Permit Roof 139 & 143 Magnolia St 2012 CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001727 , Date 11/20/12
Property Address . . . . . . 143 MAGNOLIA ST
Tenant nbr, name . . . . . . 139 AND 143
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4000
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Application desc
reroof
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Owner Contractor
------------------------ ---- -------------------
DUTTER WILLIAM M. & ELSIE ROMANO BROTHERS ROOFING, INC
1742 OCEAN GROVE DRIVE 601 OLEANDER COURT
ATLANTIC BEACH FL 322335845 NEPTUNE BEACH FL 32266
(904) 246-5649
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Permit . . . . . . ROOF PERMIT
Additional desc
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4000
Expiration Date . . 5/19/13
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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 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 74 . 00 74 . 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: , Permit Number:
Legal Description 6 0 6 0 a Parcel#
Floor Area of SG.Ft. Sq.Ft
Valuation of Work S _Proposed Work heated/cooled K non-heated/cooled
Class of Work(circle one): New AdditionIteration Repair Moved Demolition pool/spa window/door
Use of existing/proosed structure(s)(circle one):. Commercial sid al
If an existing struc ure,is a fire sprinkler system installed? (Circle one): YYes No /A
Florida Product Approval# alt�l_ &A JC 3 d r:1 r�4•t✓�z.
For multiple products use product Ef-pproval form
Describe in detail the type of work to be performed: YP rn ay a. 0/", :5/� r te- -,4_2&Z
ll 17
n /
Property Owner Information:
Name: %g Ufa tti Address: 2 4:e,-Z 1 ,ie-
City— "-r- A.Z 6,r, 0,2", Statefi—Zip Phonetr4,o(41% .2,!!��
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: c+ `;E� t ✓ Qualifying Agent: AMA-gyp
Address: 7 -city abc State Zip ?2 :p S3
Office Pho a 400 416-05176 Job Site/Contact Number Fax#
State Certification/Registration# 24-C /3a Fj9V I
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 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 null
and void if work is not commenced within six(6)months, or if construction or work is suspended or Abandoned for a_penod of six16)months at any time after
work is commenced. I understand that separate permits must be secured for Electrics Work, Plumbing,Signs, ells,Pools, FFurnaces,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 hereb 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 work wall be complied with whether speci sed herein or not. The granting of a permit does not presume to gave authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner .' Signature of Contractor
Print NamePrint Name
..~�. .t...e............. ... ..�9.��,��/... .......................................... ............................................................................................................
Before me
this y of it/o J 20 / ., ��... 1 20
M1 .�iJJ� ii4 957760
DANIEL S.ROMANO
ff-Rl
„• �:, E' e rUan/ 2014
to ublicF= Notary Public•State of Florida -
. My Comm.Expires Nov 12,2012Revised 10.24.12
� �” � Commission#00 837063
NOTICE OF COMMENCEMENT
State of County of 1 )u Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain realroperty, 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: / o�!'d /Yy,��T�� �
10A
Owner: / 'j }-! Address:
Owner's interest in site of the improvement: r-
Fee Simple Titleholder(if other than owner):
Name:
Contractor: t �. Li bre
Address:
Telephone No.: 24K �; _T Fax No:
Surety(if any)
Address: Amount of Bond$
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
Signed: Date:
Before me this day of in the County of Duval,State
Of Florida,has personally a
Personally Known: _ or
Produced Identitic n:
'votary Public:
Doc#2012263912, OR BK 16153 Page 870, Ay commissio
Number Pages:1
Recorded 11!20i2012 at 02:28 PM, trAY°�e'o 'DANIEL S.ROMANO
ro
-State of Florida
JIM FULLER CLERK CIRCUIT COURT DUVAL Nota}y Public
COUNTYi My Comm.Expires Nov 12,2012
RECORDING$10.00 Commission#DD 837063