487 SELVA LAKES CIR RERF18-0274 REROOF SHINGLE PERMIT REROOF SHINGLE PERMIT PERMIT NUMBER
r s,
CITY OF ATLANTIC BEACH RERF18-0274
J V� 800 SEMINOLE ROAD ISSUED:
ror: 9r ATLANTIC BEACH. FL 32233 EXPIRES:
MUST CALL INSPECTION • • 914 ♦ ♦ BY . PM FORDAY INSPECTION.
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • '
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
487 SELVA LAKES CIR REROOF SHINGLE SHINGLE ROOF $10000.00
TYPE OF
• • GROUP:
172027 5032 SELVA LAKES
COMPANY: ADDRESS:
AMERICAN ROOFING OF
JACKSONVILLE 2117 University Blvd. S JACKSONVILLE FL 32216
• ADDRESS: '
CHARLES CYNTHIA TRUST 487 SELVA LAKES CIR ATLANTIC BEACH FL 32233-4355
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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 RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $105.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $109.00
Issued Date: 1 of 2
Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904) 247-5845 (�
Job Address: 1 ✓��VQ.W QS�t Q 1 Z:J�Permit Number:
�r L ��
Legal Descriptionl-I I" ( T ' G e 6 ( ^
J RE# I TZOL7 -5032_
Valuation of Work(Replacement Cost)$/Di 00 !� 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 esidential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes NoN/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 perfgrmp�d: �� ,�ao� ��` Z ptn
C6 m?1 e (2- -�-�c_r n t
" S
Florida Product Approval# FL 1bS05 R6 .5 for multiple products use product approval form
Property Owner Information
Name: pa C, Address: 1493 SPival_uIeS G(-A e
City State zip 32-2-3:Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: American Roofing of Jacksonville qualifying Agent: Daniel P. Kinkel
Address 3047 St Johns Bluff Road S,Ste 7 City Jacksonville State FL zip 32246
Office Phone 904-385-4375 Job Site/Contact Number Chris Dennis,904-626-4636
State Certification/Registration# RC90227546 E-Mail dan@americanroofingjax.com
Architect Name&Phone# NA
Engineer's Name&Phone# NA
Workers Compensation Builder's Mutal Insurance#WCP1052393,expiration 5/3/2018
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. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc.
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.
(Signature of Owner or Agent including Contractor) - (Signature of Contra or)
Signed and swornn29,2O
pberet 's ay of Signed and sworn to(or affirmed)before me this� iay of
►- c Ae Deo" �� a ,
=ot`" °�`�c I SCOTT P
Notary Public-
' Commission otary
Notary Public State of Florida
••,;;off a,. My Comm.Expir ,P ,
Christopher Chasse
j My Commission GG 273130
��,��,,,,rrrr� aFd� Expires 10/31/2022
]Personally Known OR pCU'ersonally Known O
[ roduced Identification (fin '�/ L)C lon ]Produced Identification
Type of Identification: VIL V Type of Identification:
Doc # 2018290277, OR BK 18626 Page 75, Number Pages: 1 ,
Recorded 12/12/2018 10:21 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
11�
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 172027-5032
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.
1. Description of property(legal description of property and address if available):
41-55 17-2S-29E SELVA LAKES LOT 15
487 SELVA LAKES CIRCLE ATLANTIC BEACH, FL 32233
2. General Description of improvements:
Complete Tear Off and Re-Roof
3. Owner Information:
a)Name and Address: CYNTHIA CHARLES 487 SELVA LAKES CIR.,ATLANTIC BEACH, FL 32233
b)Interest in 100%
c)Name and address of simple titleholder(if other than owner):
NA
4. Contractor Information:
a)Name and Address: American Roofing of Jacksonville
2117 University Blvd S Jacksonville FL 32216
b)Phone Number: (904) 385-4375
5. 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 PAYMENTS 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 stated
therein are true to the best of my knowledge and belief.
Si lure of Owner or Owner's Authorized Officer/Director/Partner/Manager Signal_ 's Printed Name&Title/Office
The foregoing instrument was acknowleded before me this I day of `t""' ' 20
by C• nI C—kM 77'-
(Name of Person making statement)
SCOTT P DAVEY
Notary Public-State of Florida NOTA PU LIC,STATE OF FL DA
Commission#FF 227690
My Comm.Expires Jul 29,2019 Print Name: �C
N Personally Known J
N Identification'Type:
(Affix Notary Sea!Above)
Revised 1/01/18
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