309 SARGO RD - ROOF 0 LAN J��
Vis , CITY OF ATLANTIC BEACH
"` J 800 SEMINOLE ROAD
,_.)\ =" 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-1704
Job Type: ROOF PERMIT
Description: re-roof
Estimated Value: $6,250.00
Issue Date: 7/29/2016
Expiration Date: 1/25/2017
PROPERTY ADDRESS:
Address: 309 SARGO RD
RE Number: 171703-0000
PROPERTY OWNER:
Name: OLSON, GUY D
Address: 309 SARGO RD
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: - -
FEES:
BUILDING PERMIT FEE $81.25
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $85.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Jul 28 16 09:27a Romano 9042464810 p.1
BUILDING PERIVET APPLICATION I
11
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax (904)247-5845
lob Address: Sart, 4'2. Permit Number:_t 10— Q-00 F- 11-0
legal 13escritpfion , IG /7.-as Wit.' kF,,,,/ o AZt14x1 Pel^ 3 -rri i!alarm
Valuation of Work s . rr Proposed Work hea of eated/cooled.Ft. �Sv�id nom heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door •
Use of existing/proposed structures) (circle one): Commercial ideatitti
LI an existing structure,is a fire sprsukler system installed?(Circle one): Yes No OP
Florida Product Approval# / SG.3 S"3Q5;
For multiple products use pro uct approval form
Describe in detail the type of work to be performed: F&rr •
•
Property Owner Information:
Name: st e\ Address: 301 -Ca 1:00 al
City 4 ! 'kA State.a_Zip 194-33 Phone (le-e. —a' 7t
E-Mail or Fax 4(Optional)
i
Contractor Information:
Company Name: 4,....0 Srci -e:s £ccj Qualifying Agent II wV. /1"-`1 4.‘"C
Address: /t /ply A.R . i City 1 et.#Ai: heat/,! State P Zip 7 r-r
Office Phone go 4 (,/o-o v7 6 I Job Site/Contact Number Fax#
State Certification/Registration# ICc.c#0Sa
Architect Name&Phone 4 i •
Engineer's Name&Phone# i
Fee Simple Title Holder Name and'Address
Bonding Company Name and Address •
Mortgage Lender Name and Address •
Application is herby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has cottunencedeprior torthlel
issuance of a permit and that ail work will be(6)months,
to meet the standards of all laws�regulating construction in thtsjurrsdictton. This pe ome er
and wk is co commenced.d. I understand that separate permitsor must be secured foott orr Electrirk is cal-Work,pended Plum1•abandoned fns,or aWells, 000ls,of=Fuu n Boile,s,Heate s,
Tanks and Air Conditianets,etc
WARNING TO OWNER: YOUR FAILUXE TO RECORD A NOTICE OF
COMMENCETAFNT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT arra
YOUR LENDERBEFOREOR AN ATTORNEY RECORDING YOUR NOTICE OF
! CONWI N�EI'
I hereby orkwillt be have complied with irhetlher=Wed harem or oand ot.ow Theegrantng of a permitdoes not ptto be true and correct. AlI�me1Qtos give autshtrty om otlate"o ancel tlhte
provisions of any other feaeral,state, orlocal law regulating construction or the performance of construction. _
I „.....„2 , 11 ,--)1"----- ,
Signature of Contractor
�rri;natlue of Owner� cP ("1;;;4
Print Name iPit Name a�t=d /�M 61�c`
_._.L�=-..r.��.--�;--�1 �--_—.'. Print Sworn t _ id subscribed bef• e r l /�e S n to d subscribed b fore me '70this •.� Day of A,, I .20 is 'Day of
_ $ ; otat� l1c C g
C'21Ty CLeIIC °`'" "°y: AMBER C HICKS °Au"` : MY AMBO B I 1-11
1 0
MY ryOMMISSICtd xFF03321s =:' 3321i;
"��`,`Pte` y,,�� \'' EXPIRES July 2.2017
'„'fa,d!:f r1CPI�ESJuly 2.2017 _---- .
Jul 2816 09:29a Romano 9042464810 p.1
T+ :w.� ' f:;;ala :ti i' �`ait, E�'
., 16rMIl ifir s
pL5PAR5 IN Duo'ICFs__; ``
Permit Nom..- Tax Folio P - -OC,(1___
State or y�_ County. V
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
CO&iMENCEMENT.
Legal description of properly being improved: ?)-/6 /7- (9_5.-99 f ,�/p of P1 of
getI eat me, NA.11J- .94 /„•t // hi it T
Andress of proper,]being lmprnv )-1 . -)1_110 en ).- 441 Deo
� General description ofimproven - .
11:144 `•.•�--:-%-v�t;.may ( "i i' 6.. I , ,,O (J Ls 041
9
--�—� Address 3 Cy .5hlie -0 /2 6 _, cJ,-= .ir It cc; rsf lZC r-, 7,-4.,, .J Pa S3
a::ners interest in site of the Improvement ,
1 Fee Simple Titleholder(if other than owner)
S
Address r -' Th r. _
Contras -f
.r Address . r3.\; • –
Phone islr Pbt- 6 Fax No_ AlaTIMIIIIM-- LI I .
Surf•(if any)
Address Amount of bond S m
Phone No. Fax No_ c
o 0
g
U u. a v
Name and address of any person rnakinc a loan for the construction of he improvements. _ * nj
Name. '-t O 3
Address N w a
?hone No_ Fax No. 1n Cr
m 2 a z
QOM ii
Name of person within the State of Florida.other than himself.designated by owner upon...Mom notices or other }
2
documents may be served:
A..)!..,Name a
Address , :16
-,..• . V'ci.' f:
Phone No. _Fax No. `"•_ ;,s`.'•••" ..-
In
In addition to himself.owner designates the following person to receives copy c;the Lienor's Notice as provided in
Section 713.0E(2){b).Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone No. Fax No.
• Expiration date of Notice of Commencement(the expiration date is one(1)year from the dale of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY C%' � :HER
Bator+meds o in'OW
wuan Dmel,si35.a Frond.ha'spxac> >a,.eare_
: _ . ` G4 (] Flo,
S d hem:by
him�if.:bars: ard atfinrs fiat all statements and dec:eretir:s herein
are tit: ---axura
Doc#2015170977,OR BK 17647 Page 2301,
Number Pages: 1
Recorded 07.26.2016 at 12:31 PM. unty.• .1
Ronnie Fussell CLERK CIRCUIT COURT Dl1VAL No04eQ1-II
1 II ' o .z�— Imo.`
COUNTY my
RECORD:NG$10.00 Pars:nalt}l(no•.T+rms .. --� or
Prodtd Ide tiliceliol (....L...1_