1908 SELVA MARINA DR - RERF20-0025 I >4, REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF20-0025
..,) V ISSUED: 2/10/2020
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800 SEMINOLE ROAD EXPIRES: 8/8/2020
ATLANTIC BEACH, FL 32233
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:
1908 SELVA MARINA DR REROOF SHINGLE SHINGLE ROOF $13790.00
TYPE OF I REAL ESTATE BUILDING USE
I ZONING: SUBDIVISION:
CONSTRUCTION: j NUMBER: GROUP:
169462 0115 SEVILLA GARDENS UNIT
01
COMPANY: ADDRESS: I CITY: STATE: '. ZIP:
AMERICAN ROOFING OF 2117 University Blvd. S JACKSONVILLE FL 32216
JACKSONVILLE
OWNER: ADDRESS: 1 CITY: i STATE: ZIP:
SHAW JAMES R 1908 SELVA MARINA DR ATLANTIC BEACH FL 32233-4518
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.
1. 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 $120.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$124.00
Issued Date: 2/10/2020 1 of 2
Building Permit Application Updated 12/8/17
7 = City of Atlantic Beach
VIP-
.,,,„, n 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 r (� /�,
Job Address: 1908 Selva Marina Dr,Atlantic Beach,FL 32233 Permit Number: f\ lit t" 'OOZE
Legal Description 45-6 08-2S-29E SEVILLA GARDENS UNIT 01 LOT 2 RE# 169462-0115
Valuation of Work(Replacement Cost)$13,790.00 Heated/Cooled SF 2.136 Non-Heated/Cooled 328
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/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 performed:
Complete roof replacement and installation of Atlas Architectural Shingles with Synthetic Underlayment. 1 Story,6/12 pitch,38 squares.
Florida Product Approval#Shingles FL 16305,Underlayment FL 21350 for multiple products use product approval form
Property Owner Information
Name: James R.Shaw Living Trust,C/O Sarah Fisher Address: 11 Glenbow Ct
City Simpsonville State SC Zip 29680 Phone (864)363-0869
E-Mail fishfam@gmail.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) NA
Contractor Information
Name of Company: American Roofing of Jacksonville, LLC. Qualifying Agent: Dan Kinkel
Address 2117 University Blvd S City Jacksonville State FL Zip 32216
Office Phone 904-385-4375 Job Site/Contact Number 904-385-4374
State Certification/Registration# RC29027546 E-Mail admin@americanroofingjax.com
Architect Name&Phone# NA
Engineer's Name&Phone# NA
Workers Compensation Builder's Mutal Insurance#WCP1052393,expiration 5/3/2020
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. 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 ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
3
S _ i
(Signat 7 e of Owner or Agent) (Signatur-of Contractor)
(including contractor) 1041
Signed and sworn to(or affirm d)before me this / /day of Signed and sworn to(or affirmed)before me this I day of
`_CA-tilhac c/ ,p21)�D,by Q '(e- 1 GLV\-Vke.r 5Al1 i c'- ?02 O , by�7Ptn K r r0C-c. )
(Signature of Notary) (Signature of Notary)
[ ]P sonally Known OR ]Personally Known OR
[}'Produced Identification (� L. [ ]Produced Identification dor 01% hoary Pur)Mc Stats otMorlda
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Type of Identification: 3 ci k_c S L. 1_1.%.Se Type of Identification: r;>r ' Cnristopner Chasse
• My •mm$5 Of<'< 130
a M1. Expir•a 10131/2022 1
Doc # 2020021739, OR BK 19085 Page 53, Number Pages: 1,
Recorded 01/28/2020 04 :34 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 169462-0115
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):
45-6 08-2S-29E SEVILLA GARDENS UNIT 01 LOT 2
1908 Selva Marina Dr,Atlantic Beach, FL 32233
2. General Description of improvements:
CompleteIear-Off and Re-Roof
3. Owner Information: James R. Shaw Living Trust, C/O Sarah Fisher
a)Name and Address: 11 Glenbow Ct, Simpsonville, SC 29680
b)Interest in 100%
c)Name and address of simple titleholder(if other than owner):
NA
4. Contractor Information:
a)Name and Address: American Roofingof 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.
SILLO-1)/) Da-gko.,.. T?rt, sfe�- , ora�l rs4i rTrusf ee
Signature of Owner orcr's Authorized Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The foregoing instrument was acknowledged before me this 07 day of S -1 1 l/lrZ.- ,20 An,
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by S Wali Fj Shtti
(Name of Person:raking statement)
NOT PU) I ,�T E OF-FLORIDA S/ c f'v'z.• l - y
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