259 JASMINE ST ROOF PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
!9 3 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
IOB INFORMATION:
Job ID: 16-ROOF-1573
Job Type: ROOF PERMIT
Description: residential re-roof
Estimated Value: $4,645.00
Issue Date: 7/13/2016
Expiration Date: 1/9/2017
PROPERTY ADDRESS:
Address: 259 JASMINE ST
RE Number: 170861-0300
PROPERTY OWNER:
Name: GORDON ET AL, SUMMER A
Address: 259 JASMINE ST 259 JASMINE ST
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: - -
FEES:
BUILDING PERMIT FEE $73.23
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $77.23
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
Jul 13 16 10:1 la Romano 9042464810 p.1
T�Vrr:
.p BUILDING PERMIT APPLICATION
7 CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beacl FL 32233
Office:(904)247-5826 a Fax (904)247-5845
Sob Address: 11�II �j�it� � ST Autn( f)Ct1Ui PiriitlNr
Legal Description 1� - `� .� owl q4. RE t� l.�
Valuation of Work(Replacement Cost)S'+6gU S LRS$ ted/Cooled Sit `IO _Non-Heated/Cooled
a Class of Work(Circle one): New AdditiZ� Repair ove- Demo Pool WindowMwr
e Use of existing/pruposed struchur(s)(Circle one): Commercial -Emdentd
a If an existing structure,is a fire sprinkler system installed?(Circle oue): Yes No NIA
Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of Ne Tree Removal
Descdlie in detail type of work to be performed:
Florida Product Approval# C�'�( -, -- �� for multiple produm use product approval form
Property Owner Information
Name: S-J"A rZ 1, Address:
City )lp l�� Stat Zip 3zzas Phone —'�--�T
E-Mail SVMykeV' Q1(J ('61^9
OwnerorAgent 0f ver.Po .&AumnoymAerasyl,tl Raaairoll
VVAS8,I9Ii°?f> m0 07dNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT 1N YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER'Y. IF YOU INTEND
TO OBTAIN FINANCW..G CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COM\QENCEMENT.
Contractor Z forma on:
Name of Co Qual. ' g Ages . n h ( '
Address: City State Zip
Office Phone Job SitelContact Number
State CertificatioalRegistration . E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation
-MFmnpt usurer se Employ= / imuon ale
Application is hereby road¢to obmfn a permit fo do the work and imWlaGota as iMr'cated. I certify thM ro work or inslallatiw has commenced
W
to fhe issuance oJa ermit and shat al/cork wdl be performed m meet rhe amffiards ofad laws regulating mnstrucriw in Ikisjurisdia w.
This Pd. beaomef mi wid if work u not conurcnced wahix su(6)month; or ifconsbuelion err rwrk rs susoe�ed or abandoned rerr a
ppr[ad�eslix(6J monde at anY time aJ7er wdkis wmnertce2 l und¢rs(and shat separate pmmlfs mutt be seeurerljor&eCrieal honk Phwbi
rgn; t4 Poots,Furnere7 Boile>r,Heaters,Tanks aadAu Caadi[ianen,etc
Signature of PropertyOwmr: Signature of Comactor:
Before
this jDay of ) Before me[Lis Day of
p i•
Notary Pub c: GGXJ r.r �(r.r�� NotaryP ic:
l hwrfiv cerlj'y[ha!I nd It lion nd know the.some to be true a rf AI!p: 11`FI)CI49ui
ordinances governing ketiter specs fed herein or no.;+fh r�}at�'r�g q
prestore to ne au[ha �q /Mdt a o[her edaral, smtg or!o ldMi jgr" 16
erfonrtarree oJmnsn cIe`2„a-,; FJ(PIRES July2.201] ) � PIRES July 1.201]
Jul 131610:11a Romano 9042464810 p.2
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Pent NR— Tax Foba NoNo-
State of 9" Counhf a
To whom It may concern:
The undersigned hereby informs you that @epmvemena will be made to certain real prop".and in
accordance vdth Section 713 of the Florida Standee,the folawtng information Is Stated in this NOTICE OF
COMMENCEMENT. L�
L I swription 1C pe ng imPrwed:1 U ^
stress of Pro , bantg mprin ad: t
y General description of rprovanerrs:
Address � X '.Sk J 1/lP
()':mars intma:in site cm.irpmvaient_
Fee Simpla T-tdaholds,IN other than w.nar)
Nam+
;redress' 1 f,
Contra _
Add rees \' f
Phone N - l Fax No.
Surety(e.any) t
Address "mount of bond S
Phcna No. Fax No.
Name and address of any parson makatc a loan for the o nsbutben of the imri msmorbi.
Name
Address
?hone No. Fax No.
Name of person+•Alban the Sate of Florida.other then herselt designated by wmar Upon vv41om nov"S or other
documents may be Sorved:
Name $ 1V'
Add-as q
Fax No. tdfl
Phos Na. 'e.
In edW[rn ro hensali comer designates into Tglnvtrg person r rece(vea ropy of 1M Lienors Notice as provided in i
Section 713.05(2)ML Florida Starnes.(Fill N at Owners option). t
a
D
Name
Address 5 rn D
prone No. Fax No. c p r
Y =
Expimgon data of Notice of Commenwmart(de exptmion data is one iii year from the tla®o(recording Unless
diNerent data is Specified): y
TNIS SPACE FOP.RECOMEWS USE ONLY OWNER
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Recorded 07/13.201 B a.10:08 AM.
Ronnie Futrell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00
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