2233 Seminole Rd #11 shingle re-roof permit �s r vg` s CITY OF ATLANTIC BEACH
1 s� 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0176
Description: shingle re-roof FL10674.4 & FL15216-R2
Estimated Value: 4000
Issue Date: 11/17/2017
Expiration Date: 5/16/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 11
RE Number: 169519 0101
PROPERTY OWNER:
Name: OCEAN VILLAGE ASSOCIATION INC
Address: C/O SIGNATURE REALTY & MANAGEMENT4003 HARTLEY RD
JACKSONVILLE, FL 32257
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: JAMES SHELTON ROOFING
Address: 252 SANTA BARBARA AVE QA JAMES W SHELTON, III
JACKSONVILLE, FL 32254
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
Building Permit Application
h City of Atlantic Beach
800 Seminole Read,Atlantic Beach, FL 31233
Phone:(904) 247-5826 Fax: (904) 247-5845
;%b Address } ' In CA4 �.�►'lT1 �\ '1+'T1tL'Vf'K�"1 � Permit Number:
r �' \ (
LegaiDescrtptionm:�S-2qk fX's?A�1�1 1S��C -YA 1 m Ep TY 1L
Valuation of Work (Replacement Cost) S `� Heated/Cooled SF ^_ Non-Heated/Cooled _ ._
• Ciass of Work (Circle on ) Ne Addition Alteration RepairMogi Pool Window/Door
• Use of existmgiproposed strvctvrels) (Circle one). Commerc+a' Res+dentes;
• if an existing strn.,cture; is a fire sprinkler system inswiltw) (Circle one Yes N, 1i/A
• S�,Umit a gree Removal Permit Application.f any trees are to be removed or Affidavit of No Tree Removal
cscr,oe In detail the type of work to oe performed-
arida product Approval t+_ � --4-------- for multiple prod.icts use product approval furry)
Proper ty�aOwwner jnffQrmaSign C_
:,+ OXO •Si Q��DC �_ T Address cl�V-nl _
State 21_ Phuneq.Oa '7
?wrier or.Agent('f Agent, Power of Attorney or Agency Letter Required) _
Contractor Information
of Comparyt ` rf 1 _ _
_' Qualifying Ager.t:
nclaress '__t t' L �� C tC5Yy1}1� _State—S�L_.Zip_ .
01f+ce phone 41.�ft- L � lob Site/Contact Number
State Certification/R(46'Wation u � E-Mail,
Arch;tec, Name& Phone P
Engineer's Name&PhUt}N p
Wurxers Compensation : ' q,_ _—_ 15ve .. En�Q)l.gy]
.. _�_C�S__— �,z_v: i•t� C _.A
J' Exempt/insurer/ecase E.r•.otoyees'Exptratiun Date
Application is hereby made to obtain a permit to do the work and Installations as indicated. I certify that no work or mstallat on has
commenced prior to the issuance of a permit and that all work will be performed to rneet the standards of all the laws regulat ong
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
,vVIaLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR CONDITIONER5, etc
O%NNER'S AFFIDAVIT. i certify that all the foregoing information is accurate and that ail work will be done in compliance with all
applicauie laws regulatinl;construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENT YOUR PROPERTY, IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LEN.0ER R AN ATTORNEY BEFORE
RECOR ING YOUR NOTICE OF COMMENCEMENT.
(Signa +e of owner or Age,t.ncluding Contractor; LS,gnature of Contractor)
S gned end sworn to or affirr eci) before rine this ay Uf S gr dd and sworn to (vr affirmed efore rine.tills, 124 day of
Shelby Tile
Si 11&0.f otary!
i' Notary Public (Signature of Nola .. ^^
/ State of Florida JOHNNY HOUSTON
:lpNY Pv9 r
MYCommissionExpiresl)V16/2020 ?_. .`�= Notary Public -State of Florida
Commission No.FF960933 = My Comm. Expires Oct 31,2018
Personally Known OR e%� ownRDtnmission # FF 138924
j 'PfU4UCPa identitlrat on d+�(!1G► p�(✓`� ru(UCCC�YiientBtledndJltrough National Notary Assn.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE,
Permit No. Tax Folio No, 169518-0122
State of FLORIDA County of DUVAL
To whom it may concern:
The undersigned hereby Informs you that irnprovements 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:�2,5,29E ocEM va.tAoC ONC•CONDOMknUM ouvet.%.ING UNIT rt OR SK 4253.269
Address of property being improved:2233 SEMINOLE RD UNIT 11 ATLANTIC BEACH FLORIDA 32233
General description of improvements: RE ROOF
Owner OCEAN VILLAGE ASSCO. INC.
Address 2233 SEMINOLE RD UNIT 11 ATLANTIC BEACH FLORIDA 32233
Owner's interest in site of the improvement FEE SIMPLE
Fee Simple Titleholder tit other than owner)
Name
Address
�, y\ Contractor JAMES SHELTC7N ROOFING
Address 5352 HIGHWAY AVE JACKSONVILLE FLORIDA 32284
Phone No.904.378.9205 Fu No
Surety(if any)NIA
Address Amount of bond$
Phone No. Fax No
Name and address of any person making a loan for the construction of the improvements.
Name N/A
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 NIA
Address
Phone 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 Statutes.(Fill in at Ovvner's option).
Name N/A
Address
Phone 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 op*oified)-
THIS SPACE FOR RECORDER'S USE ONLY OWNER
DAT
tea ore
Q-rwd . W
,
Cquniy of t7uvat� a .has rsonatty appeared
Doc#2017265854,OR BK 18192 Page 366, erein by
himsoNi hand( rid attkms that a tatements and dociara ions heroin Shelby'Mey
Number Pages: 1 are tnta and accurate Nota Public
Recorded 11/17/2017 02:09 PM, Notary
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL " State of Florida
COUNTY T My Commission Expires02/16/202o
RECORDING $10.00 No.FF960933
Notary putSitc at L Stat Catrtty
My cammbsion expires:_.. WZ _ ._.._.
Po(
Prrodducaed ICknti4cattor w.