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715 SELVA LAKES CIR - ROOF (-- , 'r� v CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD 1 , ATLANTIC BEACH, FL 32233 ;.r PHONE LINE 247-5814 ��,i>> INSPECTION P O REROOF SHINGLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RERF18-0247 Description: Estimated Value: 7963 Issue Date: 10/4/2018 Expiration Date: 4/2/2019 PROPERTY ADDRESS: Address: 715 SELVA LAKES CIR RE Number: 172027 5866 PROPERTY OWNER: Name: KNUDTSEN KEVIN L Address: 4027 HARBOUR COVE DR JACKSONVILLE, FL 32225 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: J & M Roofing & Remodeling Address: , 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$7,500. Li; .41",'"'-, Building Permit Application Updated 12/8/17 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 Job Address: 7/SS ��t✓, (1-j S �i r t-(,1k Soul cL =Permit Permit Number: 12 ( ' 62- Legal 'Legal Description '7'1"6C) Jfv- -2 it. ttt Le 4GaS Ur,t}- .3 1. - 131 RE# Valuation of Work(Replacement Cost)$ 1963 •mac' Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration tiepajy Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial •esidentia • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No • 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: �efooc - Shy U_ Florida Product Approval# R/0(24-(-?ct ( ��(o8(Q-�3 for multiple products use product approval form Property Owner Information f'- Name: /s.vtr kr‘urlSI' ,/Address: �U277 /F.r'D .x- COve Dr- City ..Sc„ ...rw- ks State Zip 'Au j Phone 9o9 ta41 91(11-1 E-Mail Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Contractor Information Name of Company:-Z-}rI\ r1acleIry Qualifying Agent: Address 642n 1'j KJ dim V �vrr,t City v‘,r State (apt Zip 3:011.)Office Phone ` ! ,331 GS Job Site/Contact Number 4y4 ljeG State Certification/Registration# CCC L 2%."-6248 E-Mail i�,, 1 o r-. Architect Name&Phone# k1(IV Engineer's Name&Phone# KO, Workers Compensation �✓k„V,�,,,,,Ni, ft'1L1fU t / 7-f- Exempt/I urer/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. 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 NEY BEFORE RECO'DING OlAs OTICE OF COMMENCEMENT. /. (. a ure of Ow ••r or Agent) (Signature of Contractor) ( cluding contractor) Signed and sworn to(or affirmed)before me this I day of Signed and sworn to(or affirmed)before me this/ day of 4_ .c_•di' i i 4 by 4_ 401 Notary Public State of Fioritla �� Schuyler Schmidt ` _ Notary Public State of Y ,�.�s�a ) Schuyler Schmidt �� My Commission GG 214845igna ure of Nota *ufr Expires 05/06/2022 L e • Myx Commission 05/0 /2 22 274865 8 Notary) ern. Expires OSl06I2022 'Produced Identification )Produced Identification Type of Identification: A i_�1�< /.;c 1 Q Type of Identification: NOTICE OF COMMENCEMENT PREPARE;N DUPLICATE) Permit No. Tax Folio No. State of Florida 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: 44-60 16-2S-29E SELVA LAKES UNIT 3 LOT 137 Address of property being improved: 715 SELVA LAKES CIR Atlantic Beach FL 32233 General description of improvements: Reroof Owner KNUDTSEN KEVIN L Address 4027 HARBOUR COVE DR JACKSONVILLE,FL 32225 Owner's interest in site of the improvement Owner Fee Simple Titleholder(if other than owner) N/A Name Address Contractor J&M Roofing Inc Address 6020 Pkwy N Suite 500 Cummings Ga,30040 Phone No.TM-292-9054 Fax No. Surety(if any) N/A Address Amount of bond$ Phone No. Fax No. Name and address of any person making a loan for the construction of the improvements. Name N/A 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 NIA Address Phone 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 Statutes.(Fill in at Owner's option). Name N/A Address Phone 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 WNER usl/ Signed: DATE v Before me this 1�I day of [[[ in Doc#2018237100,OR BK 18553 Page 348, County pf�O val..Statspt has rsonally appeared KQ� K �d y;•yv Number Pages: 1 himsetfr herself and affirms th- all state : Recorded 10/04/2018 11:44 AM, are true and accurate gOiNevt, Notary Public State of Florida RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Schuyler Schmidt COUNTY `_ < My Commission GG 214865 RECORDING $10.00 � a . Expires 05/06/2022 notary Public at-Large,State County ofMy PerSOnay K an fres: 7 z— or Produced identification r-c.