1301 Gladiola St roof permit CITY OF ATLANTIC BEACH
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-2818
Job Type: ROOF PERMIT
Description: re-roof 1956.1 & 13857.4
Estimated Value: $12,000.00
Issue Date: 12/16/2016
Expiration Date: 6/14/2017
PROPERTY ADDRESS:
Address: 1301 GLADIOLA ST
RE Number: 171032-0000
PROPERTY OWNER:
Name: CHEEK, EMILY
Address: 1301 GLADIOLA ST
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
,CCC1328893
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: -
FEES:
BUILDING PERMIT FEE $110.00
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $114.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODE&
Dec 16 16 12:17p Romano 9042464810 p.1
r BUILDING PERMIT APPLICATION
/J CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
/� `
Office:(904)247-5826 a Fax: (904)247-5845
Job Address: f I l'l l(,)d 01 a ...31- Permit Numbe : W-00 F —a$16'
Legal Description i )
�G .Jd I - RE#
Valuation of Work(Replacement Cc st)$ I�CL;C-• Ha,ted/Cooted SF
Non-Heat Cooled
• Class of Work(Circle one): Nm Addition Alteration`Repair MB��inO Pool Window/Door
• Use of existingtproposed stiu s)(Circle one): Commercial• /�Rnsi tie)
If an existing structure, is a fin,sprinkler system installed?(Circle one): Yes No /A
• Submit a Tree Removal Permil Application if any trees me,to be removed or Affidavit of Tree Removal
Din detail the type of work to I performed:
Florida Product Approval# . I 13 J1
Cor multiple produc ,use product eppmvel form
Property Owner Information
Name - Address:
City Ll-pz, Stat I Zip. ' 3Phone
E-Mail
GWneror Agent (Ir Agrnf,Powaof Aftao or Agency Ldmraquhrt
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMME CEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. F YOU INTEND
TO OBTAIN FINANCING, CO- SULT WITH YOUR LENDER
RECORDIOR AN ATTO NEY BEFORE
NNOTICE OF O EtetENT.
Contractor Into n•
Name of Com n '
Address:r i P Qualifying Agent:
City State
Office Phon
Job Site/Contact Number
State Certific 'on/Registration#, I -Mail
Architect Name&Phone #
Engineer's Name&Phone
Worker's Compensation
xpnpt nwsc easo :tip oYces r pvatroc ate
Applirniton ie hereby made to obtain a permit to 4 10 the»ark and itwrallad,a,,as indk,uvd. f cenily that rra,nnh, or fns lotion Fm rnmmprcad
ppow m the issuance o permit and that all un wail w performed to meet the standards o 0!1 dewy re
This permit beromes rmff aml v tfwork fan commenced xdhin six(61 months, w ff tlon o iwrk fs raspp¢.e n In Ntis iurfsdiclion.
period o afx(6 months at any time er aurkw .¢Iced. l undersvn then sepamle parmirs moat 6e seprred r El M.d w abandoned/or a
Sgas.. Wells,Pooty,Pstrnaeea,Bal(¢ Heaters, erchs andAir Condtiioners,etc kal Work,Plumbing,
signature of erty
Before me Signature of Contractor:
Flus 1 D f _ 1
Be£ore me Day of 1
Notary blit- -> ,
- NouayP blit:
!�..,� w
Thereby carJrfy[h 6da§ �}11eda�n 1 IAi.�A Lica on andknoly the sarxeto he trarea .010
�-I. (t nr ,M�)BER tCKS
adiaances govern .t d+ b aoNiaa81 gBhq,=, Nr whether spedjr'ed herein 01 nu �+ "t 16
prestrrne to gree ar ,[•iolatt p� gcyl l prwsw s aj any other federal,st��e•or to t •at4� Cf��trS
performance of co sf rMahn ad1pR DPThe
Dec 161612:17p Romano 9042464810 p.4
,SLr:J"2' `.-.si
PatM. N. .'+i=SFV VIP�jcAr.
Tax FnU,Nc. I
Codmy of
ionhom itmayconcem: I . -
The
acWrdansewAh netl hereby in7onn-5 you the,Mprovemen3 will ba made m c�taip roal
Co."WENCEtAEN'�don 713 of the Flodda Statutes,the'"'MfoliWill
Ingo
8 mnaon A,Sta need
add In
da dptlona _ O1t10E OF
p� nom° i a
Address 'propyy' Na� '
'!mproved,
i
GgnSmddimcsipyon eimp,,,mens:
epi Y �,
�msr !
Address
OemysinxrEst is its Oi:!lo-impronanront
Fes Simge Tiddial erfdathalytan oemry
Nam e
Conaacrgr<,
Adtlrase Sa— `E (r 1 r1G
Suffitj Of mylL. � FAX No. t
Addra==
PmmeNa Amount aflwntl3
Fa:Nc.
i7ems enc addrega ofanYFarson ma,',i Nan- ^9 a loan mrma mnsm tion of .ImProiamams.
Address ,
PnME Y!O.
Fax Nc.
Name a pargop"4gen 2ha3tete of FIC'
doGlmania rrroy be served: I£tles"gnB!ada m'nlW UPna Yllbm ndticesa ' i y/•,;.`b
Name
Address '
Phone N, ;
Fax No. yy
In adcydon m hansdf,m no. ' o Q O 3
aesiarees. tiro m➢n.�nj2 oEryan m 2CBiYE a
Sacdon 713.0612)NA Plodda Slafums.(Fr➢in at Ovn</s op3an). �DY Atha Uenofs Notics as !yr qm vi
a
Name
Address v _
M
PnorxNo. g o 'r x
FmrFla_ 3 C. yg, N
EXP;W40n dale W Nadce mCM R
d1lfErant date isp:cifiEdy m2nM dphE ammini, Gane1 °i
I )Yaxraiom Its data of recmdi itt s
TNIS APACE POP,P.ECDROER'S USE ORLY 1 45
_ OVSRiER
1
DOC az0tages:I ,OR8KIT.67 Pape
Number Pages: 504, 6Na np� 2ro p.e AG
r[ Sass wam r
Orro
Faell CLERK CIRCUIT COURT OUVAL
Cxa ims y...a"s'� $"'ms�°'mslnamamsaeaesh ays;anayo t"T
COUNUN TY w
RECORDING$10.'v0
r. aces -aft, c
elYsmormsannaryrec
=enrmyxasun
-ratan es:a:a...w
' I