607 Selva Lakes Cir RERF20-0023 Shingle rs:: JT4, REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF20-0023
800 SEMINOLE ROAD ISSUED: 2/6/2020
____ ATLANTIC BEACH. FL 32233 EXPIRES: 8/4/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA 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:
607 SELVA LAKES CIR REROOF SHINGLE SHINGLE ROOF $10854.00
TYPE OF REAL ESTATE IZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172027 5546 SELVA LAKES UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
PRIME ROOF 13725 BEACH BOULEVARD, #13 JACKSONVILLE FL 32224
CONTRACTING LLC
OWNER: ADDRESS: CITY: STATE: ZIP:
SOARES MARIA M 607 SELVA LAKES CIR ATLANTIC BEACH FL 32233-4378
MARTINS RIBEIRO
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 J
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:2/6/2020 1 of 2
• ,t)..mre. REROOF SHINGLE PERMIT PERMIT NUMBER
411
0,4 CITY OF ATLANTIC BEACH RERF20-0023
�V ISSUED: 2/6/2020
r / 800 SEMINOLE ROAD
'; 9. ATLANTIC BEACH. FL 32233 EXPIRES: 8/4/2020
Issued Date:2/6/2020 2 of 2
•5! 1'% Building Permit Application
/' -n�
`r City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
",u;tl>�
Phone: (904) 247-5826 Fax: (904)247-5845 [� /�
Job Address: 607 Selva Lakes Cir, Atlantic Beach, FL 32233 Permit Number: ' E F'2 Cj VcD 2
Legal Description 43-11 17-2S-29E SELVA LAKES UNIT 2 LOT 75 RE#
Valuation of Work(Replacement Cost)$10,854.00 Heated/Cooled SF 1917 Non-Heated/Cooled 479
• Class of Work(Circle one): New Addition t�lteratio)Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial dtesidentiia
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 0
• 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: Replace roof with asphalt shingles
Florida Product Approval#FL10674-R12(shingles) FL17420-R2(synthetic) for multiple products use product approval form
Property Owner Information
Name: Maria M. Martins Ribeiro Soares Address: 607 Selva Lakes Cir
City ATLANTIC BEACH State FL Zip 32233 - Phone 310-951-8626
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Prime Roof Contracting, LLC Qualifying Agent: Mark Young
Address 13725 Beach Blvd Suite 13 City Jacksonville State FL Zip 32224
Office Phone (904) 530-1446 Job Site/Contact Number (904) 860-0230
State Certification/Registration# CCC1329505 E-Mail office@primeroofingfl.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation FRSA Self Insurers Fund Inc. 01/01/2021 870-040093/3EE6142 _
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 R
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg E
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.
Q-I
4141
ignature of Owner or Agent including Contractor) (Signal of Contractor)
Signed and sworn to(or affirmApp befog r(g,me thisday of Si ned and sword Ato(or of ed) efo thisday of
�_, 2.0ZD , by i �(.0 r is �iW t1N, !�'2-6 , byN I miry
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�E--_COMMISSION GG241220 -,c
�t COMMISSION I GG241220
=,, -,;• EXPIRES: Sept 17, 202""2``�� EXPIRES: Sept 17, 2022
[ ]Personally Known OR ., .' . Boflded rim
A81'011 lbi rersonally Known OR �iq,¢,,o Bonded null Aaron Notary
��nnn�"� '71
[- 'Produced Identification [ Produced Identification
Type of Identification: FL 11) Type of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN 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:43-117-2S-29E SELVA LAKES UNIT 2 LOT 75
Address of property being improved:607 Selva Lakes Cir,Atlantic Beach,FL 32233
General description of improvements:Re-roof
Owner Maria M.Martins Ribeiro Soares
Address 607 Selva Lakes Cir,Atlantic Beach,FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Prime Roof Contracting,LLC
Address 13725 Beach Blvd Suite 13,Jacksonville,FL 32224
Phone No.(904)625-1446 Fax No.
Surety(if any)
Address Amount of bond$
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 Florida,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 Lienor's Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
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 OWNER sp��,
Signed: , I DATE
Before me this T day of 2 ih �e
County of Dual, ate o Florida.Inas personally ppeare
n tdrew�! p Davis
gri0� vove
himself herself and affirms that all statements and dec n „T -i •,� COMMISSION GG241220
Doc#2020029164,OR BK 19095 Page? Fi
249, are true and accurate a
Dumber Pages: 1 EXPIRES: Sept. 17, 2022
Recorded 02/06/2020 10:24 AM, � ION��• Bonded Thni Aaron Notary
tONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
%OUNTY Notary Public at Large,State,0/// , County
tECORDING $10.00 My commission expires: of Dutra
Personally Known or
Produced Identification f'(. I D