1643 Sea Oats Dr 2013 Roof CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
AT ANTIC BEACH,FL 32233
-5814
INSPECTION PHONE LINE 247
Application Number . . . . . 13-00003798 Date 12/09/13
Property Address . . . . . . 1643 SEA OATS DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 7750 ----------------------
----------- -----------------------------------------
Application desc
RESHINGLE ROOF ------------------------ ------
-- ------------------------------------------
Contractor
Owner ------------------------
------------------------ ROMANO BROTHERS ROOFING, INC
Soo, CLARA TRUST 601 OLEANDER COURT
1643 SEA OATS DRIVE FL 322335827 NEPTUNE BEACH FL 32266
ATLANTIC BEACH (904) 246-5649
-- ------- -----------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc - . REROOF Plan Check Fee . 00
Permit Fee . . . . 90 . 00 Valuation . . . . 7750
Issue Date . . . .
Expiration Date . - 6/07/14 --------------------------------
-------------------------------------------- SURCHARGE 2 . 00
Other Fees . . . . . . . . . STATE DCA
STATE DBPR SURCHARGE 2 . 00
---- --------
---------------------------------------Paid Credited Due
Fee summary Charged ----- ----------
----------------- ---------- -----90 . 00 . 00 . 00
Permit Fee Total 90 . 00 . 00 . 00 . 00
Plan Check Total . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 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 Roadj Atlantic Beach,FL 32233
Office (904) 247-5826 Fax(904) 247-5845
&AA V. Permit Number:
Job Address: 413 e-
Legal Description Floor 2)rt�!�l Ft. Parcel
-7 767;p,,_W_ Proposed Work heated/cooled-42-1-- non-heated/cooled_
Valuation of Work
Class of Work(circle one): New Addition-:��Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Yes No
If an existing structure,is a fire sprinkler system installed? (Circle one): (Z76
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Ae3L el,�
Property Owner Information:
Name: C_&*r. 6 0,0 Address: /6 J!�3 Sa
City .4 t-Z)4;4- vd,k" State,*? Zip Phone
E-Mail or Fax 4(optional.
Contractor Information:
-R a JA — Qualify. Agent:
Company Narne: An�j 6 12-.o ij Uity -in State ip
Address:_-4b, ?) *:0ejf. J-34 -3 3�2 Fax
Office Phone U4, 4 LO-0 V7'6 Job Site/Contact Number Z?a.4 ,S
State Certification/Registration#_CCr_ 139 9193
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 lcert6 that no work or installation has commencedprior to the
issuance ofa permit and that all work will be performed to meet the standards ofall laws regulating construction in thisjurisdiction. This permit becomes null
,rk is suspended or abandonedfor aWeriod ofsbc months at any time after
and void ifwork is not commenced within six(6)months, or if construction or wo �Z�
work is commenced. f understand that separate permits must be securedfor Electrical Work,Plumbing,Signs, ws, Pools, I urnaces, Boilers, Heiziers,
Tanks andAir 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 here by certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governingthiS
to violate or cancel the
�work ivill be complied wh
type ? *whether specified herein or not. The granting of a permit does not presume to give au
provisions of any otherfederal.state, or local law regulating construction or the pe�formance of construction.
Signature of Owner/ Signature of Contractor
Print Narne da ra Print Narne ......... ................................................
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Swo,m to and subscribed 6fore me Swo to a subscribed b,46r�me 2
thi of 20 413 this r# D
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a
uANIEL 9 ROM ......
NVary Public NOWY Pubk.sun ot FWWA WL90 39 1 Wftmw Ah
my Comm.EKpwn No 12,201 aLIMMYmmmma ised 01.26.10
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commission#EE$50643
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State o County of T—
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 Information Is stated In this NOTICE OF
COMMENCEMENT.
Legal descript'top 9f property being improved:
11 1 1
Address of propeq being improved:j
Z�23-s
General descript tion of improvements: -!54 )6�- -!5V',a4& 1-16
Owner Je cL Lo�:Q,,j
Address'/(,- '3 Lit-1-< Loc.
Owner's interest in site of the improvement It&oi 101
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor V A,j2 2,c a
Address '411
P 3SOS32
h —Fax No. 011(e/I
Su ty Qf 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 receilve 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 LISff7 OWNER
Sioned, �i477- DATE
Before ffiL�'thls_day 0, in the
Doc#2013312650,OR BK 16623 Page 514, County of Duval,State of Florida,has personally appeared herein by
Number Pages�I himself/herself and fiffi d declarations herein
Recorded 1ZD9!2013 at 12:11 PMT are true and acou
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00 DANIEL S ROMANO
of FWW
Notary P &ft s- Notary 0111111M
my Commi i I I
personally CoMfniaWW 0 t 111171MR4 or
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