426 sailfish Dr 2014 Roof S CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
r,
INSPECTION PHONE LINE 247-5814
�Js3
Application Number . . . . . 14-00000437 Date 3/21/14
Property Address . . . . . . 426 SAILFISH DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5500
-
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Application desc
REROOF
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Owner Contractor
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------------------------
KLUBEK, EDMUND M. ROMANO BROTHERS ROOFING, INC
426 SAILFISH DRIVE 601 OLEANDER COURT
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 246-5649
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Permit . . . . . . ROOF PERMIT
Additional desc . . . 00
Permit Fee . . . . 80 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 5500
Expiration Date . . 9/17/14
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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 80 . 00 80 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 84 . 00 84 . 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
' r ��33 Permit Number:
Job Address: 1A - 4 �� (+, Q
Legal Description -Parcel#
Floor Area of q• t• q• t
Valuation of Work S 5�50-C,..L)p Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): \Tew Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)((c��ircle one):. Commercial Residential
If an existing structure,is a fire sp,rinklerystem installed? (Circle one): Yes No N/A
Florida Product Approvala _ formFor multiple products use product
Describe in detail the type of work to be performed: KI
Pro a Owner Inf rmation:
Name- c
Address: ' T
1
City State Zi Phone
E-Mail or Fax#(Optional)
Contractor tion:
Qualg Agent: �M c
Company Nam ' City State Zip
Address: 1S Fax#
Office Phone - Job Site/Contact Number
State Certification/Registration# Y1S
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
t no work
issuance on as hereby and hat al work obtain will be performed toork and meet the stanlations as indicated. I dards of all laws rregulating construction in othiiinstallation
juraisdicttion- Th permit bectime oor to es null
and work void
mmrk is commenced mmestand thtat�sepasix rate permits muor st be se ured for Electricction or work is al W�dPlor ums g,SSns,or aWells,Poolseriod xL'urmnaces months,at
Heaters,e
Tanks and Air Conditioners,etc
E OF
WARNING TO OWNER: YOUR
YOUR FAILURE
'TWICTO E FOR IMPROVEMENTS
COMMENCEMENT MAY RESULT
TO YOUR PROPERTY. IF YOU INTEND TO FINANCING CONSULT
H
YOUR LENDER OR AN ATTORNEY
BOBTAINC OF
COMMENCEMENT.
same
e true and
t. All
ons
laws
I here work ytllat I have read complied with waether�this
eciaepolicatherein or n �Theegr anting of a permit doescnot p esumetto give authorityrto violateorcancel this
type o p
provisions of arty other federal,state, or local law regulating construction or the performance ofconstruction.
Signature of Owner Signature of Contractor
Sign
Print Name D Wu rr� 1 r? l,+_.... .I.G__......
Print Name !Jc.r„�`.......-----..-.... ..._ ..r�__..____.___...�.._._.
Sworn Q nd subscribe be ore i e Sworn to and subscribed before me 20
this Day of 20 / / this Day of
Notary Public Notary Public
Revised 01.26.10
,•"'" "�• DANIEL S ROMANO
Florida
my
' Notary Pu01ic_Stsa 01 F
My Comm.EaMor 12,201
. 0lras
Commission#EE 85064$
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit N Tax Fol�io No.\
State of County of ri 4 f
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. Cf
Legal des ' ti of property beingi roved: / (X �,r ' ' -
Address of property being improved: i-
General description of improvements:
Owner
Address
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
n Addr ss
D ntractor -)O .n
1U'✓1 Address S e
Phone No. Fax No.
Surety(if any) r
Address Amount of bond S
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 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)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLYO ER _ // '''aua•�`�
Signed
Befor me this day of in the
Doc#2014063319,OR BK 16725 Page 2325, County of Duval.State of Florida,has personalty appeared '9 a
Number Pages: 1 herein by M,
Recorded 03/21!2014 at 03:29 PM, himself herself and affirms th titatements and declarations herein ;
are true and accurst CO
Ronnie Fussell CLERK CIRCUIT COURT DUVAL ie ce
COUNTY
RECORDING$10.00
Notary Public at Large.State of . County of iv g
My commission expires:
Personally Knoan or 1
Produced Identification