1829 SELVA GRANDE DR REROOF SHING PERM REROOF SHINGLE PERMIT PERMIT NUMBER
i' RERF19-0028
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 2/12/2019
19 ATLANTIC BEACH. FL 32233 EXPIRES: 8/11/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' ! + BUILDING
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:
1829 SELVA GRANDE DR REROOF SHINGLE SHINGLE ROOF $21922.00
TYPE OF BUILDING
• • GROUP:
169542 5036 SELVA TIERRA
COMPANY: ADDRESS:
FLORIDA ROOFING 4320 DEERWOOD LAKE PARKWAY JACKSONVILLE FL 32216
EXPERTS 1001-403
• ADDRESS:
GRAY MADELINE M LIFE 1829 SELVA GRANDE DR ATLANTIC BEACH FL 32233-4526
ESTATE
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 • !
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 $160.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.40
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $164.40
Issued Date: 2/12/2019 1 of 2
f
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office '904) 2'47-5826 Fax (904)247-5845
Job Address: X_'-¢- I;:- C Permit Number: JRZg
c _ . .�
Legal Description cue\V�. -e.rrr, Lo* Parcel#
Floor Area of So.Ft. Sq.Ft
Valuation of Work$ 2� ,°�Z-�- Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration <j�D Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial
If an existing structure,is a fire sprinkler system ins lled?(Circle one): Yes No N/A
Florida Product Approval# \-z -P.2� I S Z k (' - 3
For multiple products use product approve or
Describe in detail the type of work to be performed: eC'00�
Property Owner Information:``2e
Name: (fl NI C, Address: a Y4 6rxw f-_ —
city -j .,poi/TG Stat ip 3X33 Phone
E-Mail or Fax#(Optional)__ d��t s
Contractor Information: (� r
Company Name: L Qualifying Agent: —Tf7G.V'%'b
Address- O cw uvs City At _ State v Zip 9'L2\lo
Office Phone X2'6-(vN-'kLP Job rte/Co tact Number Fax
State Certification/Registration#.....CX-C k32e101C4-j _
Architect Name&Phone#
Engineers Name& Phone#
Fee Simple Title Holder Name and Address _
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced I understand that separate permits mast be secured for Electrical Work,Plumbing,Signs, Wells, Pools, Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc
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.
1 hereby cert6 that I have read and examined this plication and know the same to be true and correct All provisions of laws and ordinances governing this
type of work will be complied with whether speci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions ofany other federal,state,or local lav regulating construction or the perfo,mance ofeonstruction.
d
Signature of Owne f o� 1' ^lhL��'` Signature N N
Sn rr Si ature of Contractor N
:i:
Print Name 1�� P It (�f \ ZLbu� -
�X1...... .._v.`�1....V Print Name1r1 t' o
_ ..... _. _.._........._......_....-- _...1 ..........._._..._... ..
Sworn and subscri efore me Sworn to and subscribed before me
tlii� ay of --Z() _ this Day of 2 1 w
CS
Not ublic — pis
t►"'" JACK BAZZELL ..
TIFFANY
� � MY COMMISSION it(3G1SS1S1 4r�r ryBP,L,� 1.26.10
°� MY COMMISSION#lite
EXPIRES October 26,2021 EXPIRES'.JUN 14,2022
_-�','�� gong�g tpwughlsLstate Insurance
Recorded 02/11/2019 11 :31 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
rPREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of L County of
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. �, ) _ l
Legal description of property being improved. c�G�Vk ` et'r� (...CYt— Iq
Address of property being improved: Vit—,\ L2C fie- ;L,r
AAA
General description of improvements: 12E C�OF
Owner
Address .*
Owners interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor
Address '�> au
Phone N014)3215
o. -(pSt-{l,p Fax No Yu
Surety(if any) _
Address _ _ Amount of bond 5
Phone 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 Flonda,other than himself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. _Fax No.
In addition to himself,owner designates the following person to receive a copy of the Lienors Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Address
its
Phone No. Fax No. J R
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a W
different date Is specified):_
THIS SPACE FOR RECORDER'S USE
Signed. +'H DATE 1 V W
Before me this y of -- 'in ttw I
0 of ery rod X
JU herein by W
Nmst nersetf arld amrms mat all statements and deciaraticlins herein
are the e "aaw Y.
Noi Pic atTArge,S. of , Coady of
my cIornurplon expires.
Po tCnown or
Pr IdentNkation
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