523 SELVA LAKES CIR - ROOF (--S _ s5 CITY OF ATLANTIC BEACH
'' :. r 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
-Zo;3»IN INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0224
Description:
Estimated Value: 5500
Issue Date: 9/10/2018
Expiration Date: 3/9/2019
PROPERTY ADDRESS:
Address: 523 SELVA LAKES CIR
RE Number: 172027 5504
PROPERTY OWNER:
Name: DEWALT MARCY
Address: 523 SELVA LAKES CIR
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: WATERTITE ROOFING, INC.
Address: 1711 DOBBS ROAD, #E CURTIS ALDENE BLALOCK III
ST. AUGUSTINE, FL 32084
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
kiwCity of Atlantic Beach
4- ,� 800 Seminole Road,Atlantic Beach,FL 32233
<
Phone:(904)247-5826 Fax:(904)247-5845
Job Address:5'a 2 J JC \1G„ \-i L C\CcAt n Permit LNumber: R $!Ji
r�� 'd Z.-LP"(
Legal Description 1'},3-11 11_as-aq se, \...GIps 0;1„-t d LV� 5-4 RE# ('aV a I - 5:5-6 q
Valuation of Work(Replacement Cost)$ !)5U[) Heated/Cooled SF I 5aa Non-Heated/Cooled+ ` -1 to I
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool"1";)t..1/4.1n,
oWindow/Door !Jew 19,06-C• Use of existing/proposed structure(s)(Circle one): Commercial Residential 1 OW n1 Ij)Se
• 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:
ae.CO C - SL‘ lC .fio �\( ris\e
Florida Product Approval# 1(Q3 '). i vv-vAJ wre ve 1ti3 co a I for multiple products use product approval form
Property Owner Information J ( v� r�yfrve
vvi"
Name % - ‘' Addr)e s: a - kr' _ .S GSC <e
City } Gve� t . '�„L,� State FL. 3 Zip J-3 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: . .• • ;;#1% #1 Qualifyin Agent: (Lit-k-• S ' \C,\60(.._IC
Address [ilk 00`ObS be . Ire. E City .S*.ptu. sk-;,6c State L Zip 3,-).61,14
Office Phone Ci.Yy-3yn- CI 5%\ Job Site/Contact Number 601A-.)..\41-(ict 1
State Certification/Registration#d {` 13a.93't1 E-Mail U)L;. f A-, rcQS, W
t 'C..r ` - (X..) vv.,
Architect Name&Phone# J
Engineer's Name&Phone# I
Workers Compensation SOL,\-N EAAi- Yeccbv\c \ Le1.5s n 0\ Ic I I I I
Exempt/Insurer/ eas ployees/Expirati n 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. 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.
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
,'I,RECO' I I G YOUR NOTICE OF CO MENCEMENT.
?,'.Po . �• ,a //// ,„,,„_`�^V�� ( & /
,,,�_ ?)` r (Sign ure of Owner or Agent) (Signature of Contractor
;�al �y��' (including contractor) ,''tt sof
S �°'��^'''rS�'�te d and sworn to(o�r affirmed)before me this 7 ay of Signed and sworn to(or affirmed)before me this % day of
I cox J , c1ot2 , •y ON �Atf 17Q4\& 1 ZDI$by C.vr G►c o .
1 3 3 ' /pl.
t • Amanda Murdza
' , ' atur-of otary) ��w State of Flori.• (Signa re of Notary)
y Mirnmmi�sipn Expires 07/1:+2021
n nogg ] Personally Known OR 1,l;,? g''' irsona`�y,lZnowp op., 14045
• w ( s Ikoduced Identification n � Bu� ItIiPQatM `
' 15,, ,Tr, y of Identification: it N. J 130'51111P.• l te, 0 Type of Identification:cL c .j j QJ5 11 ail S
N a S
o c
N y
NOTICE OF COMMENCEMENT
State of _Florida Tax Folio No. 1345006,0004
County of Duval
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: 43-11 11-2S-29E.SELYA_LAKES UNIT 2.LOT 54
Address of property being improved: 523 Selva Lakes Circle.Atlantic Beach.FL 32233
General description of improvements:_Enlace Roof
Owner: Marcy DeWalt Address: 523 Selva Lakes Circle.Atl tic Beach.FL 32233
Owner's interest in site of the improvement: fee Simple
Fee Simple Titleholder(if other than owner):
Name:
Contractor: Curtis Blalock DBA Watertite Roofing of N.FL
Address: 1711 Dobbs Road Ste.E.St.Augustine,F132084
....)h.4,
Telephone No.: Fax No:
Surety(if any)
Address: Amount of Bond S
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
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(2Xb),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): 10/30/2018
�n � ppI
THIS SPACE FOR RECORDER'S USE ONLY OWNER: ' r `�.reSigned:1JDf1wp4? /af` I
Before me .0 day quo•(— 20►4 in the County of Duval,State
,,,'..""'� TAMMY NISNI�AIAA Of Florida,has personally appeared MAtn i,t DfM '-T
Notary Public at Large,State of Florida,County of Duval.
,PO4) Notary Public-State M Florida My commission expires: I
COMMIS1 ion 0 06 064735
Personally Known: or
:"1..,,,
••o,F;�, My Comm.Expires Jan 22,2021 Produced Identification: r p L 0 43b S 4/ 7 A ciao 0
Doc#2018182148,OR 8K 18478 Page 2298, V Gw�
Number Pages:1 34/474.41;)t ^J /y14 014
Recorded 08/02/2018 01:25 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00