Permit Roof 315 3rd St 2012 ri Row"
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
-)*'11' 4 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000339 Date 3/26/12
Property Address 315 3RD ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 4500
Application desc
REROOF
Owner Contractor
ROMAN ROMANO BROTHERS ROOFING, INC
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 . 9/22/12
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: -m-31 - 3,- a- 54(0 - 3zz Permit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.FFt
Valuation of Work V,00.td O Proposed Work heated /cooled A%if non - heated /cooled
Class of Work (circle one): New Addition Alterat cZ pa,i ' Move Demolition pool/spa window /door
Use of existing /proposed structure(s) (circle one): Commercial esidenti
If an existing structure, is a fir rinkle system installe I (Circle one): s No N /A
Florida Product Approval # 1 Lj4 ( b 8'U „ f
For multiple products use product approval form l oft Li
Describe in detail the type of work to be performed: A111- ''gal'' . i 5 4 t «'i
b sc s - cr -1- 9 -1 cl 6 /Pc ",(c4..0 -te r r a v Li-e47 .
Property Owner Inforlion:
Name: �� ,/ / C''r0 " ej ✓1 Address: - 3 V -71 - 3r -., / G. -.ate Oa,
City - (5 - /7 - 34 57' P(Pr State JZip 2 Z.- 3 Phone( 1/4)), 2.--Y 2 — 3753
E -Mail or Fax # (Optional) Qoy) z t.f °- Teo
Contractor Inform on: 1
�j
e
an Name: �l (2 Y - ar4Y
Company $ 40,c uali n A ent: I f / ) 0 ®"` U
p Y O ei Qualifying .--,1 g
Address: 38 LJ4 5 l' 7 - ,s (1(�,1 Cit u fG • f (4 Stat ,c1- ZiR 27Z-
Office Phone f2 e / -7.c/6 :-5b -( 7 Job Site/ Contact Number - 1'cy g 3 g: - .Ss ' Fax # J t� Z-'6 Y �!p
State CertificationRegistration # CC C 1) 2 8'8 93
Architect Name & Phone #
Engineer's Name & Phone 4
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 mill
a;i,_' .rid if , or is not commenced within six (6) months, or if construction or work is suspended or abandoned for apertod of six 6) months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical 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 1 have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether specified 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. 4
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Si
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Signature of Owner Si a ture of Contractor
t� gn /
r-� t
Print Name r' �� �. c C_p .,...�____- )
v t. i- I� . v Print Name ) Niel 1 P( v�'t —•e/ r-v�-�
Sworn to and bscribed before me Z Swor,, to and subscribed before me
this t ( D ; - f , 20 ( this Day • , <. ` 20 12—
WI O SEPH JUDE RO
JOSEPH JUDt KVMANO C ommission v Du s i Notary P is s� N otary P o .
n = C ommission # DD 832935 / . �. c My Commission Expires
. , / My Commission Expires 47, evjsPictf blA_40), 2012
,41:,,,, 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.
L Description of property (legal descriptiop of property and address if available):
`300 —3(7 '3.,r 5I(e_f t i - ti4..ifry- rkely ) 33 - --
2. General Description of improvements:
3. Owner Information: ��
a) Name and Address: y "'� �/l cj/"'�"► �4 .� l• 44. k. ` 2 3
b) Interest in property:
c) Name and address of simple titleholder (if other than owner):
4. Contractor Information: j -^ 2
a) Name and Address: 4 ✓'n C e • ,_,�, �, ,. .1 • i. v ? Sl 4 f .� � 2P
b Phone Number: " y) Z y 5-6
%urety 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:
� ; f
8. In addition to himself /herself, Owner designates 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 PART I
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, ,
SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOT iNSPECTION.�IF YOU INTEND TO OBTAIN
POSTED ON THE JOB SITE BEFORE THE FIRST
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF OMMENCEMENT. f�
Signature of Owner or Owner's Authorized Officer /Director /Partner /Manager Signatory's Printed Name & Title /Office
The foregoing instrument was acknowledged before me this 1 day of /x'1=9, �, , 20 , by
as for
(Name of Person) (Authority Type, i.e. Officer /Attornpjame of Party Instrument was Executed for)