495 Selva Lakes Cir RERF19-0065 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0065
ISSUED: 5/6/2019
800 SEMINOLE ROAD EXPIRES: 11/2/2019
ATLANTIC BEACH. FL32233
ALL WORK MUST CONFORM TO THE CUKKtF1 I Din cf,I jalvyullij Ir
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 restrict ons app ca e o
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,orfecleral agencies.
495 SELVA LAKES CIR REROOF SHINGLE SHINGLE ROOF $6500.00
TYPE OF REALESTATE BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: ZONING: GROUP:
1720275036 SELVA LAKES
TOWNSEND ROOFING & 10418 New Berlin Rd#115 JACKSONVILLE FL 32226
CONSTRUCTIONS SERVICE
OSSI STEPHEN V 495 SELVA LAKES CIR ATLANTIC BEACH FIL 32233
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.
D1,!C.RIPTION ACLOUf_ I QUA�TITY PAID AMOUNT $8500
U U.
LTTATTEEDBPR SUR CHARGL 455 000�1--Ul� 1 0
0 $2,00
DCASURCHAKUL 4S5 MO 208-06W TOTAL: $89.00
Issued Date:5/6/2019 1 of 2
REROOF SHINGLE PERMIT PERMITNUMBER
CITY OF ATLANTIC BEACH RERF19-0065
800 SEMINOLE ROAD ISSUED: 5/6/2019
-ATLANTIC BEACH. FL 32233 EXPIRES: 11/2/2019
issued Date:5/6/2019 2 of 2
V"i
Building Permit Application Updated 5/5/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
fill Phone:(904)247-5826 Fax:(904)247-5845
Job Address: H L"�L' C"rr'la' Permit Number;
Legal Description 11 ,S5 �SJVA LALES Lo+ 1'7 RE# /'71,0 -7-SbA
Valuation of Work(Replacement Cost)$ L,55`0 !� Heded/Cooded SIF_Non-Heated/GoOlOd—
• Class of Work(Circle one): New Addition Aiteration Repair move Demo Pool Window/Door
• Use of existing/proposed structure(s)(arde one):, Commercial (Eig%
I ?): Yes No N/A
• if an existing structure,is afire sprinkler system installed?(Circle on, of vzil
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit No Tree Remc,
Describe In detail the type work to be performed: IQ'0-0 �- k F ta,wiiue-f -S t4 kk)G LC—
F !F'f 97
-L jyq97
Florida Product Approval for multiple products use product approval form
Property Owner Information 14L
Address*
-13-5�Va� 4
Owner or Agent(if Agent,powerofAttorney or Agency Letter Requireal
Contractor Inficinmation S'W'a$' -TW-
I-------- - City -X^-A State VL- ZIP 747,�
Address I
office Pi;-.ne_1vI- 646-EF& I Job SnelContact Number
State Certiflution/Registration# QXM&7,ffq E-Mag
Architect Name&Phone#
Engineer's Name&Phone
WorkersCompensatlon 0- �I in kbrl�4.'� 6'y;�g$5
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has
commented 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 ORAN ATTORNEY BEFORE
RECORDING YOUR 7NE OF COMMENCEMENT-
(SignatureotcontA
(Signature of Owner or Agent) /0�
(including contract0r) mom to(or a before IF
Signed and sworn to(or affirmed)before me this _dayof Signed and
ignature of Notary)
zZ0Z liz oft sai bire-01011PIKIINNSEND - - - - - - - - - -
Commisi,lon#GO 183366
ON99NMOI$11011 Expires March 25,2022
_ M�4 "s
ZZ. Z C...W=31
14Personally Known OR jX P.monally Known 00 n
( I Produced Identification [ I Produced 111dentificatio
Type of Identrfication: Type of lderwk,Alute:
NOTICE OF COMMENCEMENT
(PREPARE IN DURUCAn:
Permit No. Tax Polio No. 172027-5036
State Of f�—
To whom It may ocancism:
The undersigned hereby Infamns you that Improreaments will be Made to cartaki real property,and In
e4th Sez d�713 of-he pfcr�a!!Mstutes,Me��—wlrg is started in thl-NOTICE OF
COMMENCEMENT.
Legal descripfflon of property being improved. 41-55 17-2S-29E SELVA LAKES LOT 17
Address of property,being inproval 495 SELVA LAKES CIP,Atlantic Beach,FL 32233
Gan"., Roof Reolacernent
Owner OSSI,SrEPHEN V
Address 415 54vA Lx�-; 6:1.tt AHA�ti4- FL -gLZ-3;3
Owner's interest h she of the Improvement
Fee Simple Titleinckcher(if other than cwnsm)—�--
warm—
Address
CM.thr�hM,Tnwisand Roofing and Commuo1orr Servlm�Inn.
Add, 1041SNmBuhnRd.U�t#115Jarlso�lle,FL32226
Phone No.ao�esxr Fax No.90�645-5442
Surety(If any)
Address in of bond 4
Phone No. —f-aX NO�
Name and address ofany person Making a loan for the consimn:tion ofthe improwernents.
Name
Address
Phone No. —Fax No.
Name of perwin within the State of Florida.other than himself or herself.designated by owner upon whom
notices or other d=MfttS may Me senrad:
Name
Address
Piron. ax N j
In addition W himself or herself owner denigrates ths,following perman 0 reoeive a copy of the Lienore Notice as
provided in Smiton 713,06(2)(b),Florida StaWtes,(Fill in at owners opfton�
Name
Address
Phone No Fax No.
fixpralion date a Notice a commencement(thei expration dam is one(1)year from fta�data 0 reconflev unless a
different dala is SipeCifiad):
THIS SPACE FOR RECOROM�, NER
m
Me a'.,
4�
C.Iintl al)TWO ftN..he.p ir."nd
Doc#2019103821.OR BK 187M Page 2451, f I262i --hrean by
Number Pages:I hni..rV N—iiera In..
Recorded MOV201911:20 AM, .Un.exw��.� CHRIS TOWNSEND
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Commisslen#GG 183366
COUNTY
Fde Expires March 25.2022
RECORDING $10.00
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