaminedthis a licadonaM knew the same to be true andcorrect. Allpvosions oflaws and ordinances governing this
type oljwork will be complied with whether splxed ted herein or not. The granting of permit does not presume to give authority to violate or cancel the
provutoas ofany eherfedeml,state,or local/.v egulatingcomtrvtianortheMrformanceojcoua ton. /
Signature of Owner�¢An�,y� `�, drWr�� -d 'C- , Signature of ContmctoJ/
Print Name _a l'4 w\ (r, ._HAI y�ay_^p'.C'o.p•no✓- Print Name _._/1,yY� .C....jTa ./............_._. .
Swom to and subs5=e before me Swom to and subscrtped before r�
this L—Day of, mrint -" .20 \(e III this /I- Day of 1)l�rw✓i�Y/.Q�(1C+ b,'CO 6 ((p
o Pel# % =8A n Ij
NalFlorida JENNIFERJ0IMSTON� MY .201826€g;,!„4•” C428 0
° ama.anw WYryPWeNrtler.Mten
Permit No. NOTICE OF COMMENCEMENT
Tax Folio No. 172027-5548
State of Florida,County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain met property in accordance
with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description ofproperty(legal description ofproperty and address ifavailable):
43-11 17-2S-29E SELVA LAKES UNIT 2 LOT 76
611 Selva Lakes Circle Atlantic Beach FL 32233
2. General Description of improvements:
Complete Tear-Off and j
Re-�Roof
3. Ownerinfcrmation: t�O1raA L . lel rworA—O 'C anYl o'r
a)Name and Address: o a �„ tefr - 611 Selva Lakes Cir Atlantic Breach FL 32233
b)Interest in 1 OOoA
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 consmrction
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 1,
SECTION 713.11 FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS 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. 1
Or�rbr` L ({4 reHaV`—�'�ur�or
Signature ofowaer Owner's Authorized Officer/Diregor/Partner/Manager Signatory's Printed Name&Tile/Office
The foregoing instrument was acknowledged before me this V_day of�Y�Zi� (�.20
by S6 �A^I bZ as IVO�RQ.� for —'a4t- WfM.OA-U[Anel
(Name of arson (Type ofAuthonty, .e.OO r Nomey) (Name o Party Instnanent was Execs or)
,"%onisf. SHARON Y TAYLOR
ecNotary PubIIC-Stale of Flodda N ARYUAIEOp� FLORIDA
,y ` MYComm.Expins Jul4,2018 Print Name: rant�q �Y-
°;oal1 Cammisalon 9 FF 122428
0 Personally Known
N IdentificationType:�,j1„ fY 2�81z0
Doc#2018285330,OR 31<17870 Page 2190, I�
NumberPages,1211 l DOC#2016288778,OR BK 1]814 Page2D41, Y16
Recorded 1sell CLERK
at 03:50 PM. Number Pages:1
RmnleCOUNTY
Fussell CLERKCIRCUIT COURT OUVAL Ronne Fussel1211 l
CLER1 6 K
CIRC IT
COUNTY COUNTY F�sell CLERK CIRCUIT COURT DUVAL
RECORDING E10.00 COUNTY
RECORDING$1000