1651 SEMINOLE RD - ROOF sA
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J • = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Sal>r
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-462
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $7,042.00
Issue Date: 2/23/2016
Expiration Date: 8/21/2016
PROPERTY ADDRESS:
Address: 1651 SEMINOLE RD
RE Number: 169564-0020
PROPERTY OWNER:
Name: EMANS, CHRISTOPHER F
Address: 1651 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: - -
FEES:
BUILDING PERMIT FEE $85.21
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $89.21
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORII).�
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: LT.>i kit �( , Permit NIntepizaht
.Lcgll,DesFription �S- Yom. Del - S a Q E Dc Peel (N t��Q Parcel#I l 1 5(.L1 - �� ()
{S1 r' L-!
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 1 b.,cj Proposed Work heated/cooled as non-heated/cooled
Class of Work(circle one): New Addition Alteratioepair Mov molition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Res1d
If an existing structure ,is a fire sprinkler system installed? (Circle one): es No N/A
Florida Product Approval# ` 4'S(L
For multiple products use product approval form
Describe in detail the type of work to be performed: 2g Doc
Property Owner Information:
Name: C f > s: h(t. S Address: ) I :,, Li d
City L'S I ,nth KN_Stgcl_Zip 3 Phone me -0(.0 C�
E-Mail or Fax#(Optional)
Contractor ation: i
Company Na 6__ . S i Qualif�' Agen.•1 0 r • „
Address: I � R� !I1 City �-1 State ( Zip ', ;
Office Phone - lkl. - 5►, Job Site/Contact Number Fax#
State Certification/Registration# C l e Eq E
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:f 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 is commenced I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, Furnaces, Boilers, Healers,
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 hereby certify that I have read and examin• this a plication and know the same to be true and correct. All provisi• tq. '.s 4 ancce3 o9eYNi7f is
type o/work will be complied with whet .1 specified herein or not. The granting of a permit does not presume t 's„ hpril$tio,VidMIS tiles t33 i6
provisions of any other federal,state, or al law regulating construction or the performance of construction. �a°*� EXPIRES- I,,2.2017
er398-0153 FloridallolaryService.com
Signature of Owner , Signature of Contrac or
Print Name CM Rtf 1 n1 A 1
5 Print Nam
I G�r�. Q.k,,,rt..G..✓..1..1�
Sworn to and subse.r.ibed before me Sworn to and subs '.ed before me
this l q •a, of -€-J r a _ , 20 I L this Day of r 20
/ ■i ��..:: � - / I
Notary 'ublic i ':l.`� ' o • 'u.
`s • MY COMt.'ISSION#FF033216
,,, EXPIf ES July 2.2017 Revised 01.26.10•
(407)388.0153 FlorklallotaryService.com
•
NOTICE OF' COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit N Tax Folio No. p
State of �� Ly/
County of 1 lv+/
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.
Le al description of promrty being improved: • " •_ ,y _. _ _ at
e (.f rcVQ P1, 1 5 N
D. - I'a+ It ' II' Li
1
Address f property being improved: I L'5 i) , 1 ;� _--
General description of improvements: Y,P (j .
"t .9'.vner C NrA S C: 1I A C,..,nA
Address 1 VS i ' _ & .t i nt`Nt....Q�_�r �c.a
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name —•--
Address •
Contract.,..,- 's . a ` L�
Address, A ~- I^, / a
Phone N..~re, Fax No. ...4111%WI
Surety(if any)
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. �,
to cj " E
In addition to himself.owner designates the following copy provided 6 ,2 :9,,-
g person to receive a co of the Lienor's Notice as rovided in U N
Section 713.06(2)(b).Florida Statutes.(Fill in at Owner's option). = Z T .S
-
Section
J
CC cn O N-) z
R
Address ttI z
Phone No. c( c r` z
Fax No. x o
v w u.
r
Expiration date of Notice of Commencement(the expiration date is o (1)year from the date of recording unless a
different date is specified): :. • ••.
THIS SPACE FOR RECORDER'S USE ONLY OWNER :` a
,,o. ' ;4
Sicned: �� DATE ",• a`•••' $
Bejqre me thi 7 C. day of ....c f, .>t.,)L in The
''..:' ,....1 n,} . Chu►loquivaisStaterflorlda.has personally appeared
herei
himself!herself and affirms t a aII statements and declarations herein r,by
Doc#2016036165.OR SK 174&4 Page 25, are true and accurate
Number Pages:1
Recorded 02/18/2016 at 10:00 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY ��/✓ Si
RECORDING$10.00 'otary-ublic at Large.Etat'' c�unty•.
My commission expires: - I
Personally Kno.:n \ j or
Produced Identification ,)L