580 CRUSIER LN ROOF c`; %r
?Pr
y
CITY OF ATLANTIC BEACH
-~ s :� J s) 800 SEMINOLE ROAD
j Z ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- ROOF -997
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated Value: $8,600.00
Issue Date: 4/28/2016
Expiration Date: 10/25/2016
PROPERTY ADDRESS:
Address: 580 CRUISER LN
RE Number: 170703 -0326
PROPERTY OWNER:
Name: COGSWELL, STEPHEN & DANELLA M, *
Address: 580 CRUISER LN
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: - -
FEES:
PLAN CHECK FEES $46.50
BUILDING PERMIT FEE $93.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $143.50
4
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 16 — 4es — 7
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: SRO (K ker 47, Permit Number:
Legal Description 35-6 i as --,29e Sca4p.r /off er Parcel #
Floor Ared of Sq.r't. Sq.P't
Valuation of Work $ SAO Proposed Work heated/cooled T st non - heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial esi
installed? de
If an existing structure, is a fire sprinkler system (Circle one): es No
Florida Product Approval # . / Sro •.`� 1J8 S?. t:,
For multiple products use product approval form
Describe in detail the type of work to be performed: 12e= I
Property Owner Information:
Name: V-. cphei C. e uve -JI Address: 5Q0 Cfulscr fin.
City AI t ic.h Stater-/ Zip `:.?a-a33 Phone Sty -341 - 60/2
E - Mail or Fax # (Optional)
Contractor Information:
Company Name: Zoo( i%►c Qualifying Agent: DA ity /2or•d,"
Address: ,'•o /30 i3' City l hd- State rr Zip 373 ?
Office Phone t 4 aW4 -y Job Site/ Contact Number a,a..r 616.0(/.78 Fax #
State Certification/Registration # CCU l /ag&9
Architect Name & Phone #
Engineers 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 if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for apperiod of six (6) months at any time after
work is commenced. I understand that separate permits must he secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo Heaters,
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.
'hereby certi that 1 have read and ex - • ' • • his a.. • tion and know the same to be true and correct. All provisions of taws and ordinances governing this
ype of work will be complied with . e •d he ein or not. The • • - a permit does not presume to give authority to violate or cancel the
irovisions of anv other federal. scat , or • ar ., regu •• ing construct' • . ; erfo once of construction.
110
iignature of Owner Z �.� Signature of Contractor
'rint Name k Print Name Re h'„ _._..., M
>; and sub c ibed before m - 11 Swo • nd subsc d before me
s al Day of : ! 1 , tt 20 0 th' _ j ► av of s , i , 20
air
aa
• . Public ;r�` R'"% .. •otary Public A: °E
MY COMMISSION itFFa33246 MY COMMISSION #FF033216
g
`,:� ` . EXPIRES July 2. 2017 `! . ;d � l'. dd .
h .w.
4 a '' 0X
zoo+ (4398.0153 FlaridallotarySm' ice. Com
i�071398�0153 Floridallot
OUBWO I d00: 60 9l 2Z ady
1•d 01217917Zi706
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit N Tax Folio No. / 70�7OS c)3c3C
State of i L County of D, ,i,I
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: 35-CV /7 -c25 ,e yk y hi-- (27 1,11( .2
Address of property being improved: S cr,n> cr /In • AT r t F.. 39a3 3
General description of improvements: g'l -00 F
('. 1-4 ` 9w.vner S' ' ' r r r \ COgs We' I I
Address Cr u•sPr In Ail (J T/ regaa73
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name - ---•-
\ Address w
•y \ Contract., i . , � .
Address: .� a
Phone N. . . , Fax No.
S urety (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 --,-
ddress _ 0...!
Phone No. Fax No. , L
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in 6 '',,:!.... , oe,
Section 713.06 (2) (b). Florida Statutes. (Fill in at Owner's option).
T
Name c x O D
P. - 0 y M
Address z 55 - CO
Phone No. Fax No. ; m p, ST
c O r-
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a 5,, - . _
different date is specified): Oillimum„ o N i 0
0 -n
N
/�
THIS SPACE FOR RECORDER'S USE ONLY Z .r."...)
Signed: NER
r t ��/ DATE in t Q7
Before m� .7
'1 (1 4. _ Count uval. State of Florida. has personally 1 pe ed herein by
h im e ' herse f and affirms that an statements ements and de tarations herein
are true a ccurate
r
Doc # 2016095725, OR 8K 17543 Page 727. � ��
Number Pages: 1
Recorded 04'28 -2016 at 01:28 PM, otary Public at Large. State of
Ronnie Fussell CLERK CIRCUIT COURT DUVAL M commission expires: or
COUNTY Personally Kno:•n
RECORDING $10.00 Produced Identification ` t.