1204 Hibiscus St Roof 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003058 Date 7/15/13
Property Address . . . . . . 1204 HIBISCUS ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3500
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Application desc
REROOF
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Owner Contractor
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CHIN MIRIAM ROMANO BROTHERS ROOFING, INC
1204 HIBISCUS 601 OLEANDER COURT
ATLANTIC BEACH FL 322332664 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 . . . . 3500
Expiration Date . . 1/11/14
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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.
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
I. Description of
,pyoperty(legal description of property and address if available):
2. General Description of improvements:
44-7,
3. Owner Information:
a)Name and Address: kar VIAZ CIAIII� 12 16,��g A
b) Interest in property: ./-A 11.4 4
c)Name and address of simple titleholae'r'(if other than owner):
4. Contractor Information: (mo ovz
a)Name and Address: ww,-o
Phone Number: 90Y
5. Surety Information:
a)Name and Address:
b) Phone Number:
c)Amount of Bond: $
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a) 7, Florida Statutes:
a)Name and Address:
b) Phone Numbers of Designated Person:
8. In addition to himself/herself, Owner designates of to receive a
A
coloy--fthe Notice' as provid-ed Irl Se6t;,on 713.13 (1 N fb), a Statut
a)Name and Address:
b) Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement(thc Zxpiration date may not be before the completion of construction
and final payment to the contractor, but will be one (1) year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1,
SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of peijury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein e true to the best of my knowledge and belief
I/ 22AW1 Sign tory's Printed Name&Title/Office
ti�gn�ture�-OfNvile-r/or Owner's Authorized Officer/Director/Partner/Manager
The foregoing instrument was acknowledged before me this 1-� day of 120/�
by as for
(Name of Person) (Type of Authority,i.e. Officer/Attorney) (Name of Party Instrument was Executed for)
NOTARY BL STA OF FLORIDA
.4�t
Doc#2013181638,OR BK 16452 Page 1944. Print Name:
Number Pages: i
Recorded 07/15/2013 at 11:49 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL El PersonaIL- Yrwum -
COUNTY t
RECORDING$10,00 P- Identific DMILL 3 ROWA—NO
PIOUWY POW-Sta of I
My Comm.E*m#by 12.2016 Revised 3/15/12
COMM11221IN#EE 0
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904)247-5845
Job Address: /6 1, e, Permit Number:
Legal Description Parcel#
1P,1oor /'u1,,1,,l .11.,, , ''' ''' "o'l,Ft. Sq.K
a7 non-heated/cooled
Valuation of Work$ roposed Work heated/cooled
Class of Work(circle one): New Addition 4rte�i-o--` Repair Move Demolition pool/spa window/door
Use of exIsting/proposed structureQ)(circle one): Commercial /---Residentiall—'
installed? (Circle ogy-���'aenu�"' o
If an existing structure,is a fire sprinkler-system
Florida Product Approval 4 s�&, :3
For multiple products use liroval form
Describe in detail the type of work to be performed: A
Property Owner Information:
Nam k e- I h) Address:
-1/, A 0 Aa, State J�LZip PhoAe
city f ! e
E-Mail or Fax#(optional,
Contractor Information:
uaiif�in A ent- C
Compan*Name: Kc;p- rc p V'.Z
_j �kf,-c State
y .0 zi
Address: ty
OV 76 -57 Fax 9
Job Site/Contact Number
Office Phone OiZ6
State Certification/Registration# 4-C-C /12
Architect Name&Phone#
Engineer's Name&Phone 4
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
formed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
issuancelof a permit and that all work will be per fter
or work is su ended or abandonedfor eriod of sixP6)months at any time a
months, or ifconstruction,
and void ffwork is not commenced within six(6 F,
work is commenced. I understand that separate permits must be securedfor Electrica Work,Plumbing,Signs, ells, Pools, urnaces, Boilers,Heaters,
Tanks andAir Conditioners,eir-
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 YOU� NOTICE OF
COMMENCEMENT.
I her b certify that I have read and examined this a licatz I on and know the same to be true and correct. All provisions of laws and ordinances governing this
0 to violate or cancel the
type e ork will be complied with whether speci red herein or not. The granting of a permit does not presume to give . 0 to vioate or cance, 0
71 the peiformance of construction.
provisions of any otherfederal,state, or local law regulating construction or
Signature of Owner X I Signature of Contractor
7— . j . ............
.......... -e
............(........... .................................
Print Name .........tk ............... ................................... ........... Print Name )N,
Sworn to and subscribed before me
Sworn to L-subscrftd�efbre me 20
this Day LA 20 this _Day of
NO Notary u IC
t
Notary Public-State of Flkovrm Revised 01.26.10
My Comm.Expires Nov 12,2016
Commission#EE$50643