2233 Seminole Rd #33 shingle re-roof permit \'`1�1v
s �
r � 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: RERF17-0179
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 33
RE Number: 169519 0162
PROPERTY OWNER:
Name: COPLEY ELIZABETH A
Address: 2233 SEMINOLE RD APT 32
ATLANTIC BEACH, FL 32233-5940
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$7,500.
'' '':'r•� Building Permit Application
t"1 City of Atlantic Beach
800 Seminole Road,Atlantic Beach, Ft 32233
Phone: (904) 247-5826 Fax: (904) 247-5845
Se rn� 1 �r ,'t Uig -
Job Address � Q_�,(�• 13'jPermit Number:
Legal Description U a, yr;lYl1 .1G nREiU�� g� �i1o9Ll O
B p �1' V *� — J�
Valuation of Work(Replacement Cost)$ Of -6 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one : Ne Addition Alteration Repair Mo emo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): Commerci Residenti
• if an existing structure, is a fire sprinkler system installed? (Circle one): Yes No 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:
'�Q ` �
Florida Product Approval p 7 L for multiple products use product approval form
Property Owner Information r-� ��
Naine U Ui�,pv Q- _�' -''t 1�_, Address: oo
City rk., State V Zip Phone O -
E-Mail
Owner or Agent (if Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company .6&I I.-yr. Qualifying Agent:
Address a T —CitK State.�.Zip _
Office Pnone OOH_ jou 5ite/contact Number
State Certification/Registration 9 E-Mail
Architect Name& Phone fl
Engineer's Name&Phone ff _
Workers Compensatiun VX CA A o 14 0 �t"'Q\\,sjs
Exempt/insider/Lad se 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
applicable 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 YOUR7ne
OR N ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEME
r
!� ,'iSignatu)le of Owner or Agent inclu ii!ng Contractor) (5ignature of Contractor)
Signed ano sworn to(or affirmed)before me this Z�fay ofd sworn to(or affirmed)before m this 3 day of
,vp -C I' by !� L �t
'�- _} l[t _ ax .� ��_ by
- S t ley (.
_Ata l
/ State of F(&Mtur6 of Notary)// iSi to r of otaryl
My Commission Expires 02116'2020 „ , JOHNNY HOUSTON
Commission No.FF9B0933
Notary Public State of Florida
M� gmm.Expires Oct 31,2018
( )Personally Known OR G�r f ` J r 1 O er • J Owr,mission # FF 138924
f--1 Produced identification �� O resQ ti
flone5rough National Notary Assn.
ca�tl
Ivnp of Iripntifiration• TV n of Irfd'Aii B
NOTICE OF COMMENCEMENT
(PREPARE IN D`JPLICATEi
Permit No. Tax Folio No. 169519-0164
State of FLORIDA County of DUVAL 4
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"s-2se OCEAN vilLAtaJF�ONE-CONDOMINIUM DWELLING UNIT 33 o+a 6K 5674.2130
Address of property being improved:2233 SEMINOLE RD UNIT 33 ATLANTIC BEACH FLORIDA 32233
General description of improvements: RE ROOF
Owner OCEAN VILLAGE ASSOC. INC.
Address 2233 SEMINOLE RD UNIT 33 ATLANTIC BEACH FLORIDA 32233
Owner's interest in site of the improvement FEE SIMPLE
Fee Simple Titleholder of other than owner)
Name
Address
Contractor JAMES SHELTON ROOFING
Address 8352 HIGHWAY AVE JACKSONVILLE FLORIDA 32254
Phone No.gG4-378.92.0 Fax No.
Surety(if any)NIA
Address Amount of bond$
Phone No. FaX No.,
Name and address of any person making ra loran 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 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
_... _._.._.._._.-_ ____........._.._,__ ... _ i 4YNER
TM)S SPACE FOR RECOf3DEFt'S USE t3NLY
Signed; _ DATE �f-7
13erore a is day _ .,3., n the
Coun� jata of Flodda as uaona appeared
ttBrein by
himeairr her seH anti iris ii�at an aterem is and declarations herein Tile
Doc#2017265858,OR BK 18192 Page 370, a+e true and accurata Shelby Y
Number Pages: 1 Notary Public
1 ,.
Recorded 11/17/2017 02:09 PM, State of Florida'ry� y Com 'on Expires 02/16/2020
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTYNotary Pu is nt Lar , tat t i county of on No.FF960933
RECORDING $10.00 Myoammfssionexpirac, _ ,..........-....._-
PerBonaily Knovm_ .-...>.,
Produced IdentNlcanon� .._. _ m.