1835 Hickory Ln 2013 roof CITY OF ATLANTIC BEACH
11
Ss3 800 SEMINOLE ROAD
J
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003849 Date 12/18/13
Property Address . . . . . . 1835 HICKORY LN
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8000
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Application desc
reroof
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Owner Contractor
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STORY GRAHAM N ROMANO BROTHERS ROOFING, INC
1835 HICKORY LA 601 OLEANDER COURT
ATLANTIC BEACH FL 322334547 N PTUNE BEACH
FL 32266
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Permit . . . . . . ROOF PERMIT
Additional desc . . 00
Permit Fee 90 . 00 Plan Check Fee 8000
Issue Date Valuation
Expiration Date . . 6/16/14
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--------------------------------
----------- 2 . 00
Other Fees . . . . . . . . . STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2 . 00
_ ________ ----
Fee summary Charged
Paid Credited ----Due---
. 00
_ ----------
--------- ----------
- . 00
Permit Fee Total 90 . 00 90 . 00 00 . 00
Plan Check Total • 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00
Grand Total
94 . 00 94 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Pennit No. Tax Folio No.
State of County of
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 description of property being improved: 8J 47q
Address of property being improved: �d .� l fy i ,��t , ,(,L y: 7�.�� t✓ - �a'
General description of improvements: 5 it
Owner
S
Address
Owner's interest in site of the improvement_ /Y l,?e s,L. A", •-
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor I
Address O
Phone NJ Y 61/0 -D y74 Fax No.
Surety 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.
.j In addition to himself,owner designates the following person to receive 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)yearfrom the date of recording unless a ®,-5d
different date is specified): Z
0 s
THIS SPACE FOR RECORDER'S USE ONLY OWNER o Z=W
/� IE°A ' s
Signed: DATE ���
h
Before me tttls day ofin the u W
County of Duval,State of Florida,has ersonelty appeared z
Doc#2013322345,OR BK 16635 Page 944, herein by c CL E as
Plumber Pages: 1 himself/herselfand affirm statements and declarations herein 3
Recorded 12118/2013 at 11:40 ANI, are tare and accurate
Ronnie Fussell CLERK CIRCUIT COURT DUVAL g
COUNTY
RECORDING$10.00
a
Nota Plic at Large, tate of County of
My commission expires:
ti•
Personally Known of ''°;������;,•�
Produced Identification
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road;Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904)247-5845
Job Address: � �f Permit Number:
Legal DescriptionParcel#
oor Area o q. t. Sq.Ft
Valuation of Work$ OOG, Proposed Work heated/cooled non-heated/cooled _
Class of Work(circle one): New Addition Alteration Repair Mov emolition pool/spa window/door
Use of existing/proposed structure(s)(circle one):. Commercial Reside
If an existing structure,is a fire sprinkler system installed? (Circle one : es No N
Florida Product Approval# l- 1C/s6. 3
For multiple products use product approval form ,
Describe in detail the type of work to be performed: _14 00i4-Akl Z
smell 6AC 4 ✓Z4- 3a c r G�Q rr� hlf/
Property Owner Information:
Name: f!r'r,al a.. �� l�� S�r Address: / S 1 / !�
City Statpo5/ ; �3 Phone 96Y 410-047G
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: �,..d 3YJ� � 246-,j C Qua lifyi g A ent: �� � / �g��
Address: P.0 lvw &3033'7 City e.j► State _Ztp
Office Phone 2- Job Site/Contact Number Fax#
State Certification/Registration# CC C RoIR993
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 thisjurisdiction. This permit becomes mill
is and work void
a commenced of commenced I understand that six separate permits mumonths, or fst be secured for Electricconstruction or workal-Work,Plumbing,Sigor abandonedns,swells, Period ols, Ptirnaces, Boils s months at anv time after
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 ATTO ONMMEN ORE RECORDING YOUR NOTICE OF
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions o f laws nd ordinancesalate or rni gl this
his
type of work will be complied with whether specified herein or not. T granting of a permit does not presume too authority
provisions of any other federal,stat or local law regulating construct' or the performance of construction.
Signature of Owner Signature of Contractor
p� Print Name �G rn'L� /"" � -
PrintNamen ............................................................................. ..................................................
Sworn to and subscribg4 before me Swo o and subs d�efore me 20
this Da f UCC. 20 /3 this Day of
Notary Pu lic �1` °p Y DANIEL S ROMANO otayy,,Ppblic
StPH JULIE ROMANO SR.
• Notary Public-State of Florida
• - Notary Public-State of Floret sed 01.26.10
• My Comm.Expires Nov 12,2016 • My Comm. Expires Mar 7.2017
Commission#EE 1150643 9
,�„„l�•a •.,e „; ”' commission #EE 881666