930 SAILFISH DR - ROOF L`1k(----
,,-,S
�' Is. CITY OF ATLANTIC BEACH
(, , _ ;) 800 SEMINOLE ROAD
J _ AATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5814
1i
0
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-1148
Job Type: ROOF PERMIT
0 Description: RE-ROOF
Estimated Value: $5,100.00
Issue Date: 5/18/2016
Expiration Date: 11/14/2016
PROPERTY ADDRESS:
Address: 930 SAILFISH DR
RE Number: 171165-0000
PROPERTY OWNER:
Name: BROWN, DOLLY R LIFE TRUST
Address: 930 SAILFISH DR
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: - -
FEES:
BUILDING PERMIT FEE $75.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $79.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
r, 1Pj1
f � BUILDING PERMIT APPLICATION- . - - _ - - - -
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CITY OF ATLANTIC BEACH
\• 800 Seminole Road,Atlantic Beach FL 32233
Office:(904)247-5826 • Fax:(904)247-5845nn 1
1� ROC) L (4: )
Job Address: •
`1 } L ,\,-\
Permit Number:
Legal Description 3h - �.�b �j`v -�— #(`4.45 1'
Wit. -k 4
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Valuation of Work(Replacement Cost) $ i t : - ., . ooled SF
Non-Heated/Cooled
•
s.
• Class of Work(Circle one): New Addition . Iteration :•epair dve Dei Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Resi 'al
• If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A ,
• Submit a Tree Removal Permit Applicatioff ifan ees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
.-17C-4---
Florida Product Approval# I g3-1
-1 for multiple products use product approval form
Property Owner Info 'on
name ,l P t� Addr ss:
City r, --1' \)'''',.,)(-
S ta't l Zip' Phone "t5L,tki
E-Mail
Owner or Agent {1f Agent,Power of Attorney or Agency Letter Required)
.,`!A•MING TO C.`.7. ER. YOUR FAILURE TO RECORD A NOTICE OFCOMMENCEMENT MAY
RESULT EN YOUR to • z,-,.,i� TWICE FOR IMPROVEMENTS
OUR :P<!. INNG 1 .VILE , OR IMPROVEMEN,S TO YOUR PROPERTY. IF YOU INTEND'
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTI'' ECO'. .,_ -7rEivMENT.
Contracto nformatio 1 :
Name of Comp., To. ,!_ i,,�`j • • ualifying Agent: �L
Address: 1 -1—, .IP „; L►e N
ity C\' States Ziip �
Office Phone 1L\ - _ -.LJ 4 Job Site/C ntact Number
State Certification/Registration# 0 c� >G -scc.' E-Mail
Architect Name & Phone#
Engineer's Name& Phone#
Worker's Compensation
Exempt / Insurer i Lease Employees !
Expiration Date
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 laivs regulating construction in this jurisdiction.
This permit becomes null and void i , - is not commenced within six(6)months, or if constriction or-work is suspended or abandoned for a
period of six(6)months at any time a-fter .rk is commenced t zrnderstarid that separate permits must be secured for Electrical Work,Plumbing,
Signs. ells,Pools,Furnaces,Bo' , , jor,tets,-7'anksand Air Conditioners,etc.
Signature of Prop- ,O A � �r�
Befo me Signature of Conirac r.
this Da ' . -.AugBefore me . s In V1 Day of ,4 c r �(J.)
r'
Notary. •ublic: c--,- ' t._ / No-. Public: '/ ,�� It -
I hereby Certify that I' °t.+ead an d ;�+.
� Qicgnlic ion and know the__same to be true and .v'e `''t djp;-otAMi k/jOKS
ordinances govei-t i t r e F v r !r e r ,� virlr w t ` '. €,�
P fret.ter sTec:hed herein or not. 1° e ;.
r give �. t -'87 Y f r f 13321
presume to tr.tt �jgt3'r iso any other federal .s-ate or `' ' i�t9 6
C; of mance o Co?;ili? . local ltl1� a r�[jhr)�Cr + t� n
n ., f r: EXPIRES July 2.2017 -,..A6,,,?;` ' gi July 2.2oi 7
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NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit Nq-- Tax Folio No. , , 1(-47:3-000
State of r c 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
C•is u ENCEMENT.
Legal de-cription _property being,(mproved: , I- r ' � -Qg ,
wit ) ll _,,t4 ont
k I 1,
Address of property being improved: y) i I `h.....N :..
J
General description of improvements: re,m..)-f---.
rt 4 ' �wner t---- b p -„,.,
..e.Th--> Address � a
Owner's interest in site of the improvement if-NO L 1 Q 0 ftp
Fee Simple Titleholder(if other than owner)
Name
Address
.....4..._A
Contract., , t . r .& - IF_ \►� l
Address j Q iy ,�, �'
Vt r
Phone N .t`ILAFax No. lb.
, _
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:
a . ..
� No +' Oame
,:i fi .L-
R
Address l').�'
•
m:7 c
Phone No. Fax No. `'`�c �<!,
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). o X n0 D
Nameit
Z rn � m
Address irri 33
u'
Phone No. Fax No. _ __ _ _ i$ . O r
<_. ry 4k
i N T n
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a $ o
different date is specified): 3 N
THIS SPACE FOR RECORDER'S USE ONLY O
• OWNER °'
;YKs• DATE LI L Lp
iii
� B= r day in the
` . t n4.—__ C•• ty• • .,ate of II rtda.h ,- •• apps red
l p , herein by
Doc#2016101848,OR BK 17552 Page 866,
himself/ er = a • - ,tlfat ri sta e is= • •-•Jr�atidts herein
are true and accurate
Number Pages:1
Recorded 05/05/2016 at 12:25 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY :-r-------:"'-7'24'
RECORDING$10.00 Notary Public at Large.State of - , Corti 1;W/re f
My commission expires: .• _
Personally Known '. �or
Produced Identification ' ' • — i0
Dol/'e Days Bra ' -"