527 SELVA LAKES CIR - ROOF !,,,,,
.c')1 ;f'. , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
1514, �~ ATLANTIC BEACH, FL 32233
"L,i1 v%' INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0164
Description: RE ROOF SHINGLE
Estimated Value: 7800
Issue Date: 11/2/2017
Expiration Date: 5/1/2018
PROPERTY ADDRESS:
Address: 527 SELVA LAKES CIR
RE Number: 172027 5506
PROPERTY OWNER:
Name: RIGBY DOUGLAS D
Address: 527 SELVA LAKES CIR
ATLANTIC BEACH, FL 32233-4361
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: PIMENTEL ROOFING INC
Address: 321 4Th AVE
JACKSONVILLE BEACH, FL 32250
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.
F
/1....,v77,..,,,,
- - BUILDING PERMIT APPLICATION
(-;----
OES1
�- CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
-----.91119'," Office:(904)247-5826 • Fax: (904)247-5845 P
Job Address: 52 '7 5e/v4. ,ak.e5 di ;- Permit Number:
./Legal Description i - 11 t 7 4) •,dt i E 6 -(&'A I-4 k,,/ Z RE# /7 Z e Z
Valuation of Work(Replacement Cost)$7 AZ',�o Heated/Cooled SF ZZ Non-Heated/Cooled
• Class of Work(Circle one): New Addition Geratioy) Repair Mov- I-mo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residenti.
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 67—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:
-ejr n1IO. 61 CP fjI.iii/g/o, 1-na.t k,e/'J.zarWoo 11-al't `-€-Air,;/AZ,e..71-,:vs, 6.14--i4-A...Qsv150tth_dOle.
Florida Product Approval# FL I et 5-0,'5 7-4-0,1/4 k o -3if tr. 414e,.. for multiple products use product approval form
Property Owner Information F L a 5 6, Cl - 2_ 1 D
Name: 1)444,5 (R t IN, Address: s--) 7 S w ii/, 4406 e€1- ,
City 4_ rJ. ,%.1-te. /32,,A or,, StateF/,Zip Phone ;,2 V''- r3'' 5.7
E-Mail
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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 YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
Contractor Information:
Name of Company: pi mP0
Address: O Z -Ir�, b Qualifying Agent: i� f.
OfficeddrPhone �� ` ' v," City �.4-Y , � Fl State Zip 3 2 2 Sv
'S'6'V- ,s/4ØJob Site/Contact Number R,Q,, 5-g/- ‘ -le-ggi
State Certification/Registration# C C G/, 109,35- E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation III\
digwir nsurer -. e mp oyees xptratton l ate
Application is hereby made to obtain a permit to do the work and installations as indicated. I cert 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 laws regulating construction in this jurisdiction.
This permit becomes null and void if work is not commenced within six(6 months, or if construction or work is sus ended or abandoned for a
period six( months at any time after k is co men d ,understand that separate permits must be secured for Electrical Work,Plumbing,
Signs, Wells,Pools,Furnaces,Boilers aters, T k ' • ' Con':toners,etc.
C- A.
Signature of Property Owner: - _ .4' / Signature of Contractor.
Before me � -
this / Day of No 0 f - 001 2 Before me this Da of 'j
�,� I - / i - -�1 f
/ _ik, ANN MARdADONNA N
Notary Public: r * ;. MY COMMISSION#FF 181400 NotaryPublic:iaI �r.— '1
,' EXPIRES:September 18,2018 RES ti p 0
'• Bonded Thru Notary Pudic Undenrriters EXPIRES:September 18,2018
e --.7------77T-7:—
[Yffifi Bonded Tha Notary Publ c Undemders
I hereby c��ti •t'. I • e e:. �'--"--- — ;know the same to be tru• ` : ..----.7-7---;---,-
nd
ordinanc's governing this type ofwork will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violte or cancel the provisions of any other federal, state, or local law regulating construction or the
performance of construction.
Rev.3/14/16
•
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
rZE# /7202-74 1Z
0 Description of property(legal description of property and address if available):
2. General Description of improvements:
5 AL/y/III 7113 e5 4 :it/54g re—ra v r S.A-. t.i.,io .2,/lzf�.-(s/-/ O y . AP le_,,v 1'i'.�
/
3. Owner Information:
• a)Name and Address: —1)aL,r- 71 "� £ 7 ..Solr/a k kph ('I,- ,4 /-/6i,.1 ,C
b Interest in roe ' / b S .
property:y: !'��z e?bot ,v4''
c)Name and address of simple titleholder(if other than owner):
I
4. Contractor Information:
a)Name and Address: [ = .. Ar.... ,:, w, R
b)Phone Number: 6---nj /— 5 ‘ 1
5. Surety Information:
a)Name and Address:
b)Phone Number:
c)Amount of Bond: $
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a) 7, Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to himself/herself, Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713.13 (1) (b),Florida Statutes.
a)Name and Address:
b) Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one (1)year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER. AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAY: NTS UNDER CHAPTER 713, PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR 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 COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts statedz,
therein true to the best • + y knowledge and belief.
(e '
: (.1
y7- OCCAS. 0 CK—g(4
'signature of wner or Owner's ' thorized Officer/Director/Partner/Manager gnatory's Printed Name&Title/Office
The foregoin: '- ment was acknowledged before me this ( day of / 0 0_ ,20/7
,_ as for C �`
by(N..e of' rLP' ' (Type of Authority,i.e.Officer/Attorney) am of7Party to ruMent was Executed for)
rm,iANN MARGADONNA
*1Y MY COMMISSION#FF 161400
-p.d EXPIRES'September 18 2018
NOTARY PUB ,_'',pi' 6 m ryCr ' 6 ers
Doc#2017249762,OR BK 18169 page 1989, ^ _.. _ _ -`
Number Pages:1 Print Name:144,jI A.1,-1,4 r r 4/#v _
Recorded 11/01/2017 03:25 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY Personally Known
RECORDING $10.00 ❑ Identification/Type:
Revised 3/15/12