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40 Robert St 2013 ROOF ,�� ` ° °�'� , CITY OF ATLANTIC BEACH 1 800 SEMINOLE ROAD !? ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Jit Application Number . . . . . 13-00003366 Date 9/05/13 Property Address . . . . . . 40 ROBERT ST Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 500 ---------------------------------------------------------------------------- Application desc EVE METAL, FASCIA, ROOF REPAIR ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- OSSI KLOTZ LLC ROMANO BROTHERS ROOFING, INC P O BOX 330833 601 OLEANDER COURT ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 246-5649 ---------------------------------------------------------------------------- Permit ROOF PERMIT Additional desc . . Permit Fee . . . . 55 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 500 Expiration Date . . 3/04/14 ------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 --------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 55 . 00 55 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 59 . 00 59 . 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: v Permit Number: Legal Description Parcel# Floor Area o q. t. q. t Valuation of Work,,,, * Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition AlterationRe air ,Move Demolition pool/spa window/door Use of existing/proposed structures)(circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval# For multiple products use product approval Form Describe in detail the type of work to be performed: Property Owner Information: Name: i � Address: ��L -` 1�S y I`d '.L t l� City C State_LZip 3B.173 ; Phone c E-Mail or Fax#(Optional) M Contractor Information: CONTRACTOR EMAIL ADDRESS: ��nc�r S r�•� � uali m Agent: `�/1 r-` 4,rt c Company Name: b17�0.r�pjc� Q fy' g g ��''"'` Address: c c Lev k — —Ci - �c 1. Stated C- - Zip's �� Office Phone �i�`L1 " AV'(�gn Job Site/Contact Number'= y, 3 –5 .S S Fax# State Certification/Registration# GLG 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 performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void tf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools,Flirnaces,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. I hereb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type ofYwork will be complied with whether speci ted herein or not. The granting of a perm it 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 Owner Signature of Contractor Slgn ••��__ Print Name Print Name , rim C.- /�'+"' ........................................................................ .................................' ..'...............................__............._.._.. Before me Before me this 1 Day o ? "� 20 1 this D4 %/ ••;►��-l"N JOSEPH JUDE ROMANO SR. JOSEPH JUDE ROMANO SR. s Public-State of Florida Nota P lc s. V le- s Notary. ,,� • a, My Comm. Expires Mar 7,2017 ? My Comm.Expires Mu 7,8017 ? CIF FL p•� Commission#EE 881666 Commission#EE 801666 / "" �q�NN