Permit Roof 1751 Sea Oats Dr 2013 J
,�3 " S CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00001917 Date 1/02/13
Property Address . . . . . . 1751 SEA OATS DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9000
----------------------------------------------------------------------------
Application desc
reroof
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
GROSS, JASON D ROMANO BROTHERS ROOFING, INC
1751 SEA OATS DR 601 OLEANDER COURT
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 246-5649
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 9000
Expiration Date . . 7/01/13
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
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.
NOTICE OF COMMENCEMENT
State of Por.A(. Tax Folio No.
County of P44 v&
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: /41 A v
Address of property being improved: 12S-1 p '40 lie- A.E'cJ+ gj-�233
General description of improvements: kv-o C-47
Owner: jos n•-) c1r' ,5=- Address:----17 / See__ 0(-)-S dr Al -/ ICA Irl
Owner's interest in site of the improvement: �3�'
Fee Simple Titleholder(if other than owner):
Name:
Contractor: t
Address: k4
41 -�
TelephoneNo.: q0,1 (�/0 --o y 7 c- 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: / Datery
I.Z-IPS
efore me t z s day of in the Bounty of Duval,State
Doc#2013000733,OR BK 10201 Page 1540, f Florida,has personally appeared
Number Pages: 1 otary Public at Large,Sta
Recorded 01012013 at 11:35 AM, ly commission expires:
JIM FULLER CLERK CIRCUIT COURT DUVRL rsonally Known: �� �'.
COUNTY Public- or
RECORDING$10.00 -oduced Identification: �`
•. or fcn;;' Commfs>sion i EE 850"M
--` BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: L.2� St0. axl s ejf Permit Number:
Legal Description Parcel#
Floor Area of Sq. t. Sq.Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): ew Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s)(circle one):. Commercial If an existing structure,is a fire sprinkler system installed?(Circle onegisidentia
No
Florida Product Approval# 19SG3
For multiple products use p o uct approve orm
Describe in detail the type of work to be performed: zer-00-r
Property Owner Information:
Name: .Jo.S on ro Address: /7S/ Ste- Qea S d,-
city ")" State 17_Zip 301'33 Phone gov 610 '� t
E-Mail or Fax#(Optional)
Contractor Information: r� 1
Company Name: RsrnaNO
o rofV%-rs 44(. Qualifying Agent: 1�w �+ �o/'�os+►�o
Address: Pe) box- -73,0332 City A46,1.i be-c 4 State r/ Zip I33
Office Phone qpq Job Site/Contact Number 9c`i (,l0--a Lf 7 6 Fax#
State Certification/Registration# CCG i 3)i8'893
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 and that all work will be pe ormed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void f work is not commenced within six(6 months, or if construction or work is suspended or abandoned for apenod of six )months at any time after
work is commenced. I understand that separate permits must be secured jor Electrical Rork,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.
1 here b certify that 1 have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type 1 work will be complied with whether speci zed 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.
Signature of Own Signature of Contractat .
Print Name 11Q,:Y1_.. ............................_.................................... Print Name ..........�...�!.Yl.��..�....._� ..�-•.......................................................
.....
Sworn to and subscribed before in Sw o s bs ibfore e
this o�3 Day of_ � t 20 /Z
IRLE'Y L.GRAB
ROMANOc mesio a
Notary y'PublicIs
txF�Rss: a,zo a
: Notary Public-State of Florida : ;F hg. 3unded Tnn�N ry tic Uirlerwriters
` F
My Comm.Expires Nov 12,2016 .:., -
;'E dw�'� Commission•EE 45M3 ed 01.26.10
.�\a� \\�.