Permit Roof 1739 Live Oak Ln 2011 C.)'' CITY OF ATLANTIC BEACH
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800 SEMINOL ROAD
' ' ATLANTIC BEACH, FL 32
" INSPECTION PHONE LINE 24 7 -
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Application Number 11- 00002555 Date 8/29/11
Property Address 1739 LIVE OAK LN
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 4500
Application desc
replace peel and stick and sublayer
Owner Contractor
PARKER, DAVID F. ROMANO BROTHERS ROOFING, INC
1739 LIVE OAK LANE 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 . . . . 4500
Expiration Date . 2/25/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 79.00 79.00 .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: /7 — 3 / 7 L' i v 0 7 1-( L`1 v\ t' f111, 3 Permit Number:
Legal Description 1 ? t (k 0 V-r(4 (40 fL.-- Parcel #
Floor Area o Sq.Ft. Sq.Ft
Valuation of Work $ 1 8 - 6 U Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alterat 16pair Move Demolition pool/spa 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
Florida Product Approval # 4 13 8 .C7
For multiple products use product approval form
Describe in detail the type of work to be performed: ( 0 6 cc ,.cc,/6f, 7Cc-- p k / —L) vc f— SP( -tic) .-
Property Owner Information:
Name: dtz l yvl ( 4; Ad dress: i �1 �( v-N f
City 1, ,:, , I i ■ 1 ( State i - t. 2.;? Phone (7 `i f 2 i c'78"/
E -Mail or ax # (optional)
Contractor Inform 'on:
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Company Name: 70 0 fL- r ('i_5 ge)(7K - Quali ing Agent: P % C
Address: 2 s 5/O- -/---' City y e% , /" (c- 0 C l.i State - Zip"Y"Z -2-3
Office Phone polo-um-56 ,,Job Site/ Co tact.,Number f` a CY 3k Sax # 'Z C/6 '�- ye / ‘'
State Certification/ Registration # C' L — 13 Z ,
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 certibi that no work tr 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, Boilers, 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.
1 hereby certify that I have read and examined this a plication 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 herein or not. The granting of a permit does not presume to give ' thorny to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction. ✓
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Signature of Owner E ii _. _, ' _ Signature of Contractor it
D e , ' �.OI,C �,� 11 ,- \ � 1 �C� f -- Print Name D % � ` D Print Name e.. v
Sworn t and subscr'bed before me Sly. t. and s. ed bef r me
this 2.-7 Day f / J t l J5- - , 20 this ': Da, of /1 ;� 0
t- o • "`i '% JOSEPH JUDE ROMANO
" " "" JUDE ROMANO "'
Notary Pu i .►�" �` •� Notary P
f_' � Commission # DD 83293 • � `
My C Expires
� My Commission Expires 3i' it' . Oot- et 21 , ,
„r October 21, 2012
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
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 availabl ):
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2. General Description of improvements:
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3. Owner Information: /
a) Name and Address: /!r'lG, -`7' l Y4 / i 4C C -- / % G f 1 -- -- c ,G,/ ,., f' r'r' /. '3 �%
b) Interest in property:
c) Name and address of simple titleholder (if other than owner):
ok 4. Contractor Information: r.- f �*` ___ fC }---
a) Name and Address: t� -,t +, �`r� !' ('` d L�, ' ;i 'tc�. —_,� r i ,} ` r
b) Phone Number: (2c" �` S S 9 7
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 or other documents may be served as
provided by 713.13 (1)(a) 7, Florida Statutes:
a) Name and Address:
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:
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 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.
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Signature of Or or Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Name & Title /Office
The foregoing instrument was acknowledged before me this c , Y day of At-- V'- -r , 20 (/ , by
� D .vim, ki.. L} as 64 '( C - ----
for -' ,--- I r �� C
(Name of Person) (Authority Type, i.e. Officer /Attorney) 7 ame of Party Instrument was Executed for)
, --'2,
47:44 JOSEPH JE ROMANO NOT ARY P . ":LIE STATE OF FLO
Co mmission N DD 832935 -- ' , ' „/ •4^ g ►`/1Y C Expires p N ;r ( c. j `"1 3i_ ,f ( , ; ,__
�. October 21, 2012
-f Personally Known (
0r Identification/Type:
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Verification pursuant to Section 92.525, Florida Statutes. Under penalties of e
forecyninn ,,.,a 4-�...� � p perjury, I declare that I have read the
best of m knowledge and belief.
00C 4 201'i'16826 CJR BK 15697 Page 1140
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Number Pages: 1
Recorded 08,29 201 at 11 '02 AM
J PULL CLERK CIRCUIT COURT DUVAL
COUNTY Signature of Natural Person Signing Above
RECORDING $10 00
Revised 1 Oil 1')nn4