Permit Roof 381 3rd St 2013 r ��y
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002232 Date 2/27/13
Property Address . . . . . . 381 3RD ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4815
----------------------------------------------------------------------------
Application desc
reroof FL# 1956 . 3
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
BEW DAVID FITZSOMONS JR ROMANO BROTHERS ROOFING, INC
381 3RD ST 601 OLEANDER COURT
ATLANTIC BEACH FL 322335231 NEPTUNE BEACH FL 32266
(904) 246-5649
--- Structure Information 000 000 REROOF
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4815
Expiration Date . . 8/26/13
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 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: 721r _Cj Yjv Permit Number: 3 °1 -3
Legal Description Parcel#
Floor Area of Sa.Ft. Sq.Ft
Valuation of Work$ 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/pro osed structure(s)(circle one): Commercial
If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No �=-
Florida Product Approval#
For multiple products use product approva orm
Describe in detail the type of work to be performed: Xrr,b
Property Owner Information:
Name: tV,, ,�zs l �S / '�,cf Address:
City __2+1 jcjn State 9 Zip T223.3 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: 9_QualiAnt: ia t1 44.-1ary
Address: State )cf
ty
Zip m2-1 Z
Office Phone 1D-0V-r0 70 Job Site/Contact Number /G Fax#
State Certification/Registration# -CC-
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 cert 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 rf work is not commenced within six(6)months, or ijconstruction or work is suspended or abandoned for a_period of six 16)months at ny time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,eta
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 hereby certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws ar ordinances governing this
type o work will be complied with whether speci ted herein or not. The granting of a permit does not presume to gry rori t to violate or cancel the
provisions of any other federal,st4rte, or local law regulating construction or the performance of construction.
l
Signature of Own _y Signature of Contractor
Print Name -V9 .....J.. '✓'%r..l .{'x.k! ' .......—A,6- .............. Print Name 2_1r.�. .1.........1.` v
Swo and subscribe before me Sworn to and subscribed before me
this=Day of } .20r this Day of .20
Notary PublicNotary Public
�AN11 pNN
DANIEL 6 ROMANO
Notary Public-State of Florida Revised 01.26.10
My Comm.Expires Nov 12,2016
Commission#F EE 850643
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No
State of County of, t,vim,/
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 Informatio is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:
Address of property being improved: "� !'< `" / 1 A
General description of improvements:P.
J
Owner l u`" Ct f r 5 V0, y C
Address
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
V-0 ' i Contractor
Address Cr U (r:C I'
Phone No. Li �£4' f L Fax No.
Surety(if any)
Address Amount of bond$
Phone 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
Phone 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 Statutes.(Fill in at Owner's option).
Name
Address
Phone 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 / ^ r O
Sig nA,
DATE D-02 /3
Bef e rn is )fay of I in the
Doo#2013051084,OR BK 16269 Page 1646, County of Duval.State of Florida.his persly appeared herein by
Number Pages: 1 himself herse8 and affirms ternent�JJs and declarations herein
Recorded 0ell 013 at 12:19 PM, are true and accura
Ronnie Fussell CLERK CIRCUIT COURT DUVAL —
COUNTY
RECORDING$10.00
.`�`�PRY PVb���
Notary Pu ai _f Pubite-CAW
or-
My
corn i �f p' •t [i�[0 �f
Personally n'a,, OMM.Exphl or
Produced n,
•r,u,a