2220 FAIRWAY VILLA ROOF r r J \ I A CITY OF ATLANTIC BEACH
J J '�
J 800 SEMINOLE ROAD
K IF j ATLANTIC BEACH, FL 32233 _ .... /i INSPECTION PHONE LINE 247 -5814
\J.219
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- ROOF -901
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $6,400.00
Issue Date: 4/18/2016
Expiration Date: 10/15/2016
PROPERTY ADDRESS:
Address: 2220 N FAIRWAY VILLAS LN
RE Number: 169398 -1122
PROPERTY OWNER:
Name: MUNOZ, GUADALUPE & CINDY L, *
Address: 2220 FAIRWAY VILLAS LN
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: - -
FEES:
PLAN CHECK FEES $41.00
BUILDING PERMIT FEE $82.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $127.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Apr 1816 11:30a Romano 9042464810 p.1
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BUILDING PERMIT APPLICATION - -
I.
"..a " —e CITY OF ATLANTIC BEACH
1-6 890 Seminole Road, Atlantic Beach FL 32233
=c.'.t `' Office: (904)247 -5826 • Fax: (904) 247 -5845 1 - (j a
Job Address: C) �—�,-, r L ' Ur ) c nh . , Permit Number:
n
Legal p al Descri lion )-
- �-�'� -L, _l . \ c :-)RE +
1
Valuation of Work (Replacement Cost) $ 4 b& Heated / SF -D- D Non- Heated /Cooled
■ Class of Work (Circle one): New Additio Alterat' , Repair Demo Pool Window/Door
O Use of existing/proposed structure(s) (Circle one): Commercial Residential' •
• If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
...
Florida Product Approval # (,: 5 f / r , / for multiple products use product approval form
Property Owner Information
Name: .
•`._ Address: D D a �.w r c r \n \ \c
� C____---or8alk.)0,2_ � Phone � � -
City �
Sta\ Zi .►
E -Mail
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) T E MAY
•
*;.r./ r... , y:T _' ;: -� o. YOUR FAILURE L �O RECORD NOTICE COMMENCEMENT MY'
. i~ ._Y .".`- riF�."°. � vUic � li "LUR RECORD � A a � �L�E O C T .
RESULT :I\i YOUR l k IN TWICE FOR IMPROVEMENTS 'E`_�'TS TO YOUR PROPERTY. IF YOU INTEND
TO ^BTA INT FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE CF COMMENCEMENT.
Contractor , r orma on:
� Quali - ng A ent_ c. - ' •.•*, • e
Name of Compa ow. _ � ^ � � Agent_
Address: r ` 9 v� , - _ 1 City State Zip '
Office Phone -0- .f • 50 1 Job Site /Contact Number
State Certification/Registration # C ' t :D-Y-' t'..q 3 E-mail .
Architect Name & Phone #
Engineer's Name & Phone #
Worker's Compensation
Exempt 1 Insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced
"mar to the issuance of a permit and that all work will be performed to meet the standards of ail laws regulating construction in this Jurisdiction.
'This permit becomes null and void if . r • 's not commenced within six (6) months, or if construction or work is sus ended or abandoned for a
period of s ix (6} months at any tint • • ter wo . ; is commenced 1 understand that separate permits must be secured for Work, Pl um b ing,
Signs, Wells, Pools, Furnaces, 1 • tiers, • L saw A Conditioners, etc.
Signature of Property • . -r: /� b 9'3 Signature of Contractor: `& �..
this of o r Say of � Before me this j Day of 1.. t 1
Notary Pu• 'c: ....0.0- _ / Notary P •lic: / -.'
1 hereby certi ' that Ili ve7t`, ri • Y?? el etia e ion rid know the carte to be uric and r ?_ .!'les tnuL'tK0
�r� FF vttlr :.hetker specified kereirt or rtoi. co 11 x.; tr t,� or � siAtk €j j(ssib a 033 216
ordinances oove;•r:irrg Lt= :� h ; � ��. j,, trf_ �a�ork � r ri"c'br r P � con rLec�• -r2qr7 o stit t
presiurte to gn.e acttltnr t i ieleY Cg1MMISStCp11 1133x16 any ot.rer,feaeral, state or local la : , deg PI S Jur 20 _17 , 2
o_
a te. •
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No._ Tax Folio i� o I a = 113a-
State of b L County of ) A; - /�`)
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.
L I description of grope D
ein �mproved:
Address of pro erty being improved: _ V I '
General description of improvement
( `° ;,,nor C . Lynt
Address) _ • fNt a 1)P. jib 3
Owner's interest in site of the improvement )
Fee Simple Titleholder (if other than owner)
Name _ - --- .
Address
Contract...+ - ; y �3 � a
Address ,l ` '� .►_.. ^:
Phone N.. [�� � e Fax No. MIIMIMIMIE
Surety (if 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 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
4 .. i
ii.
Phone No Fax No ° ;'
w., .. :
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a b .
different date is specified): ,,„
THIS SPACE FOR RECORDER'S USE ONLY y .(,tur7 OWNER
ad: e%i, r#.M 1. DATE di ) 141 L i o , o D
'afore me this day of in the a
F� C��(y \ nty f Duv State c. ^da. he p r ovally appeared z`' W
ir I r 1� - �� — It ›t' t` �/2 1,j�1j h2r2ir, the
O (n rrt
himself; _jai . nd affirms that all statements dnd declarations heroin r-
are •e and acwrate _
m � Z
Doc # 2016086615, OR BK 17530 Page 1348,
Number Pages: 1 �� o o
Recorded 04,'18;2016 at 12:01 PM, G 9% 3 „ w N
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Notary Public at Larce. Sta`. County
COUNTY My commission expires: MEM
RECORDING $10.00 P or
Produced n roduced Identification _ ralMIGIMEWO
air