Permit Roof 2010 144', � CITY OF ATLANTIC BEACH
'' "� '' 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 10- 00000981 Date 8/05/10
Property Address 415 IREX RD
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 4800
Application desc
REROOF FL9631.7
Owner Contractor
BLUNK, CLYDE ROMANO ROOFING SERVICES
415 IREX ROAD P.O. BOX 33037
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 246 -5649
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 4800
Expiration Date . 2/01/11
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 75.00 75.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: I #' E eX R Permit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work se y Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window /door
Use of existing/proposed structure(s) (circle one): Commercial
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No 1:*
Florida Product Approval # FI QQ3/ , 7
For multiple products use product approval form
Describe in detail the type of work to be performed: Re t''
Property Owner Information: --��
Name: 1 cue _ ) 6, Address: 9!5 2�L ,ex c
City kti-c f.. ae lt State t�`Lip 3,923r Phone 90 V ATZP 5r 3.496 2
E -Mail or Fax # (Optional)
Contractor Information: /� �
Company Name: /e2r► -' Qualifyin: ' gent:
Address:cW /O e e _S /art ' c✓t City : anci' - State 7/ Zip
Office Phone qh0 y s- Y9 Job Site/ Contacl umber IY. /. Fax # „? Y6 l ir°
State Certification/Registration # 4c c /3� evy3
Architect Name & Phone #
Engineer's 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. 1 understand that separate permits must be secured for Electrical Work, Plumbing, S Wells, Pools, Furnaces, Bo 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.
I hereby certify that I have read and examined this a plicati 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 specified on ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
%i ' i' i "''
Signature of Owner A ...0. Signature of Contractor
Print Name /x 4 T F1,, /< Print Name ah f1 a..., o
Sworn to and subscribed before me a -- /o Sworn to and subscribed before me
this .- D ay of , 20 this Day of g---a- /C7 . 20
A lig ......
otary 7 ublic k Notary Public - State of Florida I Notary Public
Adi' ) My Comm. Expires Nov 12, 2012 ► Revised 01.26.10
q'- Co:emission # DO 837063 I
« "Tar - MI NE, w —
Lioc # 20'101632W, OR 6K i 5325 rage 4 3,
NOTICE OF COMMENCEMENT Number age 08/0512010 : 'at 04:23 PM,
JIM FULLER. CLERK CIRCUIT COURT DUVAL
COUNTY
Permit No. RECORDING $10,00
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance warn ,e .uu
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property (legal description):
a) Street (job) Address:
2.General description of improvements: ,)e/'ootc
3.Owner Information C l ye /5"--
c .� `� /`,! 1 / '''L f " G , r r f rd ` `// " / rate‘ P/ Jolt
a) Name and address: 7 C °�"" C
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property
4.Contractor Information
a) Name and address: . f1 f liNe 46 c� Cl /d �/�'t l fS .4Cr +1 AP/ / b) Telephone No.: _ 3 '1 1) 4 C kfl - 0 4/ T C Fax No. (Opt) /0 tV
,95z,-Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6.Lender
a) Name and address:
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address:
b) Telephone No.: Fax No. (Opt)
Sin addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9.Expiration dote of Notice of Commencement (the expiration date is one 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 YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COUNTY OF PINELLAS • 0.
ONIIR S. ROMMO Signature of Owner or Owner's Authorized Officer/Director/Partner/Manager
Min Nat • $111b Si MON t�1 J✓
- 7 t > M 1 On Print N i e l .a fG
•IMfurr • M NiNS
•
The foregoing ' S _ day of c , , 20 / 1S, by
as (type of authority, e.g. officer, trustee,
attorney in fact) for (name of party o of whom instrument was executed).
Personally Known OR Prdduced Identification Notary Signature / 1
Type of Identification Produced Name (print) JA 41-*4"
OR
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated in it are true to the best of my' knowledge and belief.
FORMS/NOC.rvsd2010
• Signature of Natural Person Signing (in line # 10.) Above