471 Selva Lakes Cir RERF21-0128 Shingle ri'1,,V1r,., REROOF SHINGLE PERMIT PERMIT NUMBER
r CITY OF ATLANTIC BEACH RERF21-0128
„ ISSUED: 5/10/2021 EXPIRES: 1162021 800 SEMINOLE ROAD
X01119 ATLANTIC BEACH. FL 32233 11/6/2021
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:
L1
F
Shingle: 0124-19,
471 SELVA LAKES CIR REROOF SHINGLE e. L1 R1 $6000.00
TYPE OF REAL ESTATE ZONING: • BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: I GROUP:
172027 5024 SELVA LAKES
COMPANY: ADDRESS: CITY: STATE: ZIP:
MONAHAN ROOFING 2050 S KING CIR NEPTUNE BEACH FL 32266
OWNER: ADDRESS: CITY: STATE: ZIP:
Deborah Andrews 471 Selva Lakes Circle Atlantic Beach Fl 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If\
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.
FEES .llailiiiiiiiiIii
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $85.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$89.00
Issued Date:5/10/2021 1 of 2
rt-A"-- Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
.-un s r IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: t-t-) ( ,Se(oc-, L.ckLe C.(rc( ,2,_ Permit Number:
legal Description LQ t Lt. t Se Ivo- ,Cc.kca , p k t GS00 IL `f 1 104FI' 5 S. 4-r-CARE#
Valuation of Work(Replacement Cost)$ (,00O . 0•' Heated/Cooled SF Non-Heated/Cooled
R e_ro d z (.i,4
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair Rfvlove ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial .2T dential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes Cifro-
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) 136-
Describe in detail the type of work to be performed: ,
CTy) ric k. N rc o 1— ttsnr.\ (j-A F I. nnhe.-I‘n
NtuJC-CT+r-t--(cnu 4u bc_-ettisk-.,-;f 1eryhbwy -rcrc.L
Florida Product Approval# FL- /(, / 2 L1 -/ 61 for multiple products use product approval form
2<Property Owner Information �`r���r c-42/
Name 0,2-►5i-‘AN (- nclrcW f Address t-i11 Scluc, Lc k4 C'irc(eJ
City () f lc 4 c Qe tc_h A State F (� Zip - 223`. Phone Z,2 G -_TGG S
E-Mail (tttot'-ac,. O-4rt.w 1 . esta1W
ry . l ,c. ‘
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company (7100 ham., Roc,F i n ` Co Al-ronc.forqualifying Agent 1,....51a '
Address 205-0 k-inys Cnrcf.e City wptun4. State FIc, Zip 3Zz-GC.,
Office Phone 22-t - '"5" Job Site Contact Number 'Torn SC,c4- Y9 2 0
State Certification/Registration# 12.CAV'7 "?1-1"\ E-Mail L r lora le .... 3 C-0.c-cx.i i-- . n e t---
Architect
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt 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 regulating
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
R `� 'DI�; is U ' •TI i OF COM i NCEMENT.CY r I ("7,-- c<2,92,--e•
(Signature of Owner or Agent) i (Signature of Contractor)
Signed and sworn to(or affirmed)b-fore e this O day of Signed and sworn to(or affirmed)before me this 1 f1 day of
10 , J--( ,by ' •►. 1 ANA. Mhl 2011 [,y A°" ���
;''"°t 1 (Signature of Notary)
=,a r; Notary Public-State of Florida
..N ' Commission#GG 913529 %.''-. DACODAH PARRISH
My Comm.Expires Sep 16,2023 [ ]Personally Known OR ,,. .� :,,_Commission#HH 024083
[ ]Personally Kno OR ����,
[ uced Identification [ roduced Identification — L -;��`-�' Expires July 27,2024
L-V ="?�•n4,':' Bonded Thru Troy Type of Identification: _ \ : ' 1 '1'l,Z Type of Identification: I� yFain Insurance 8Q0-E
NOTICE OF COMMENCEMENT
Permit No. --)Parcel ID/Tax Folio No. I a V a` —3 0 a ,
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.
. Description
of
property(legal
description
escription ofproperty and
address if
ddressif available):
vLo+ It , div cLkt S (,(„-k- boo ICT I 11Q4,G„_` S _4-"J.v/
2. General Description of improvements: r
Co Pry 1P.i-C R.e_r0uc USi (,) Arch. 1- e, t-- .sh,ns )42f '4' M.Uv'C 4.4-4 .Q,..,(4..
03. Owner Information: f n /�
a)Name and Address: J Lv s 2<A8' R€uc ccJ Le ( r,sfi , IQ Loral-/�-cOrews,T/ -z2.
b)Interest in property: tee lIJarro•,.4,, ,/
c)Name and address of simple titleholder(if other than owner):
4. Contractor Information:
a)Name and Address: YYlo n a hc.,, Ro� 1( ,..‘ \ f =„(c c 3 , 2c,S O lc_f n 5 .s Cc f /._X04/,.
b)Phone Number: 2.2_f -o o S
5. Surety Information: `
a)Name and Address: ,v/ ►4- Doc#2021097095,OR BK 19681 Page 1032,
b)Phone Number: Number Pages: 1
Recorded 04/15/2021 03:20 PM,
c)Amount of Bond: $ JODY PHILLIPS CLERK CIRCUIT COURT DUVAL
6. Lender Information: ROCNRY
RECORDING $10.00
a)Name and Address: k•; / r't--
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a)7,Florida Statutes:
a)Name and Address: /V/11
b)Phone Numbers of Designated Person: _
8. In addition to himself/herself, Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. ,
a)Name and Address: N /P--
b) Phone Number of person or entity designated by owner: _
9. 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
th- • are true to the ..t of my ., owledge and belie
, & titid ' ' a4newk newS
,e'Signature of i wner or Owner's Authorized Officer/Director/Partner/Manager '1/4---Signatory's Printed Name&Title/Office 0 JZ.
OI
The foregoing instrument was acknowledged before me this day of p rd ,20 a-1 ,
by 6r4tin lQto WS as 0 ()Jive r for___ -
(Name of Person) (Type of Authority,i.e;Officer/Attorney) (Name of Party Instrument was Executed for)
J.
a►RY�� MARIE HAMLET NO ..� PUBLIC, ST' OF LORIDA
'� Notary Public•State of Florida
I %.7 0_0s �' Commission#GG 913529 Print Name: ��LQ J C �yP✓'
' ..... My Comm.Expires Sep 16,2023
■ Personally Known ` Lt 21 dentification'Type: . pf ' �' (-'em!
(Affix Notary Seal Above)
Revised 1/18/18
GENERAL INSTRUCTIONS FOR FILING A NOTICE OF COMMENCEMENT
In accordance with Sectioi 713.135(d) of the Florida Statutes, a "Notice of Commencement" must .
be filed with the Clerk of the Court (County Records Division) prior to the commencement of a
construction project of more than $2500.00, or $7500.00 for a direct contract to repair or replace an
existing heating or air conditioning system, and a certified copy of the Notice of Commencemegt,
must be posted at the jobsiie.
This notice contains de iled information about the project such as property owner, fmancial
institution,jobsite address contractor, etc., and protects the property owner's title to the property.
Duval County Clerk o Court Office Locations
Location Address Directions Hours
Downtown
Downtown 501 W. Adams St Jacksonville on West
Courthouse Adams St. between 8:00am- 5:00pm
(904) 255-2000 Pearl and Broad Streets
Located in the east
Beaches Branch 1543 Atlantic Blvd corner of Tradewinds
(904) 255-2000 Neptune Beach Plaza near the Duval 8:00am - 4:30pm
County Tax Collector's
Office
Fees for Recording Docu II ents - Effective June 1, 2004
• First Page of Docum-nt - $10.00
• Each additional page - $8.50
Revised 1/1/18
i