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503 Selva Lakes Cir - Roof � '. CITY OF ATLANTIC BEACH j. 800 SEMINOLE ROAD ,v �~ ATLANTIC BEACH, FL 32233 1'2.011 ! INSPECTION PHONE LINE 247-5814 REROOF SHINGLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RERF17-0096 Description: SHINGLE ROOF Estimated Value: 8200 Issue Date: 9/19/2017 Expiration Date: 3/18/2018 PROPERTY ADDRESS: Address: 503 SELVA LAKES CIR RE Number: 172027 5040 PROPERTY OWNER: Name: MELVIN SHEILA F Address: 14446 LOOKOUT PL JACKSONVILLE, FL 32224 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: RADON PROFESSIONAL SERVICES Address: 336 14TH AVE QA WILLIAM TONY DAVENPORT JACKSONVILLE BEACH, FL 32250 Phone: PERMIT INFORMATION: Please see attached conditions of approval. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU 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 RECORDING YOUR NOTICE OF COMMENCEMENT. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. i r1=„,,%:. Building Permit Application �► City of Atlantic Beach 1‘ •• 'Y 800 Seminole Road,Atlantic Beach,FL 32233 ',..o;t,,Y Phone: (904) 247-5826 Fax:(904)247-5845 i 7 C� Job Address: X03 SeLtm LA/:rs eiiec G R Permit Number: ERF ` -0O /c Legal Description' /-5-r 11-ZS -29 E t o/ / 9 RE# Valuation of Work(Replacement Cost)$ 2Oa ' Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door R U 0 f--- 12 e iL,,}C ern er1T • Use of existing/proposed structure(s)(Circle one):one): New LRe ential • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes o N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: R.._ I?Oo F 7 ,-7''L 7/i Z P.'74 I Florida Product Approval# Cit-le A.L Ay/Me'J7-FL/S 17 for multiple products use product approval form Property Owner Information `�/`i4'te” FL $haL/Z. ( Name: �,lj P L q F. met V PJAddress: G".6.2. Set 1./4- t itke s G i�st e l e. City �?Litn(7i C 13eflcti State PL- Zip 32 233 Phone --/( /2u E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information / t Name of Com any: gAcfor•S P,of . S X t)i`L€s Qualiying Agent: W ( hi3 !) e r�iP4�17 Address 33 6 / Yrs iry /u - City.lAyL 8ekt ff State FL Zip 1Z2S-0 Office Phone 2 yG - Ss 1 7 O Job Site/Contact Number SI/- (2-/ o State Certification/Registration#C-CC. 13 Z /677 E-Mail g,4/o N[l it a w AOL.Cor,-) Architect Name&Phone# -^ Engineer's Name&Phone# —. Workers Compensation - Exempt/Insurer/Lease Employees/Expiration Date Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all Iapplicable laws regulating construction and zoning. ` 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. W (Signature of Owner or Agent including Contractor) (Signature of Contractor) Signed and sworn to(or affirmed)before me this I, day of Signed and sworn to(or affirmed)before me this (? day of %err , 7-6.17 4. 551- , ei17 ,by - - - - - - - - ' ......"4,,..Wei ITEMOEN MALT le • "Nv,, STEPHEN HAFT i,' ',A i . - - t MO M PlOrlds • 1 \Y • E Put&-State of Florida •f`�n ,.;.AeOoMiutoo,�PP MOP ` f; otliOMmisstoe I FF 975623 Mr Comm WWI Mall S.40* - Mr Comm.Woes Mit S.2020 '4"4^s badv1 OoloM , Aim. . INOMMot_lisOlmi Nov/Mit RiRersonally Known OR /Personally Known OR [ )Produced Identification [ I Produced Identification Type of Identification: _ Type of Identification: I NOTICE OF COMMENCEMENT State of Tax Folio No. County of 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: T J - TS- - Z.5 — 21 g 107" /9 Address of property being improved: S © % se l (IA 1-61 ke s C i 4 cC e , A LA-4 /:e 6 e/te te � General description of improvements: .rp ,7- - L /2ta, - 2 d O/= Owner: (� L .i F me L V/,•4 Address: S-4. L 5 e L (JA LAkc C C!teC L C Owner's interest in site of the improvement: //D a Fee Simple Titleholder(if other than owner): I cirJ Name: f,4coFI Pd&OP S e,( Vi( e -'v _ Co tractor: 14 % DA t e A f o/f Address: 3 3 6 1 VIZ ,�d- dt9 • ��+x /e4 C i f L ? 2 Z S O Telephone No.: Fax No: Surety(if any) Address: Amount of Bond$ Telephone No: Fax No: _ IName 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 State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b), Florida Statues. (Fill in at Owner's option) Name: - Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: (4t.. Date: 9411(7 Doc#2017213264,OR BK 18120 Page 2290, Before me this_i9.___day of 4 20,7in the C ty of al,Slate Number Pages:1 Of Florida,has personally appeared S e a, C l)/t h Recorded 09/1912017 at 03:56 PM, Notary Public at Large,State of Florida. .. 'n-111,.:..... .... COUNTY FussellRonnie CLERK CIRCUIT COURT DUVAL My commission expires: M k , ��,t>a $ PHMA Personally Known: rit4� NO�Tr 'StR�pt flotldtt RECORDING$10.00 • -Commission it 14 975123 Produced Identification: s4• -�,�: My Cam+n,Eg1rn May-5,2020 -_ - m (11a7Ya1NOM*Ivy Asia.