855 Sailfish Dr (vault) CIT)( OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
iINSPECTION PHONE LINE 247-5826
Application Number . . . . . og- 0001842 Date 11/03/09
Property Address . . . . . . 855 SAILFISH DR
Application type description ROO1 PERMIT
Property Zoning . . . . . . . TO 'E UPDATED
Application valuation . . . . 5900
--------------------------------------- ------------------------------------
Application desc
re roof FL 1481 . 2 FL 1956 . 1
-- ---- -- ------ -- ------
Owner Contractor
------------------------ ------------------------
OINEILL, JAMES W. ROMANO ROOFING SERVICES
P.O.BOX 330721
P.O. BOX 33037
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 246-564 9
--------------------------------------- ------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . . RE ROOF FL 14�1 . 2 FL 1956 . 1
Permit Fee . . . . 80 . 00 i Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 5900
Expiration Date 5/02/10
--------------------------------------- ------------------------------------
Fee summary Charged ---laid Credited Due
----------------- ---------- ------ ---------- ----------
Permit Fee Total 80 . 00 1 80 . 00 . 00 . 00
Plan Check Total . 00
. 00 . 00 . 00
Grand Total 80 . 00 80 . 00 . 00 . 00
PERMIT IS XPPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
DP^, RTMeNT OF WILDWO
CITY OF ATLANTIC BEACH
-PERMIT
ATION, ------
LOCATION INFORMATION
14
utn er
12153 Address:', 855 SAILFLSH DRIVE
it ty0e:XECONICAL
31,
ATLANTIC SEAdH, FLORIDA 322
�Ass Of Wpik'-ALTERATION L - -----
ZOAL ,DESCRIPTION
str Tyoe:WOOD FRAME- 1 oak.*,
olp os ed Use:SINGLE FAM,rLy 0 Subd: R�g* 0
SabdivislonROYAL PALMS
Est vaa ue.,
0..'00
'*nprov �Cl !t
. 0 00
To t Al vle�
37.100,
1, Y t�Jf
I /I g2g,
�'Lk, (;AS FURN kCE- 'KENMORE $EE &PP
10
----------
APPLICATION FEES
QrIT
37 .()0
r: S RIVE
PLOR IDA
AP
R FOAIMA`Tl
c; AT ,
PL 3,2211
A
NGS
ALL CM CREm T BE, OEFORE POUIPONG
NO FOOTI MU.
Y010 SIX MONTH DATEOFISSUE
AFT''R'
GMATERIAL,RUSSISHANDDE9 �wflbmtm�WORK MUc TNOT BE PLACED IN PUBLIC�WE,ANOMUST BE_
'j4 By EITAlS
,g
ED UP H A TOR 0
AND ,AULED,AVIAY RAC ROA NeR
#
kk RES
HA
ocs: LIEN: LAW C
u IN,
fo THE S 0
VVILDIN IM
0 tf*$PE A%U RE.
DACCOADING TO APP IOVED
'OF MIT
�A�*BLE'P :KNI
Nd
D
C SEACH,�RU
JOI-
BUILDING AND ZONING INS ECTION DIVISION
' I
CITY OF ATLANTIC EACH
ATLANTIC 89AC". FLORIDA 2238
APPLICATION FOR MECH NICAL PERMIT CALL-IN NUMBER
IMPORTANT — Applicant to complete all Rems in sections 1, 11. 111, and IV.
LOCATION
OF lof*rIogliall streets: Between A�0�4?01q)l— ?,0,4b ,
WILDING f I i
11. IDENTIFICATION — To be completed by all applicants.
In consWoraflon of porn';, given for doing the work as described in the above flaternent we hereby agree to pirform said work in accordance
with the o"achpd plan. and Specifications which are a Port hereof and in acco,dence with the City of jacksonville or
of good practice Good th*ro;n. dinances and standards
Home of hol"thdo"I
Coellrogfw I Print) W,216CRA TID!�e 7—"c— Master A C
kamo of --i 1 0 33 CA
Isropert, ow"r t'A7it-1C-iA
sigmad%ft of Owner
or Ae*wi"4 Aloof Arghifet t or Engineer
Iii. CrOtERAL IN
A. T"W 04 lb"fixt W.-
socl, IS OTHER CONSTRUCTION BEING D";
fm—0 LO 13 Netweel C) Caa#WUHIWf THIS BUILDING ON SITC?— "M
Of if Yes, Give NUMBER Of CONSTRUCTION
PI XMIT
0 O`*W
IV. M@CKANW.AL I*UftWg TO N OWALLO K kTURE OF WORK
(140,,46 completo liet 04 conspe"Whs*a boa of this fWal Residential or 0 Commercial
No
A0 H", (3 Sp,* C3 ItemseW it C4,#,w 0 F6w U ow Building
C) Aar Cooirlionial: C3 Iteen C3 CoatoW It Existing Building
(3 Doct $rrfta: Maftvi*L� TWOIHI6� X Nplacoment of existing system
mosinsem calsochy, gJAW 0 Now installation JN*system previously installed).
C3 EJ Extension or add-on to existing system
Cn�f--i ftww.
. Capeciof 13 Other— Specify
(3 N9 sprinklers: Nv@Aw of
IM 3 FA= MR OMN US ONLy
(3 6"sAft
13 Tomiks Illet"Pis
0 LPG swis'
(3 Uefired pmswm
C3 Smilere
13 OOW — Speckly Pero"I"_-_
UNT ALL EQUIPMOM
AM CONXTIOML14G AND RUWAItATION EQUMMW
Nul"er Mom
'D I
WArNG7MACIEL BOILERS, FIXEIPLACZA
Number V*ft
Duavow Ke"Number 2SRUMOMAb- 0,j1!!LW- Afpmvft
CITY OF
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
TELEPHONE(904)247-5800
r
FAX(904)247-5805
SUNCOM 852-5800
Ocotber 3, 1997
Margaret O'Neill
855 Sailfish Drive
Atlantic Beach, F1 32233
Dear Sir:
Our records indicate that you are the owner of the foll�wing described property in the City of
Atlantic Beach:
Re: 855 Sailfish Drive
It has come to our attention that the assigned house st eet numbers are not permanently attached
to your building. This is required by Chapter 6, section 108 of the Code of Ordinances of the
City of Atlantic Beach and Jacksonville Electric Authority Rules and Regulations section 6-108.
The absence of these numbers affixed to your building and visible from the street is a determent to
your safety should you require police, fire or medical e�nergency services.
I urge you to install a minimum of four inch high nu ers in addition to any numbers presently
displayed on a mail box.
Failure to properly display the numbers can result in t+violation being brought before the code
enforcement bw- d. Under F1 . S.S. 162 you can be fiped $2 5 0.00 per day for a first violation
and $500.00 dollars per day for a repeat violation.
Sin rely,
Karl W. Gru fewl
Code Enforcement Officer
KWG/gah
cc: Public Safety Director
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH, FLORIDA 3591
PERMIT NO.-
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date-���19_18
Valuation$ 1-000 Fee$— 5 .00
This Parmnit not valid until above fee has been paid to City Treasurer, and a
subJect to revocation for violation of applicable provisions of law.
This is to certify that jaries W. C;Neill & -11an's Patios
has permission to build a garalae, driveway, and patio
Classification residential Zone—
Owned ldll I
Lot —Block——S/D
House No- 855- Sailfish Drive
According to approved plans which are part of this permit
NQTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SJIECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
0 Ill ilding material, rubbish and debris
fri�m this work must not be placed in
Public space, and must be cleared up
an I hatiled away by either contractor
or owner.
R. C-,. Vogel
Building 61hU
11 11
FOR OFFICE PERMIT
---!�!E—ONLY NUMBER DATE CONT%X&OR
#
PLUMBING 4""
ELECTRICAL
SEWER
WATER
FOR OFFICE USE ONLY
Date__/�...i;Z.....19 Zl�f
Permit #........................Fee$4�
CITY OF ATLANTIC BEACH Valuation .................
FLORIDA House ..............
............................................................................
APPLICATION FOR BUILDING PERMIT
............................................................................
-------------------- ......
Application is hereby made for theapproval of the detailed statement the plans and specifications herewith submitted for the
building or other structure described. This application is made in (ompliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Bullding ermit is automatically responsible to ascertain that all sub-
a i
contractors engaged by him are duly licensed in the City of At n ic -Beach,Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub ontractors be submitted to this office so that licenses can
be verified.
Date.....zl�i..1111........ ..............
Owner._��A, ---------*-----------------
- -----------------_--------_Address.—i ALTelephone
Architect-_ ..... Z....(.............................Address..... ......................................................Telephone No.............................
Contractor Builder_/'.�?'."e_�.....AvA -----------------------------------Address------------------------------------------------------------Telephone No-----------------I-----I---
LotNo-_------------------------------------- ----Block No-------_--- --------------Sub Divisl)n-.........---------------------------------------------------------------------Zone................
--------------------------------------------------Street-----------------.......Side Between..................------------------------
t . .......and---------------------.................................Sts.
Valuation ----------For what purpose will building be used.4-4- ---------------Type' of con'struction.---------------------------_---
Dimensions of Building............ ------Dimensions of Lot- ----------I..............Size of
Size of Piers..------__------------------_Size of Sills_-----__.......----------Greatest ill Span in ft..---_--_---_----------Type Roof......................................
How will Building be Heated? -----------------------------------------Will E uilding be on Solid or Filled Ground?.... ...................
Size of Ceiling Joists.-XX....it......------------------ Distance on Centers----wk-1.......................... Greatest Span----1_4...............................
Size of Floor Jo1sts___eA1_eA',�4Z--------------------_- Distance on Centers...... --- ----............................ Greatest Span.......................................
Size of Rafters---1'�'X --------_ ----------__---------- Dist I\ F) PROVED I q i
affNo]�,JCeA*9AJNTX. 7-AtH----_-_-------------- Greatest Span..........410------------------------------
BUILDING OFFITE This rectangle is to represent the lot.
Locate the building or buildings in the
F,L_8 2 1978 right position. Give distance in feet from
all lot-lines and existing buildings.
REAR LOT LINE
Two copies of plans and specifications shall J
be submitted with application.
Inspections required.
I. When steel is in place and ready to pour footing.
2. When steel is in place and ready to pour columns and/or lintel. Z Z
3. When steel is in place and ready to pour beam. $4
4. When framing is completed.
5. When rough plumbing is completed,-and ready to cover up.
,(_ >
6. When septic tank drain field or sewer is laid but before it is covei ed.
7. Electrical inspection by City of Jacksonville. W
8. Final inspection.
Note: In case of any rejection,re-inspection MUST be called for after
corrections are made.
FRONT OF LOT
In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said
work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building
regulations of the City f Atlantic Beach.
!, I � '-
Signature of Buildgr
...................................... Ad�tress--- ------------------- 0-
..............................4�-------I----------
................ Ad�ress...................................................................................................
Signature of OwrW-/_ 1,_ -------
QIX
low
CITY OF
office of Building Official
REQUEST FOR INSPECTION
2 Ic)
Permit No.
Date
Time
Received
Locality
Job Address
Cnntr ctor
Name ICAL PLUMBING MECHANICAL
BUILDING CONCRETE _ELECTR_ � F Rough 1-] Air Cond. & 171
Rotp V�1�109-' L
Framing Footing Top Out L-j Heating
Re Roofing Slab E Temp Pole Fire Place Lj
Li FZ1 Sewer
InFulation i Pre Fab
Y� F O$:R?'6I NOS 6PIE:icff�!I0,N A.M
Friday--RM.
Mon. Tues. K--VJ.d J114111 Thurs.
A.M.
jr,,;pe,-tior. Madc
Final Inspecti0f,711-1pancyL
-pecticf ficatp of
Certi
Date
DATE i
PRE-SERVICE DIVISION
JACKSONVILLE ELECTRIC AUTHORITY
233 WEST DUVAL STREET
JACKSONVILLE, FLORIDA 32202
THE FOLLOWING FINAL INSPECTION(SI HA ?E BEEN MADE AND ARE
SATISFACTORY:
----------------------
--------------------------------------------------
--------------------------------------------------
--------------------------------------------------
------------------------------ -------------------
Enclosed are the blue copieg of the permits,
SINCERELY
I I NCEZRELZ
A ILDING INSPECTION DIVISION
cc:FILE
CITY OF ATLANTIC BEACH ' FLORIDA
Appr APPLICATION FOR ELECTRICAL PERMIT
E=
TO THE CHIEF ELECTRICAL INSPECTOR: DATE:—_4LLl__19
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOIN( THE WORK AS DESCRIBED IN THE FOLLOW.ING, WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDAP CE WITH T14E ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN'ACCORDANCE WITI- THE ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
o'
It,L_ S&Z 1);ce s 14�4'Ml c_ Xvel V /
XA
ELECTRICAL FIRM: MASTER LECTRICIANSISNATURF
TE --MUBNaMAN
ESS. C5�)
NAME
A RESS:155 DVIUL RFD—BOX
BLDG.SIZE I I
—BETWEEN:
RES.(y) APT.( COMM- PUBLIC It DUS.'(' NEW OLD REW.
ADDITION ( TRAILER ( TEMP. ( SIGNS SO. FT.
SERVICE: NEW INCREASE ( REP�IR FEE
CONDUCTOR SIZE AMPS COPPER f AL
SWITCH OR BREAKER _Lm—ps PH W VOLT nACEWAY
EXIST.SERV.SIZE AMPS
.___L_PH 3 wAfOLT RACEWAY
FEEDERS NO. SIZE LNO. SIZE j,.,NO. SIZE
LIGHTING OUTLETS 0
CONCEAL�ED PEN TOTAL
RECEPTACLES CONCEALED OPEN
0-30 AMP9. 00 TOTAL
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0-100 AMP9. ovcn
APPLIANCES 13ELL TRANSF.
AIR !H.P.RATING !H.P. RATIN—G
0 MOTO
CONDITIONING COMP.MOTOR OTiHER M70TORS A EMP S CEIL HEAT: KW-HEAT
0-1 OVER
MOTORS H.P VOLTAGE PHS NO. I II.P. VOLTAGE PHS
HAGcE-
MISCELLANEOUS
QAQ-- _Y_
_4k-' Q_
TRANSFLORMERS. UNDER 600 V.
�i- I I I I_. OVER soo V_
RESOLVED '6�
DATE : 05''17/89 INQUIRY C-RESPOND
TIME : 06:30 AM ATLANTIC BEACH
SCR : CR-INI Action Center
........... ......... ........... ...........-------
DATE ACTION BY COMPLAINT : 01 OOOOOGG
04/26/69 RENE ANGERS COMPLETED
SENT LETTER TO OWNER, TO TAKE IMMEDIATE
CORR--CTIVE ACTION.
04/27/89 MADE ASSIGNMENT
05/05/89 RENE ANGERS COMP-ETED
REALE-STATE MANAGEMENT COMPANY CALLED;
ONE RLDERLY MAN AND ONE YOUNG MAN LIVE
THER , NO ROOMING HOUSE (MR. HAYES) ;
MA.A ER VERIFIED BY GOING TO HOUSE.
05/17/89 RENE ANGERS COMP ETED
DETERMINED WRONG ADDRESS WAS GIVEN BY
RUTH GREGG. ASKED R. G. FOR CORRECT
ADDR -�SS. NO FURTHER ACTION UNLESS
RECEIVE FURTHER COMPLAINT OR CORRECT
ADDRrSS.
Esc TO RETURN TO PREVIOUS
CITY OF
iqmwdic
Office. of Suillding Official
MEQUEST FOR INSPECTION
Date Permit No.
T rhe A I
RleceiVed m
Job Addres,�
Owner's
Name Contractor ,17
BUILDING CONCRETE ELECTRICAL �PLLUIVIBING MECHANICAL
I
Framing Footino Rough Wir j h Ai, Cond. &
Re Roofing
Slab Tarnp PoIr- Top Udf Heating
Insulation Lintel Final Sewer Fire Place
Pro Fab
READY FOR INISPECTION
Mon. Tues. 'Werl. Thurs. Friday
Inspection M
C',r!11ft,:,)!,, 0"'Upan-,",
PS�-3$1 4
08
DEPARTM04T,OF 61)ILD048
'CITY OF ATLANTIC i 3EACH
PERMil T lNFORMATIPN LOCATION INFORMATION
'�*it Number*
Addr ?ss : 855 SAILPISH DRIVE
FL
*tmi t T y p e,. PLUMSING ATLAXTIC,,ZtACH� ORIDA 2 3
f of Work: ALTZ ATION LEGAL DESCRIPTION
Cows t r . T y 0 e,: WOO-DIFRAME 40t : Stock, 1
0
Proposed 'Tise, ISING�E FAWLY Town,344: RNG.' I
i rigs Co0e: 0, 5ubd vision., ROYAL PALMS
E
mtrov, C $0 00,
Totat-
Amount"
D � 94
-De
T ON
VIM
P
ex%4, 2 5 0 0
ggy
DRIVE T T
RE
C A, 4�A
PLORI DX`l,,,"`Zll
Ao. 7,
WATER XltTER/TAP $0 ,00
RADON GAS-H R. S. $0.00
C RA OMAT"I 1 0- 4- 1 MDO� CAB 5%
'A
1�_Aam� utall-W-1c"16,. MPROVE. $0 _00
n
"'ess- P� 0
SEWER TAl , $0 -00
;0 E, FL 3,:2245
CROSS C6NINECTION OQ
L L e,.
J "Type , SEC H ' ItAPACT FEE
'Ai
ScilA 11CH,
Na ms:
NOTICE Cq�CRE '
ALL TEFORIVISANDFOOTINGSIUILSTSE4 SPIECTED BEFORE 00URING_
PERMIT VOID SIX MONTHS AFT-R DATE OF ISSUE
Lbl-N 'R ED IN PUBLIC SPACE,AND MUST BE
�3 MATE IAL,RUBBI�H AND DESAIS FROM THIS WORK MI JST NOT JBE'PLAC
D UP AND HAULED AWAY BY EITHER CONTRACTOR OR O�VNER
T LAW CA
0 COMPLY WITH THE MECH NICS' LIEN N RESU IN
Eff,
tJ4t ,PR0PtRTY d`WNERPAYMG TWICE,, R SUILDINIG IMPACIVEMEN
THIS PERMIT AND SUBJECT TO ReVOCATI
A
DAPCORDING EED PLANS'WHICH ARE PA
TO,AP�ROVE FIT 0
FOR
NOFAPPLICABLE IROVISIONS.'OF LAW.
w 14
C =-PARTmENT, omm 0*00000
AT i4TIC BEA H BY ILDING D % 01 R*:
tet 10/13/
om
CITY OF ATLANTIC BEACH
APPLICATION FOR PLUMBING PERMIT
JOB LOCATION:
OWNER OF PROPERTY:
--------------- ----------------------
BUILDING CONTRACTOR:
PLUMBING CONTRACTOR
AND ADDRESSt
Y-�-------------------
TELEPHONE NUMBER: 7
--------------- ------ ---------------
STATE LICENSE NO: ft
TYPE OF BUILDING: 7-"ve
-------------
------------SINXS ------------SHOWERS
------------LAVATORY --------------WATER HEATERS
------------BATH TUBS DISHWASHERS
--------------
------------URINALS --------------DISPOSALS
------------CLOSETS --------------WASHING MACHINE
------------FLOOR DRAINS ------------SHOWER PANS
OTHER
TOTAL FIXTURE COUNT:.......... x $3. tO + $15. 00 = $
----------------:--------------------- ---------------------------
INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH
THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE.
CALL A DAY AHEAD TO SCHEDULE INSPECTIONS (904) 247-5826
NOTICE OF COMMENCEMENT
(PREPARE IN DUPOCATE)
Permit No. Tax Folk No.
State Of County c I
To whom It may concern:
The undersigned he"Informs you thert Improvement;will be made to certain real property,and In
accordance with Section 713 of the Florida Statute%the IbI owing IftformatiOn Is stated In this NOTICE OF
COMMENCEIRENT.
Legal description of property being lmprmovedd: 4
Address of property being Improved: 3 3
General description of improvements:
Owner' C)*,\el
Add;;� 7 ArAp,
owner's interest in site of the improvement
Fee Simple Titleholder(d other than owner)
Name
Address A 4.n14
Contractor 0'04-4,ez - --
Address
Phone No. (PY) -LW-S6 - Fax No._jj�
surety(if any) 0#WV
4
'0,
Address Amount of bond
Phone No. Fa�No. k4 4fto*
Nam and address of any person maldng a loan for the Wnst�cfion of the Improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florkla,other than himself designated by owner upon whom notims or other
documents may be served:
Name
Address
Phone No. Fa c No.
In addition to himself,owner designates the following person o receive a copy of the Lienor's Notice as provided In
Section 713.06(2)(b),Florida Statutes.(FBI In at Owner's opi!on).
Name
Address
Phone No. Fax ND.
Expiration date of Notice of Commencement(the expiration c ate is 0 year from the date of recording unless a
diflixerit date Is specified):
THIS SPACE FOR RECORDEWS USE ONLY OWNER GTE
W A,,,44&-A"o, &X94Z
t ds----Lday Of in
Of State of F has pem-fty appeared
rein by
Doc#2OW265183,OR BK j5d��- Page i 760, hknusWaW thwe d AM -L.��, , ————
Number Pages:1 am true anc a NQwrV Publid Stele of"a
Recorded 111012009 at 12:04 PM, Jo8*0h Jude 1111"Wrio
JIM FULLER CLERK CIRCUIT COURT DUVAL MY COmmitelon OD81,12936
COUNTY Expim IMirpol
RECORDING$10.00 Of co
My 00 or
Pemwnaffy
Produummed I 011cm3tion E77
j1P
09-
CITY OF ATLANTIC BEACH
Date: ROOFING PERMIT APPLICATION
Job Address: sqd_r,�4
Owner of Property: Im CI-q ;�-e-f- okle;
Address: t4?l t Telephone: 14-72—
Roof Contractor: koe,4.'k 0 state License Number:
Contractor's Address: 12
Telephone: -L-q6 eL(,g —Fax: Email: -7—;' 6 t"
Scope of Work: Ale ,-,9&4- Roofing Material_ /t-0(54L,,,R
FIL Product Approval#- r , If�b, Val4tion of Work: $
Required Inspections: Sheathing/in Progress-Dry In /Final
if re-roof: Assessed Value of Structure: $300,000/___�>$300,000; Roof-to-wall improvements required?
(Applies to single family structures only)
'WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY 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 INTEYD TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
SIGNATURE OF OWNER: Date: //- 3,-6-cl
AS TO OWNER: "At;%;I otary p('61iC 0(ate of Florida
Sworn to and subscribed before me this day of Z� 0$60h Me Romano
Y COMMISGOOM D0832935
State of Florida,County of Duval Notary's Signature: X orn Expires 10/21/2012
Perso'11i,nown
Pro c i c entification
ype(of identification produced
SIGNATURE OF CONTRACTOR: Date:
AS TO CO NTRACTO R:
Sworn to and subscribed before me this day of X _40N�! No ry Pu, -IzWe Flwida
JosephMeh,d;
My I
Fyp*r&A IMI12012
State of Florida,County of Duval Notary's Signature: Comminion D0832935
0 Perso ly I nown
V(
ProPted ic entification
Ty#of ide tification produced
800 Seminole Road-Atlantic Beach Florida 32233-5445
Telephone: (904)247-5800-Fa :(904)247-5845 F:\roof permit applicaton.docx 7/28/09