2233 Seminole Rd #12 shingle re-roof permit s 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-SS14
PERMIT INFORMATION:
PERMIT NO: RERF17-0177
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 12
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, II I
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
t1, ,
SOU 5errinole Road,Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (1904) 247-5845
lot;Address 11 Qmlln( &2 IJYIr# I r. a��Permit Number: 1– ( c l
tegai 0esCnpt,onM-1,;-at�aL , ttst nw,n
Valuation of Work 1Replacement Corti> �.Z� Heated/Cooled SF • —.Non- Heated/Cooled_______-___.
Ciass of Wurk(Circle on ) Ne Addition Alteration Repair Mu PUo VVindvwA)oor
• use of exist ng/proposed structures) (Circle one). Comrnerc Res,dentrs�
If an existing structure, is a fire sprinkler system installed? (Circle one Y
• Soomit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
escr oe In detail the type of work to be performed
orida Prodt.ct.Approtia' �+ j0�._ __ ,1- L _for multiple products wse product approval f.-Y,
Pr�peRy Owner Informtion
Q�Q{ _ fto V�r;,0C � Address: OJ" jQYn
L � � ---state _Zip Phone L71 01i
i)wnm or Agent(,f Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of CompanyV C r r __ __Qualifying Agent.
Ac'dress �Y _- City__ . \!:-_ State �i. .zip
Office Phone ��,.�� �. _ ,ub Sste/Contact Nurnt)er T � �--
St.1te Certtf CBfion%Registration a _ E-Mail
Architect Name& Phone ti
Ef.• )ee''s Name& Phon, 4
Workers Compensation �CY!.1t1 ar�(11(1'�f�C� – c�SvCti.i�CQ � '_•�'_
_.� f xernp ; ns�rer i lease Employes/ExpuatlurUacc
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 trle standards of all the laws regulationg
construction in this jurisdiction, I understand that a separate permit must be secured fur ELECTRICAL WORK, PLUMBING. SIGNS,
**:LLS. POOLS, FURNACES, BOILERS, BEATERS, TANKS, and AIR CONDITIONERS, etc
0WNER'5 AgFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with a!I
aooi,caole laws regulating construction ant) zoning
UVARNING 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 l R OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEME
( g
,ure of owner or rt IncludingContractor) _ _— - (S gnature of Contractors - -
5 fined nd sworn to(vr affirmed) before me this lay of Si ned and swor�n�'t�o�(Ur affirm me this l3 day cf
.L._._, by S rl
;Signa ure of N460tfyT119y r r otary
�sgry Notary Public JOHNNY HOUSTON
^,PNY PV9 iii
y� State of Florida cr. ,`-�.;
Not Public •State o1 Florida
My Commission Expires 02/16120M :•. My Comm.Expires Oct 31,2018
(Personally Known OR Commission No.FF960933 j e '�owr�romission # FF 138924
}rociuceo identification �Z - rotfuuee�`fden8llindo Brough National Notary Assn.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No, Tax Folio No. 169519-0124
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:09.25-28E OCEAN VILLAGE ONE-CONDOMINIUM DWELLING UNIT 12
Address of property being improved:2233 SEMINOLE RD UNIT 12 ATLANTIC BEACH FLORIDA 32233
General description of improvements' RE ROOF
Owner OCEAN VILLAGE ASSOC. INC.
Address 2233 SEMINOLE RD UNIT 12 ATLANTIC BEACH FLORIDA 32233
Owner's interest in site of the improvement FEE SIMPLE
Fee Simple Titleholder(if other than owner)
Name
Address
n ` Contractor JAMES SHELTON ROOFING
q7, Address 6352 HIGHWAY AVE JACKSONVILLE.FLORIDA 32254
n(Q 1 Phone No.904-378-9205 Fax No.
Surety(if any)NiA
x 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 to at Owner's option),
Name NIA
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
dttfcrent dote la apuvfied): -- - •-
THIS SPACE FOR RECORDER'S USE ONLY OWNER
ftp; _ DATE C /
Ballots his _day of in in
coon of Owel.S ate of F a sonatry appeared
.4_�7 - - i l*Tiley
Doc#2017265857,OR BK 18192 Page 369, h+mseifr hersett d atRrme that all a and rat ons her i
are true and accurate Notary Public
Number Pages:1 State of Florida
Recorded 11/17/2017 02:09 PM, } �° res 0211812020
on Exp
My Commission i
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL MCp tSsi FF960933
COUNTY
RECORDING $10.00 NataryPutileif late Of C of
my Commission expires.
Personally KrWhn or
Produced identification