2233 Seminole Rd #10 shingle re-roof permit .j!.tLy j•Jv�.
3r
SS f CITY OF ATLANTIC BEACH
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: RERF17-0175
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 10
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$7,500.
Building Permit Application
City of Atlantic Beach
�J 800 Seminole Road,Atlantic Beach, FL 32233
?...1
t ''+f) Phone;(904) 247-5826 Fax: (904) 247-5845
job AddressC� J��`t11tln (?d _ lY tb tC&" , Lr �� 33 L� �F l�-0
Per
mit Number: _
ega. Desorption( -r3ia`C�1OCQt1 V 1�\ i� c1s� y1_ 'REt;
Valuation of Work(Replacement Cost) 5.L U—U Hearted/Cooled SF Non-Heated/Cooled
• Class of Work(Circle onC) :Ne Addition Alteration Repair eve---fjetr o Pool Window/Door
• Jse of ex;stmg/proposed structute(s (Circle one) Commerce Residential
• Ir an existing structure, is a fire sur nker systern installed?(Circle one) 'les N NSA
SuOm;t a f ree 1iemoval Permit Application if any trees are to be removed or Affidavit of No Tree Re,rtoval
tscrioe in detail tr,e type of work to oe perfurmed �—
Fior,da Product A � -
pprova! L� for multiple products use procuct approval form
P,,operty Owner Informotion
Name QI�K]_.�� o S UC '7Lr �Addresrs�: ` Yb�1Y �>J
City_ ,P fA 1� State �,Zip p Phon. 1 c B 5
;:-IV1a�I
Owner or Agent i0f Agent, Power of Atturney or Agency Letter Required)
�gntractor Information
Name of Company: _ 1 1�'r Qualifying Agent. f
Atsdress SLY �... ___�:tc Y-c )1/ifr _ stat E ZI --�'I
f'
0(fice Phone qQ Vt\_. _�� Job 5ite(Contact Number _
State Certification/Registration t$ _E-Mail
Arch,tect Narne& Pho^e p
Ftiglneer's Name &Phot a --••--------•_------_-______....__-__�._.._.__.__._._.�.� ____ .�
V
Workers:ompensaUori
txemut,'..surer/lease Ernplc;yens,'fxpuaUvn Date
Application is ttereUy made to obtain a permit to do the work and installations as indicated. ! certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to rneet the standards of all the laws regu!at long
canstruction in this}urisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
W!:LLS,POOLS, FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS,etc
OWNER'S AFFIDAVIT I certify that ali the foregoing information is accurate and that all work wtil be done in compliance with al
applicable laws regulatinil construction arid zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMES TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR L ND R 0 N ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMEN .
(Si atu(e of Owner o,Agertt including Contractor) !� (SIdmiture Of Corttractor)
Signet�}}and sworn to(or affirmed)before me tnis of S gne and sworn to iu, affirm•-edd'' oefor_e me.this ��..'Jay Of
. by - _ �Qv !_�, by
Shelby Tiley
-� Notary Public
1, (Signatur of Notary) taro)
State of Florida
JOHNNY HOUSTON
My Commission Expires 02116/2020 Notary Public -State of Florida
Commission No.FF960933
My Comm. Expires Oct 31,2018
Personally Known OR r O P riN •$ion prRommission # FF 138924
r #Produced identineat on (7�(� t ( h I ) P t Vit!1!� n tt rnrough National Notary Assn.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATEI
Permit No. Tax Follo No, 169519-0120
State of FLORIDA County of DUVAL
To whom it may concern:
The undersigned hereby informs you that improvements will be made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following Information is stated in this NOTICE OF
COMMENCEMENT,
Legal description of property being improved:09625 29E OMAN VILLAGE ONE-CONDOMINIUM DWELLING UNIT 10 Om RK 5628-521
Address of property being improved:2233 SEMINOLE RD UNIT 10 ATLANTIC BEACH FLORIDA 32233
General description of improvements: RE ROOF
Owner OCEAN VILLAGE ASSCO. INC.
Address 2233 SEMINOLE RD UNIT 10 ATLANTIC BEACH FLORIDA 32233
Owner's interest in site of the improvement EEE SIMPLE
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor JAMES SHELTON ROOFING
Address 5352 HIGHWAY AVE JACKSONVILLE FLORIDA 32254
�� Phone No.904-318-9205 Fax No.
Surety(if any)NIA
Address Amount of bond$
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 N/A
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 Owner'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
diftb,ont dot*is op.tified>-
THIS SPACE fOR RECORDER'S U$E ONLY OWNER
Signedutero: Y UriTE �/1
Berare a Athj.4 de or Gv In /
Cou of Duval, of Florida. perwMNiy a -rain by
himrafft herso ariftiflimm that all slaterrieniWarid dAClaratiom herein
Doc#2017265856,OR BK 18192 Page 368, arv"arid accurate Shelby Tiley
Number Pages: 1 Notary Public
Recorded 11/17/2017 02:09 PM, State of Florida
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL f� My Commission Ex ires 02/16/2020
COUNTY Notary PurAlcatlaro. tate of
County FF960933
RECORDING $10.00 my commit wnexpires., t ?s0 .. -.
Personally Kna.Kn_ _._ �r e�. ► __ or
Produced idontft llon,.,..,,i .�!_„„I 4t.tl...._.., u?.x.7✓-,.....-.. .1.. 1 5-'�—