945 SAILFISH DR - ROOF -)"I; \S� CITY OF ATLANTIC BEACH
r) 800 SEMINOLE ROAD
j ;r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-1150
Job Type: ROOF PERMIT
Description: RE-ROOF WITH SHINGLES
Estimated Value: $4,500.00
Issue Date: 5/18/2016
Expiration Date: 11/14/2016
PROPERTY ADDRESS:
Address: 945 SAILFISH DR
RE Number: 171256-0000
PROPERTY OWNER:
Name: BROOKINS ET AL, MADISON RUTH
Address: 945 SAILFISH DR 945 SAILFISH DR
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: - -
FEES:
BUILDING PERMIT FEE $72.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
I
Total Payments: $76.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Maayy 1816 12:25p Romano 9042464810 p.1
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�� BUILDING PERMIT APPLICATION- . - - .. • _. - .
-':::-)' :.:j. " CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
<I.cisti. Office: (904)247-5826 • Fax: (904)247-5845 i c-- __
Job Address: q4c,s _. ..)i-,........,(L,DPe it N�� �.X`ii Permit"Surat,-r:
Legal Descriptions -14.C) 3 Q eQ.S -7.)-ci D l 'E I � �� {'�K�
Valuation of Work(Replacement Cost)$-'SoD Heated/Cooled SF )''� Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Pr < "--Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one : commercial esidentaal-/
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application • - trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
Florida Product Approval# 1 R S L r 155s-1.4 for multiple products use product approval form
Property Owner Information
.. t � I(Tsme: YI(trot n rr ` � Address: QyS ��( •--1 • er
s1, �t (� W �S+ AL
City � !� t, ?c�ch State ',27-/
Zip 3hh-33 Phone 94‘1,-99 3•- ja y7
E-Mail
Owner or Agent ([f Agent,Power of Attorney or Agency Letter Required)
7.11. -TT.ISJG 'TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMIviENC MEj'T MAY
RESULT
ES T IN '[CUR PAYINC TWICE, FOR IMP RO` E1 vfSOOUR PROPERT :. IF YOU INTEND
TO ULFAIN FINANCING, CONSULT WITH YOUR LENDER OR Al'! ATTORNEY BEFORERFCORD1 'G YOUR NOTICE OF COMMENCEMENT.
Contractor Information:
Name of Company: r+,A..'t e �3re1h .S /°c c-rt„ Qualifying Agent: IX n Ay ie:rta,1e
. Address: I SS /rt, 21 ,s-,..,!4, F City )41 a t,L.bc•<<hState Zip 3a?3.3
Office Phone Joy -d -5'`99 Job Site/Contact Number
State Certification/Registration# (c<. ,3 a,6'i E-Mail
Architect Name &Phone#
Engineer's Name &Phone#
Worker's Compensation
Exempt 1 Insurer / Lease Employees I Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated I certffir that no work or installation has commenced
prior to the issuance ofa 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 construction or work is suspended or abandoned for a
) period of_six(6)months at any time after work is commenced I understandthatif separate permits must be secured for Electr'cal Work, Plumbing,
Signs, Wells,Pools,Furnaces,Bailers,Heaters,Tanks and Air Conditioners,etc.
--if
Signa a 1 f Property Owner xTha J i .- u C. Signature of Contractpr. '-
Beforii
this Day of ' ''te: -! -�/ Before me this Day of
Notary Pub ".7- /7. � Notary Pu tc: - '.� ,t✓
,......-
1 pt..
I hereby certify Ma i 11z%''••tad and examined t.Ti f• hca, on and l:no„•the sante to be true , r i ro!•t•ei.4 /111 ff3�J>+$! t.1•u �n ,rrl
ordinances goi�ern'no,�l`hAs'°l is of AMOER144�+! ied l 'it/i whether specified herein of 7 �,l ilkfil pe r_ fo93246
preswue to sive at►rho,'-1lJ4t tt tlCiMidali•F,POCiTb1� s ofany e t a` ' o ICbDtt
r1 } federal,al, saute, or c` attlat.{��rsrp'ltt�ii' the
.t1er•,o,nta;tce ufc•w -ter;--�,f �..: � 'p.�ti
,Pr-.r_es EXPIRES July 2.2017
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit Nil Tax Folio Nq. 1 Th ,S 6 •000
State of 1'L 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.
Le al des iption of pet i g improved: -l; J 3 - -o t
A dress of property being improved: X.11-1 S Sty, 1 t-t h L
General description of improvements:rf LQ r(-1-,C-
.
f t .vner y ___,A 4,r, , �{� 4 "t C A— Address 61 :41 T,S �_
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name---
Address
Contract , ,1 f_� ��
—4-4-7Address j" j ��,I _ '
Phone N tr\ l
`� lllill C Fax No. .,, r , _
\ 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 I Ile r j
documents may be served: Y
y N ti
Name 2 ae N
Address J 0
Phone No. Fax No. W w
In addition to himself.owner designates the following person to receive a copy of the Lienor's Notice as provided in Uco 3 cc i
St- Z
Section 713.06(2)(b).Florida Statutes.(Fill in at Owner's option). >'
Name
Address ;i`` 1 Z'_
Phone No. Fax No. �t
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
OD
THIS SPACE FOR RECORDER'S USE ONLY S' i
C:•";
' ignec r o,r t ::1:e;aj
!!CITE '( Si6 Y o ,r7-„
r Befo,'''��S i���iia this day of in the V LL N z
t •u. .f Duval.State o' I. da.ha •=rsonall appeared — a N '2
r I• `� er. f .n. I// •i herein by 2•
Doc#2016112305,OR BK 17566 Page 1461, Se.
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himself herself and affirms that all statements and declarations herein w
Number Pages: 1
are true and accurate W U) N 2
Recorded 05/'18/2016 at 01:40 PM, m
Ronnie Fussell CLERK CIRCUIT COURT DUVAL /.4(
g aCOUNTY < o wRECORDING$10.00 / i� }
otarf Public at Large. tate of 5 r.oun% •
My commission expires:
Personalty Known or y w r:o
Produced Identification �'
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