736 SELVA LAKES CIR - ROOF 4 ' r 1. CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
11,
INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0169
Description: re-roof FL10124R7 & FL18686R1
Estimated Value: 9769.5
Issue Date: 11/8/2017
Expiration Date: 5/7/2018
PROPERTY ADDRESS:
Address: 736 SELVA LAKES CIR
RE Number: 172027 5850
PROPERTY OWNER:
Name: PARRY PHILIP CLAY
Address: 736 SELVA LAKES CIR
ATLANTIC BEACH, FL 32233-4368
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: K & D ROOFING & CONSTRUCTION
Address: 2758 DAWN RD SUITE 1 NE QA ROBERT ANTHONY HILE
JACKSONVILLE, FL 32207
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$7,500.
.r
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 715k40 361a a La e.3 C re-NC.. Permit Number: e-Cg-FI1--b l(01
Legal Description LSH'IQp14-a5-act r 5eloaLake's Uri;4.3 Lo-t- la a) Parcel II, I1, c.a`1-5?S"O
/� rloor Area of Sq.Ft. Sq.k't
Valuation of Work$"17 L •5� Proposed Work heated/cooled non-heatedlcooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing sti acture,is a fire sprinkler system installed?(Circle one): es o N/A
Florida Product Approval# FLt of am fr1 leder lcjw jrr+ Puede ic#Cpp 2.04&-D-14--1L iscp.210e I
For multiple products use product approval form
Describe in detail the type of work to be performed: f €.yo 0-F
Pronerty Owner Information: ,�,,II7
Name: � 'h. \t9 P�rrL1 Address: T7 3r_o Set0a_ LA l!!Ke;f.
City pl;%yy,1 it- Civ o c. h State l j Zip 37.2.3-D Phone Qv-1-343-lc.o 2
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: V.0-0 ;Zapf:r.q.4-CO3,s4r,..ae.sn Qualifying Agent_ Ro z)e14 '1 i le....
Address:l`t to-t"' Sk•ce+s•.5/. ‘o`k City OaAL.8c.}-N- State- Zip 32L3-1
Office Phone CIo`t- 591-rt otb Job Site/Contact Number goy-1 L1y-1 a ICI Fax# &o 4 cp`d•3.)49 e "mac
State Certification/Registration# Cee- 13A 5'662
Architect Name&Phone#
En' Seer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address PP‘1 i,4 $f B 3 66`I l le-S
Mortgage Lender Name and Address
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 workwill be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void ifwork is not commenced within six(6)months,or if construction or work is suspended or abandonedfor a�period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc. ,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT ENT MAY RESULT IN YOUR PAYING TWICE FOR INIPROVEMENTS
TO YOUR PROPERTY.IT YOU INTENT) TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR.NOTICE OF
COMMENCEMENT.ENT. -
/hereby certij5'that I have read and examined this ggplication and brow the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with ther•spec''4 d herein or not. The granting of a permit does not presume to give authority.to violate or cancel the
provisions of any other federal,st , r 17a11 regulating construction or the performance of construction.
/ 7 him, /
A, Signature of Owner y. / - . 7 Signature of Contracto
\OC Print Name ItA i LI F (! . V"k larI Print Name Q ..-1- h1�
Sworn to and subscribed before me Sworn to and subscribed before me
this at,Day of a e�vloe✓ .20 I.-3 this .1 Lo Day of nc.4-b>oe✓' .20 177
Notary Public Notary bib
,,a 1 0 i.1 ev ed 0 .26.10
ROBERT HILE tSNAN'R id 1
IIS '=MY COMMISSION ? ' M' r'=:i ` ;C*#GG087345
Es:
' *GG082, .y rtrai,;. .
-y>r'' uxptR' c+arch 27,2021
• 1:0vEXPIRES March 14,202'
•
Doc # 2017255481, OR BK 18177 Page 2485, Number Pages: 1,
Recorded 11/07/2017 10:44 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL•COUNTY
RECORDING $10.00
i1OTICE OF COMMENCEMEda C
P=._- =.e
Parmit No. Tax Folia Re
-
State of FLORIDA Count:•of
To whom it may concern:
The undersigned hereby informs you that Improvements wilt 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.
Leeal description of property neilno-mproved: 4y'lA I> • "n S -a9 C
C vc�. _0.1EtPS tc i 6 l-crrtaai
Address of property being improved. —7 3 Cr> S Lo k..& C
s _t._r-
dA1e•e.!iG &22.53
General deest_riiation 'c R of improvements:RBOO -n VS SHI]GLGS
`
^.miner r 7i,s t Pc.,rrt�� P1 l
Address (.P e.. Q.— t—c3,11e5 �•lr. (4ILLrv# G_Pw-!.t.-1,,"qf 32-2-
O:nor s interest in site of the improvement oa:NEtt
Fee Simple Talehotder:r'other than o.nen
Name
Address
Cortractor h&1]ROOFING Si CONSTRUCTION COMPANY.INC.
Address 7•t 6TH STREET-SOUTH,SUITE 104 JACKSONVILLE BEACH.FI.33350
nOrE ftO 904.5:'-/7CCi99L-223.6eE8 Fol;n0.904.369.3249 E•Pd.\
Surety of any/
.Address Amount of bond S —
Phone No. FLY.No._.
Name and address of any person makir-.o a can for the construction of the improvements.
Name
Address
Phone 140 Fax No.
Name of cersort within the Slate of Fiance.other than nimsetf.desianated by a::ner upon:-.herr notices or otner
documents may be served.
Name
Address
Phone No. Fat No.
in addition:o himself onner designates:he failo::•ina person to receive a copy of the Lienor s Notice as provided in
Section 713.OS(2;ib).Florida Statutes.)Fill•n atO:•:ner's option)
Name
Ace;ess _
Pnone Nc. Fax No.
=*.pirat:on date of Nonce of Commencement.the expiration dale Itf offs(1;year ftQjn tha date of recording unless a N ry
different date:s specified): •i •
f 4] a
THIS SPACE FOR RECORDER'S USE ONLY OWNER
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