Permit Roof 358 11th Street 2012 b J��
CITY OF ATLANTIC BEACH
Is1
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001349 Date 9/17/12
Property Address . . . . . . 358 11TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9000
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Application desc
REROOF
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Owner Contractor
------------------------ ------------------------
HAMILTON ROBERT C & ETHEL ROMANO BROTHERS ROOFING, INC
358 11TH STREET 2410 CYPRESS LANDING DR
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 246-5649
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 9000
Expiration Date . . 3/16/13
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95 . 00 95 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 99 . 00 99 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE. WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERNUT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: 5-p tI 7% S1- Permit Number: J
Legal Description 35-00 1/ ' s Parcel#
loor Area of Sq.lt. - Sq.Ft
Valuation of Work S17000 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures) (circle one): Commercial
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No
Florida Product Approval# S6 • '
For multiple products use product approval form
Describe in detail the type of work to be performed:
Property Owner Information:
'Name: P-0 Address: �,�� �� � �' ��c �e.4,
City 44 StateZip 222Phone
E-Mail or Fax#(Optional)
Contractor Information:
-ompany Name: e ro Avg-A Qualifying Aggnt: 104V%4) s-'?op c>
address: ?,0 laa, 33 C5 33 7 City X( b4� State Zip
Mice Phone 900 y 410--OV-7C Job Site/Contact Number gacj Glia m y2e Fax#
State Certification/Registration# c.CC. /32 M:5-
architect Name&Phone#
Engineer's Name&Phone#
ee Simple Title Holder Name and Address
3onding Company Name and Address
vlortgage Lender Name and Address
fpp"ca tion is hereby made to obtain ape m
'Y to do'heyand installations as indicated. I certify that no work or installation has commenced prior to the
ssuance?workpermtandthaatl workwallbe performed to meet the standardsofall larggconsruconnthisjurisdiction. This permit becomes null
and void isnotcommencd within six(6)months, or if construction or work is susppended or abandoned for a_penodofsix16)months at anytime after
varkiscmmenced I understand that separate permits must be secured for Electrical World Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
hanks 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.
hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
vpe o work will be complied with whether speci ed herein or not. T7xe granting of a permit does not presume to gave horny to violate or cancel the
rovisions ofany otherfederal,state, or local law 'e Mating construction r the performance ofconstruction.
,,
signature of Own r - Signature of Contractor
'rint Name . /e%4 � Print Ne
..... ......... m �t - i
worn and subscri ed efore me Swo and subscribed before e
pis Day ofg t ay of �
20�Y° '•; DANIEL S.ROMANO
Totary Public N,` �=My Comm.Expires Nov 12,2012 No
�'`,� DEBORAHNNwIANDAWN�
/l J"' MY COMMISSION#EE 057349
7 EXPIRES:Ma'Nbvic�?� Rrwe� sed 01.26.10
Rf
Bonded Thru NotauY
NOTICE OF COMMENCEMENT
State of '' G r+ � Tax Folio No.
9 H
County of Y�
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved:
Address of property being improved:
General description of improvements: C`
Owner:
�. ��'+c f Address: f 1/ � �� /'�� s
`�'"
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor:
Address: t
ti tCi, .
Telephone No.: ��� Fax No:
Surety(if any)
Amount of Bond$
Address:
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Date..
_
Doc#2012200809,OR SK 16072 Page 429, Before me this day of in the County of Duval,State
Number Pages: 1 Of Florida,has personally appeared
Recorded 09117 2012 at 0227 PM, p
JIM FULLER CLERK CIRCUIT COURT DUVRL ; Co of Duval.
Notary Public at Large,State of F
COUNTY My commission expires:
or
RECORDING$10.00 Personally
w
Produced Id ti�� ,
5 Notary Public•State of Florida
My Comm.Expires Nov 12,2012
'•:, ��1�� '�� Commission#DD 837063
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