354 11th St 2013 roof CITY OF ATLANTIC BEACH
is
800 SEMINOLE ROAD
j .. ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Jia )i?
Application Number . . . . . 13-00003017 Date 7/08/13
Property Address . . . . . . 354 11TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8800
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Application desc
reroof 1956 . 3
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Owner Contractor
-
------------------------
-----------------------
TRUSSELL, GALEN ROMANO BROTHERS ROOFING, INC
354 11TH STREET 601 OLEANDER COURT
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 246-5649
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Permit . . . . . . ROOF PERMIT
Additional desc .
Permit Fee 95 . 00 Plan Check Fee . 00
Issue Date . . . Valuation 8800
Expiration Date . . 1/04/14
----------------------------------------------------
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 PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904)247-5845
Job Address:
3yr/� f� f l Allot +1C_ &k Permit Number:
Legal Description Parcel#
oor ea o q. t. '3�o q. t
Valuation of Works Proposed Work heated/coolednon-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 Residential
If an existing structure,is a fire s rinkler system installed?� ircle one): Yes No N/A
Florida Product Approval#
For multiple products use product appro al orm
Describe in detail the type of work to be performed: `►�
Property Owner Information: fh
Name:
y� n c Address: 3 /
City k�.c�k�C S-'n c State ip Phone 9��f .24907-7
E-Mail or Fax#(Optional)
Contractor Information:
Company e: /"�Q 1�'�c�ry� �rd 4►&t-5 �tnG Quali ing Agent: �(�1C'- d rnao
Address: Y' City t State _Zip3ao13 3
Office Phone L Job Site/Contact Number Fax#
State Certification/Registration# LA, 12P
Architect Name&Phone#
Engineer's Name &Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
work or
has commencedprior
is�ualnceionis a perm amade to obtain nd that al work well the
beit to do the performed toomeet therk and standards of all laws nstallations as trregulating onsatruotion in thiis installation
on. This permit becomes onull
and work void If
If mrk is not
commenced I understand within
separate permits muor st be conssecured for Electricction or work is al Workd Plutnbing,Sior gns,or aWells,Period o is I urnaces, Boilsix months at ers,Healers,
Heaters,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN TO OBTAIN F NANCWICE ING C�ONSIJLT WITH
TS
TO YOUR PROPERTY. IF YOU INTEND
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOVk NOTICE OF
COMMENCE
I hereob work w h t I have read and complied with whetheed this
aedlication and o not, Thegrantingof e to be to peon doesnd cnot. �p�ll-esuniet to ons o�eaauthori ordinances
vaolategor cancel this
ripe p
provisions of arty other federal,state, or local law regulating construction or the perfor nance of constructi z
Signature of Ow
Signature of Contractor
Print Name ..........
�l�`............._..........................
Print Name J/1 ..........
.. ....... ........................._.........................._...........-.....
4
Sworn m
subscr' for e Swo d subscribed of t me 201
this Day of 20/ this a of
Ot
Not DANIEL S ROMANO NI •,. ;`N4. JENNIFER WALI�R
• MY COMMISSION a Fe 01.26.10
' • ,": Notary Public Sate o 12 2016 •a EXPIRES:N ^-
• =My Comm.ExNres NovRd?•° Bonded Thm N-'
� r Commission I EE 850643
•N.
���,il11$11���
Doc#2013173506,OR BK 16441 Page 1707,
Number Pages: 1
Recorded 07/08/2013 at 12:33 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
>,.}J COUNTY
RECORDING$10.00
Permit number Tax Folio number
NOTICE OF COMINIENCEMENT
STATE OF FLORIDA
COUNTY OF DUVAL
THE UNDERSIDED hereby gives notice that improvement will be made to certain real property,
and in accordance with Chapter 713, Florida Statutes,the following information is provided in
this Notice of Commencement.
1. Description of property:
5 5-L A I -n 4 i c &a& . 32Q33
2. General description of impruvements,
�g f
a
3. Owner information:
a. Name aiyl Address: �5� 1Q ►c „
lix f,
b. Interest in property:
c. Name and address of fee simple titleholder(other than owner):
4. Contractor's name and address:
r e f) n ��1� .Lev
a. Phone number Off• o�y�o -���� b. ax number: 96 2 �F�
5. Surety information:
a. Name and address: d. Amount of bond:
b. Phone number. c. Fax number:
6. Lender's name and address:
a. Phone number: b. Fax uumber:
7. Person within the State of Florida designed by owner upon whom notices or other documents
maybe served as provided by 713.12(1)(a), Florida Statues.
Name and Address:
a. Phone number: b. Fax number:
8. In addition to himself/herself, owner designates
of to receive a copy of the Lienor's Notice as provided in
Section 713.12(1)(b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration date is one (1) year from the
date of Recording unless a different date is specified).
Signature of Owner:-
_•
Sworn to ands scribed before me this day of j lit,• 20
Notary:
Known personally/1D shown: comnmission expires:
DANIEL S ROMANO
W� T�! '• Notary Public-State of FloridaMyComm.Expires NoV112,2016Fi0 Commission#EE.850643