663 SELVA LAKES CIR - PERMIT RERF18-0138 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
f3 INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0138
Description: Reroof
Estimated Value: 9900
Issue Date: 6/14/2018
Expiration Date: 12/11/2018
PROPERTY ADDRESS:
Address: 663 SELVA LAKES CIR
RE Number: 172027 5892
PROPERTY OWNER:
Name: BYERS NANCY B
Address: 13753 NIGHT HAWK CT
JACKSONVILLE, FL 32224
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: SHORE ROOFING COMPANY
Address: 914 7TH AVENUE S QA THOMAS LOUIS SHORE
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.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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$7,500.
Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
P one:(904)247-5826 Fax:(904)247-5845
Job Address: l0� U l Permit Number:RO {/
8 -0139
Legal Description ���y `�'� f yd�� 1 .�Z J UV% �1f�Yj� ()V k'` 3 LOTL�5 J RE# t 1 o.O Z`So 5;L
Valuation of Work(Replacement Cost)$_ ,, Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair 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 N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in dgtail the type of work to be performed: ����j ye,4 r (� ,5 C j/ 1145
0l4'1�P� �sl,,�J {�/V1� 0U�)�4 C, "L� UA/
lfy�
Y
Florida Product Approval#F1 IC6
7 L rl,2076 ! for multiple products use product approval form
Property Owner Infor ation _
Name: (LAIC �}� Address: /,37-7-3 ) 5 A
City d uj t State —( Zip 3 22 / Phone - _5Y,3,?
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name o Co pan ��C � (1Qualifying Agent:
Addres l Avt .�� City �T4>c f3Ycc state��z� Zip U
Office P one Job Site/Contact Number !$29- 12A- 1 YS `7
State Certification/Registration# Q- E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
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 in this jurisdiction. l understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,et
on E I
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 YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
(Sig(4ure of Ow or Agent) (Signature of Contractor)
including c ractor)
Si ned and sworn fto' r affirmed) before me this r°�'day of Signed and sworn to(or affirmed)before me this IL( day of
by �i'lt�M�t
vw =tl,.
NotaN ry)CM 2021Perso ly1 �R dyAssr. [ sonally Known OR �,`,,,�`�
[ ]Produ [ ]Produced Identification fC'�' *s JENNIFER JOHNSTON
Type of Identification: i� Type of Identification: _t. ;*= MY COMMISSION#C,G042884
�=a,PJ o?'
Bonded Thro Notary Pulk ndenaibrs
NOTICE OF COMMENCEMENT
State of �'I Tax Folio No.
County of DU VA t
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: yl/`1,6 /6 �-as —�qL ftJ"y� 14k-1, G-.V �'_2 �n J�6
Address of property being improved: 66-3 �t.�u►4 r/'}/1 t ('�`/ f/� �l���'G 13t c.1 CY 3D33
General description of improvements: /ZL 4?0,/F
Owner:
-
Owner: AI&Awy OYcYS Address: 137S-3 1/,`,&t (7.4ij/(r'-f"'Z4K Ff 324
Owner's interest in site of the improvement:
;U0XXzv
co
Fee Simple Titleholder(if other than owner): cmi o z o 3 n
0zzaIMT N
Name: mg;o
Contractor: sLrc- l?v �"�' C� G) cn$0 $
Address:q�� v, cS'd t/ 1� c Glx ('}�� 1—� L7LIrO r N J
o �o 00
3 Telephone No-:961 'Atf(--4940 - Fax No:
o w
MN m
Surety(if any) 0-U 8
Address: Amount of Bond$ 0
Telephone No: Fax No: 0 c
0
Name and address of any person making a loan for the construction of the improvements C N
Name: 0
C
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:
Address:
Telephone 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 Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: 18 &Mt-
Date: oG /
�'Ay'P PAMELA JE:SHORE Before me this day of in the County of Duval,State
NotaryPublic- orida Of Florida,has personally appeared
Commission22 Notary Public at Large,Stat o Florid ounty f uMy Comm.Expi2021 /`� scrdeanNaryns�. My commission expires: V
Personally Known: or
Produced Identification:2C R(- O— (nZZ—G-L_ Z