1830 Mayport Rd 2013 ROOF CITY OF ATLANTIC BEACH
1 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003363 Date 9/05/13
Property Address . . . . . . 1830 MAYPORT RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 500
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Application desc
EVE METAL, FASCIA, ROOF REPAIR
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Owner Contractor
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--------------_____
OSSI KLOTZ LLC ROMANO BROTHERS ROOFING, INC
P O BOX 330833 601 OLEANDER COURT
ATLANTIC BEACH FL 32233 NEPTUNE
BCHFL 32266
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Permit . . . . . . ROOF PERMIT
Additional desc . . 00
Permit Fee 55 . 00 Plan Check Fee .
Valuation . . . . 500
Issue Date . . . .
Expiration Date 3/04/14
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STATE DCA SURCHARGE 2 . 00
Other Fees
STATE DBPR SURCHARGE 2 . 00
Fee summary Charged Paid Credited Due
g ----------
00
----------
- - . 00
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
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
l 30 Office (904)247-5826 Fax (904) 247-5845
Job Address: Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq. t
Valuation of Woi w 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: E�yn
Property Owner Information:
Name:
Address:
City C State Lip .S a: °; Phone
E-Mail or Fax#(Optional) M
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: bhrVUr o c�
���nc8r �``t nC� Qualifying Agent:
Address: c vCi -�- .c 1� State _Zip's
S j
Office Phone �� Job Site/Contact Number ,��'
State Certification/Registration 4�
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 if 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, urnaces,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 a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type certify
wt[I be complied with whether sped ied 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 Owner Signature of Contractor -
Print Name .�:�_t...................�5.�_kL.............................................................................. Print Name
Before meBefore me
this Day o Y + ; 'l n this j�D D72r
—
// :•;►*"�'�ys JOSEPH JUDE ROJOSEPH JUDE ROMANO SR.
N Public-Sht
- Nota My Comm. Expires Notary is y ry ,,� • vMy Comm.Expires Mu 7,2017 i '•;�OFF", Commission#Ed Commission#EE 8S1880 / "„� R evisg4 P1_;6
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