Permit Roof 524 Viking Ln 2011 A 0 t 1 � a
�� z ss
C ITY OF ATLANTIC 1-4 on
C BEACH
J r , 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
' ' ' ' ' '1, 0111 1 : )I14
INSPECTION PHONE LINE 247 - 5814
Application Number
Property Address 52 VIKINGS Date 8/01/11
524 VIKINGS LN
Application type description ROOF PERMIT
Property Zoning
Application valuation . TO BE UPDATED
• 6000
Application desc
REROOF
Owner
Contractor
524 VIKINGS AGNES ROMANO BROTHERS ROOFING, INC
524 VIKINGS LANE
P.O. BOX 33037
ATLANTIC BEACH
FL 32233 ATLANTIC BEACH
(904) 246 -5649 FL 32233
Permit ROOF PERMIT
Additional desc .
Permit Fee 80.00
Issue Date . • Plan Check Fee .00
Valuation . . . . 6000
Expiration Date
• 1/28/12
Other Fees STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2.00
2.00
Fee summary Charged Paid
Credited Due
Permit Fee Total 80.00
Plan Check Total 80.00 .00 .00
Other Fee Total �00 .00 .00
4.00 4.00 .00
Grand Total 84.00 .00 .00
84.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
y
t
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: Si ' Vi /(, 11 1 LI/
Permit Number:
Legal Description .5 V'/ k. A4
O. A rea o r q. t Parcel #
Valuation of Work $ d�0 Proposed Work heated /cooled - heated /cooled
t
non
Class of Work (circle one): New Addition Alterat io n j
Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial Residents
If an existing structure, is a fire sprinkler system installed? (Circle one): No /
Florida Product Approval # 3 ,
For multiple products use pro uct approva orm
Describe in detail the type of work to be performed: 11401 OVs. C ( 44 (Gt. iii Q -4 .
y t, rirt.. /1 — " , '#) , 7/d/ �« 7`�� �.
Property Owner Information:
Name: A h" < 1 " -r- V-1-1 , / 1
City ,DA- � ei. AN i... (� ,�� i �L. State �Zi Address: s Z� V � �v �+; � 1,x,4
E -Mail or Fax # (Optional) P 322 3 Phone q OH - 2 H (_ L 1 -
Contractor Information: / �/0 _ In
Company N me: J 'G.Mre . (J! t�'
Address:_ me. . C' - 0 i s : Qualifying gent: , ,. - _, // 4 d �.-
Ci
Office Phone i « — �' State L Zip .1 .;.)...V.)
Site/ Contact Number .... Fax #
State Certifica ion/Registration #
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address !_ - . J �"
Bonding Company Name and Address L ° t c.t n ti , .4. 0 '
Mortgage Lender Name and Address
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 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 aperiod of six (6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, 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 hereb certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions o • : nd ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume - : rve aut 'ray to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner .� i ,
-:
�" °`� �� Signature of Contra tor
Print Name > ,.* • �.�
�►� � � . .: '` � � Print Name A> �d^" H
Sworn to nd subscribed before me= * i �'� _
this`�D;��Jof Sworn o and :..scri d • .efore
offArespur,� �, = this , /Y�'s, IA_ 20 ii
Notary ublic y • .. ..• , 4, ..44
- "/// /C STASE��`� No :h ,,. kWli�s Februa 14, 20
t I N/1fIl (Np\ \ \ �
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f ' Rf � ` Banu Tlrru otary Po, fa Undenvrif ..
I • ,
ised 01.26.10
Permit No. NOTICE OF COMMENCEMENT
State of Florida, County of Duval Tax Folio No.
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:
S 2 , tom' LeNIAc. A414.4 )
N
2. General Description of improvements: p ' �` �' Z2 3
w ab 0 c.
3. Owner Information:
\\ aa) Name and Address: A r VI S L� V V
b) Interest in property: s1 ' L
\ c) Name and address of simple titleholder (if other than owner):
4. Contractor Information: , .,. -:' itv"• -/ .6./r4V0 a) Name and Address: ,,,/ r', '°,, f,,; , ,,P� �'�•c.�
b) Phone Number: ...u= /0. c s; .e5Ls .1a,
5. Surety Information:
a) Name and Address:
b) Phone Number:
c) Amount of Bond: $
6. Lender Information:
a) Name and Address:
b) Phone Number:
7. Person within the State of Florida designated by owner upon whom notices
provided by 713.13 (1)(a) 7, Florida Statutes: or other documents may be served as
a) Name and Address:
b) Phone Numbers of Designated Person:
8. In addition to himself /herself, Owner designates
a copy of the Lienor's Notice as provided in Section 713.13 (1) b Florida Statutes.
a) Name and Address: to receive
() (),
b) Phone Number of person or entity designated by owner:
9 Expiration date of Notice of Commencement (The expiration date is one (1) year from the date is specified: he date of Recording unless a
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT PAYING TWICE FOR
E EXPIRATION OF THE
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT IN YOUR R CHAPTER 713, PART
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN CONSULT WITH YOUR LENDER OR AN ATTORNEY CEMENT MUST BE RECORDED D AND
YOUR NOTICE OF COMMENCEMENT. NEY BEFORE COMMENCING WORK OR RECORD NG
The foregoing instrument was acknowledged before me this a y of _ (�
����tu1ullUNq� ` / ,� f
S 5. zo 49 �a N • T ARY PUBLIC,
_ TAT OF FLORIDA
S • s
. * = Print Name: (_____L___ '1,//1-Add d ! y
p ; MD 865772 : v
9'•. r �„wa,a+� r :4i1 Personally Known
ii p�c
Identification/Type: e:
S111us Illte
Verification pursuant to Jecilon 92.525, Florida Statutes. Under penalties of er' I declare and that the facts stated in it are true to the best of my knowledge and be ief. Clare that I have read the
r '
Doc # 2ui 1 166288, OR Br. 15616 Page 2200,
Number Pages t .
Recorded 08 01 2011 at 08 12 AM, Signature of Properly Owner
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY ' 1
RECORDING $10 00
Revised 10/1/2009