Permit Roof 1509 Mayport 2100 AL GI
` y CITY OF ATLANTIC BEACH
s -) 800 SEMINOLE ROAD
tit ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
51731:
Application Number 11- 00001742 Date 3/03/11
Property Address 1509 MAYPORT RD
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 2300
Application desc
REROOF
Owner Contractor
ALL BEACHES CHILDCARE ROMANO BROTHERS ROOFING, INC
1509 MAYPORT ROAD P.O. BOX 33037
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 246 -5649
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 65.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 2300
Expiration Date . 8/30/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 65.00 65.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 69.00 69.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERNIIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: /Soq / (1-Ar--q -- Pc Permit Number:
Legal Description / CO 4 v>4 ay pgc-i Parcel #
Valuation of Work $ o9 3 / Floor Area of Sq.Ft. Sq.rt
Proposed Work heated /cooled 7°9 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): o u II
If an existing structure, is a fire s rinkler ) inst. Residential
p system mst. i e.. (Circle one): Yes No C-
Florida Product Approval # _5-6 $o . /
For multiple products use product approval form
Describe in detail the type of work to be performed: P/./ rob P On t
Property Owner Information:
[lame: 0 f 1(-(t t 3 c h.S o.t Address: f �� 9 o�� t City / /wr ,lfc /_fc A State, Zip 3 et 33 Phone °/
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: 20772Q/2 A, Ar /J' .,-;1 Qualifying Agent: at ►+n Ro,-. •4-0 4ddress: ay /o C r r SS 4n State pf Zip n/�" Cit I. bc4 �
Jffice Phone lba ' LI - 5 r. 9 ob Site / Cont t Number Fax # p ? ���
State Certification/Registration # c Cr ' $r :
rrchitect Name & Phone #
Engineer's Name & Phone #
: ee Simple Title Holder Name and Address
3onding Company Name and Address
Mortgage Lender Name and Address
1pplication is hereby made to obtain a permit to do the work and installations as indicated. I certa, fy that no work or installation has commenced prior to the
ssuance 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
end 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
vork is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo Heaters,
ranks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMLVIENCEMENT 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.
hereby certify that I have read and examined this a placation and know the same to be true and correct. All provisions of laws and ordinances governing this
vpe of work will be complied with whether specified herein or not. The granting of a permit does not presume to gave authority to violate or cancel the
rovisions of any other federal, state, or local law regulating construction or the performance of construction.
C „; c. 37-5U ol 34(o.77.5a
signature of Owner *___. 4 Signature of Contractor
f /
'rint Name oke i'l ! ck .I AG _ el Print Name A tol n ar a
worn to and subscribed before me
— aq / Sworn to and subscribed before me
ii Day of 1 this Day of , 20
1 0.1.4,-,,,,,, DANIEL 8. AOMANO
IF .Llt. st
lotary Public i' il AlsOomm. Wino Nor 12, 2012 Notary Public
%,.0 , -, Commission di 00 $1117063
_ _ Revised 01.26.10