Permit Roof 332 Seminole Rd 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001527 Date 10/17/12
Property Address . . . . . . 332 SEMINOLE RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6500
--------------------------------------------------------------
Application desc
reroof
-------------------------------------------------------------------
Owner Contractor
------------------------
------------------------
ANTICO, DAVID W TRUST ROMANO BROTHERS ROOFING, INC
1465 HOPKINS CREEK LN 2410 CYPRESS LANDING DR
NEPTUNE BEACH FL 32266 ATLANTIC BEACH FL 32233
(904) 246-5649
-----------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 85 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6500
Expiration Date . . 4/15/13
------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
---------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 85 . 00 85 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 89 . 00 89 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
g CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: ? Sc o'j".4k )001 Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work S 6S00 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/propposed structure(s)(circle one): Commercial Residential
If an existing struc{ure,is a fire sprinkler system installed? (Circle one). o
Florida Product Approval# /9. •3
For multiple products use product approval form-
Describe in detail the type of work to be performed: leer-M&C--
Property Owner Information:
Name: lxv iA a_rJ'`C-a Address: ?
City ??^ Stat _Zip '32233 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: 8--4o Qualifying Agent: ,Pru+d�-� lZ •�
Address: z.a 16o>r o 3 3 2 kI City _T2213! __ State Zip
Office Phone Job Site/Contact Number Fax#
State Certification/Registration# CCI_ 132 U93
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. I certify that no work or installation has commenced prior to the
issuance of a permit ar�d 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 a period of six(6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, Furnaces, 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.
I hereb certify that 1 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 sppec'led her n or not. The granting of a permit does not presume to gt authority to violate or cancel the
provisions of any other feder or local la regul ng c nstruction or the performance of construction.
Signature of Own Signature of Contra r
Print Name / '� Print Name "VW
-, .N.l.. ........................ ........................................................................
.... .I... ........ ... T . .. ....................... ...... �.
Sworn to and subscribe before me worn to subscribed efore m
this�Day of 242 this D of/," 20 2._
r
Notary Publi
r
DANIEL S.ROMANO �l Pi1 v cQ tAtss P4 ri DC 90
o r;% Fh i a+r 14 2014
Notary Public-State of Florida lnn,
lr,,V,,,t $ Revised 01.26.10
My Comm.Expires Nov 12,2012
Commission#DD 837063
NOTICE OF COMMENCEMENT
�-J
State of �/D��I Tax Folio No.
County of
To Whom It May Concem:
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 NQTI OF COMNMNCEMENT.
Legal Description of property being improved: ,-
Address of property being improved: -�r'1,vj,A0lr-- r�"
General description of improvements: C�t ,
Owner: n[.u�-e � �`
r C .b Address:
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: a✓ gr.o
Address: X � / d
: