667 Selva Lakes Cir re-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: 17-ROOF-3130
Job Type: ROOF PERMIT
Desciption: re-roof FL10674 R10 & FL15216
Estimated Value: $7,469.40
Issue Date: 1/30/2017
Expiration Date: 7/29/2017
PROPERTY ADDRESS:
Address: 667 SELVA LAKES CIR
RE Number. 172027-5890
PROPERTYOVMER:
Name: BURRES, LESTER C
Address: 667 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: ROGERO &WILLIAMS ROOFING CONTRACTORS INC
3evemey S. Rogera,CCC1330387
Address: 883 Lawhon Dr ST
Phone: 904-518-5463
FEES:
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
BUILDING PERMIT FEE $87.35
Total Payments: $91.35
PERAHT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE �ORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845
Joh Adtimms. All
"Z� %on* ermit Number: jj- 3114
AIL AU
Lvgal Descriptiot-q- 64 S L4nS"'M 1
DOT rea o q. q-
Valuation of Works-%Wo -IYA—Propmed Work heated/cooled non-beated/cooled
12�, ol Worh leirele onc): Nvw Addition Alteration Q!�a Move Demolition fxx)l/,qpa window/door
Use ofexisting/pro used structure(s) circle one): Commercial lcl I
If an existing structure,is a fire spriler system installed?(Circle one): �esNc
Florida Product Approval 9 AZ 14& 74f 09 oP CtAdtd"
For amitiple products use product approva- lorm
Describe in detail the type of work to be performed:
le 1eNK1Ke-r Addre,s:J6 te-9-A�4g 6y//e
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I 4tad_ji� �AVkp�Phone 0 —
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Contractor Information:
Compa iy Name 4 it rAs 66N 64. uait Ing Agent
Address,9W city te 151,7 zip-b22.6,7
Office Phone 51!R �Wblli Job Site/Contact Number
State Certification/Registration llAM"A3b3?,--7
Architect Name& Phone#
l'o,inevi , Name&41hone 4
—s
Bonding Company Name and Address
Moi tgage I.ender Name and Address
Application is herein,madle to obtain a permit to do the work and installations q Indicated I"Hify that no work or installation has commencedprior to
issuance qi�.pe, I ad(hot allwork wall be performed to meet the standards ofall laws regulating Construction in ihisjurisdiction. Therpernot becomes
and�,,od V,mvp k is not commenced within six(6)months. or if construction in work is gr4ded or abandenedfor a meriod qfxajN,months at-mv time o
u,,,ki,vomm,n,,d loade,,aaed that separalepermifs must be securee1jimEledd "ask. PlumblatS4iffs, Will;, pasers, ummsivollels, Heal
Ta.Aim,2AirCondiIhmers,e1c.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR imPROVEMENT�
10 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y61JR NOTICF OF
COMMENCEMENT.
11.... I h,",........i....d uned do,tyiplic.tion and know the sons,to be trur and correct Iflp................. and od..........
4 "W'h ........hedoith .-hethcrspe,tio,ti herein �,00l The doc., 00l pre-,00n, to Kill 1111hotit, I"
1111,;� "; b"l,"I ,,, i,,d ......co,,oiser.1dion.
Signature of Owner u4j—OL,-� - Signature of Contractor
Print Name A40' 1 P4
0444C5-- Print Name,-;GeA0".;e
Sworn t-qAnd subscribed bet-ore me Sworn to and subscribed before me
this4c Day oj�P�Aqfie— 2010 this / - to
.57Day of .2
AAR411. Tit*Naza - Notary 11
NOTARYPUBLIC
STATE OF FLORIDA NOTARY PUBLIC I�evised 0 1.26.10
ceenow FPZ&%u STATE OF FLORIDA
E)VIM 51211/2019 can,*FF236512
IV c—i.512812019
Doc # 2017021058, OR W 17857 Page 2271, Number Pages: 1, Rewrided
01/27/2017 at 10:48 AN, Ronnie Fussell =RK CIRWIT COMT D� COUNiff
MDRD� $10.00
NOTICE OF COMMENCEMENT
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