502 SELVA LAKES CIR - ROOF ♦ 0y1
4
1:r4.
4
S CITY OF ATLANTIC BEACH
_ 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
o; .c.) PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0036
Description: FL10674R-10/FL17420.1
Estimated Value: 11752.5
Issue Date: 1/30/2018
Expiration Date: 7/29/2018
PROPERTY ADDRESS:
Address: 502 SELVA LAKES CIR
RE Number: 172027 5050
PROPERTY OWNER:
Name: THIBODEAU MICHAEL P
Address: 502 SELVA LAKES CIR
ATLANTIC BEACH, FL 32233-4360
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Poe Enterprises Contruction LLC
Address: 13241 Bartram park Blvd
Jacksonville, FL 32258
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$7,500.
DocuSign Envelope ID:7DC4F047-6D56-4B8F-DCA4135304F722EFE
;, 'a 41r,,
4,' Building Permit Application
?, . it• i City of Atlantic Beach
^,s�l)' 800 Seminole Road,Atlantic Beach,FL 32233 J 4 r -c03)4
Phone:(904)247-5826 Fax:(904)247-5845 r,
23-C :5
Job Address: 50 2 5 c I,,, I-a�S C;rL'e. 3 Z 2 Permit Number: 74 ` l
Legal Description 4/ -S - - -
Z REN 17 2-02-1-30 0
Valuation of Work(Replacement Cost)$ 11,752'SO Heated/Cooled SF (n7 0 Non-Heated/Cooled 76 7
• Class of Work(Circle one): New Addition Alteration epalr Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No
gip
• 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: �nt
r- -O- lQ.. Qo, -
Z i for multiple products use product approval form
Florida Product Approval N FSI D(n�y �- )0. �r L 11y O
Property Owner Information s'''''',11" u.ct.+I,t��r,--
Name: T1-‘1 oAe.a a) Ml,-1,,,.e/ 4- -Indo, Address: I Z Sc( : • , i _ _ 0
OW Alin..- t R Q.eJls. State Pt-- Zip
3 2Z 33 Phone
E-Mail a.' . . . x C5 •. -
fawner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Poe Ea44-trpri et ..f4i-UcA-ino (AL Qualifying Agent: �� Zip 3 ,
Ci �a co ,all• State
Address 13 LK t {��r+r.•-+ f�k 61��f. +>�G.n+ City �—`�-- -
Office Phone Job Site/Contact Number_q04 --11 0 zla
State Certification/Registration N GCC 13 3 0Z
E-Mall '»• •'...:
Architect Name&Phone#
Engineer's Name&Phone N i
Workers Compensation •• •Exempt/Insurer/Lease 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
this
BOILERSeHEATERS,TANKS,and AIR ONDrT10NER5,etc.
d for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,
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 P RECORD
V M NTS TOOICE YOUOF R PROPERTY.nEF YOU INTEND
NT MAY
RESULT IN YOUR PAYING TWICE FOR
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
,--D.c.s.Q..d by:
„---z' 4 i_. --/ . - 2/Ce
(Signature of Contractor)
(Signature.a_{p,o.patemincluding Contractor 44
Signed and sworn to(or affirmed)before me this Z1 r day of Signed and sworn to(or affirmed)before me this 3_D oay of
3.-. e.. , 2f7i ,by Mic,(u e.( .71,41.dea.i �,-•unvy , ZL?IQ ,by (.0 col o-e-
. ; 1V.ur , Shawn C. Uvesey `:—___,,,/ / (s+srre of No
?4 yF'� Commission 1' CCO (signas) `ignatuvS,•, 2020 ' r.�, ComissionC OL vesey 30
='K til = es: mbei 2�,�� fxnd bete .4=4:.
aR Bonded thN Aaron Notary _•:(.i-_ ► i :December 22 2020
( J Personally Known OR (SQ Personally Known OR , jF BonOed thru Aaron Notary
( -Produced Identification t )Produced Identification ,,,,,,�„
4ype of Identification: .( /- -e-' r b Type of Identification:
NI
Scanned by CamScanner
Doc # 2018020347 , OR BK 18263 Page 1266, Number Pages : 1 ,
Recorded 01/26/2018 10 : 04 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
(AR EP.:RE IN DUPLICATE:
Permit No. Tax Folio No. 1 7 20 2.7 - S Ci G
State of Ft e`.dL- County of CIvG
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 staled In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: `II -S-S" 11 -2. - 2.9 Z.
2.4
Address of property being improved:- S s 2 Lrt C._,-c le
2_2 3
General description of improvements* f >;rn/ -0'4• ,/
owner Tt-su e,i ,,d
Address 5o 1L Sr_Lu. Lraicf__s C-: .-rte . 44.1.. 2.2-
•
Garet s interest in site of the improvement
Fee Simple Titleholder(If other than oarteri _
Name -
Address
Contractor cr•2_ er.I cp 4.t '-1..C.
Address i 52411 P.`-• Q: tLei II- 322j E
• Phone No. c'V K - 7/., -u Z-(. Fax No.
Surety Cr any:
Address Amount of bond
Phone No. Fax No
Name end address of any person making a!can fo`the construction or the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida.other than h:fnseir designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to n!mseli.oanner designates the foiicvinc De-son to receive a copy of the Lienor's Notice as provided in
Section 7133.06(21(bi,Florida Statutes.iFitl in at Owners option).
Name
Address
Phone No. Fax No
Expiration date of Notice of Commencement ithe expiration date is one it)year from the date of recording unless a
different date is specifiedh:
THIS SPACE FOR RECORDER'S USE ONLY NSR
,/G••{,tZ ,
7->4.7144"--fte+ c <044.DATE/��(�
Before ms this a{.ra day cf. ..D.'s c e r►h�s r .. ;.the
con'cc C ys:.Stale of Portia .qe5 per!orel!y appeared
�i• G� 'LJ1 r 1s .sle'_.•.L..---...._.. nesir hY
himself manWM
manic and mn stetereens arta de;.iararort(if )in
are iw.anci accurate AP,Y.ppd,�' Shawn C.Livesey
�■ "s Commission t GG057730
��� • Expire:December 22,2020
-'�'�t ' Bonded thru Aaron Notary
ay Pubuc et La•ge.State cf tL4/1 " Coco*of
r•Fti commitsion exoi•a'
. eemana'!y Kr.cr..n _ _ of
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