71 W 10th 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-2820
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated Value: $4,950.00
Issue Date: 12/16/2016
Expiration Date: 6/14/2017
PROPERTY ADDRESS:
Address: 71 W 10TH ST
RE Number. 170811-0000
PROPERTY OWNER:
Name: WHITFIELD, LYNE MELISSA
Address: 71 W 10TH ST
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
CCC1329893
Address: 1188 N 12TH ST CIA DANIEL JOSEPH ROMANO
Phone: -
FEES:
BUILDING PERMIT FEE $74.75
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $78.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Dec 161601:27p Romano 9042464610 p.1
BUILDING PERIVIIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beacb,FL 32233
Office (904) 247-5826 Fax (904)247-5845.
Job Address: 71 u; iG"1} 1^ SJ-. j'ermit�Np�mber-
LeWDeseription�y 3k4 JS 34 F_ : ei3 1¢�aw}.'c eTr." jars l r.ra
n Jy I ot— sq.Ft. Parcel'}Sq
ki
Valuation of Work$ e/Y 5 0 Proposed Work heatetUcooled fti S, non-hoite&comled
Class of Work(circle one): Nei Addition Alroration epair Move Demolition poolkspa window/door
Use ofexistingt=strueture(Is)[cercieone): Commercial Rest "
If an testing s r¢.is a fire rm system installed?(Circle one : es No -
Florida Product Approval# ��/s C. 3 �S
For multiple products use pro pieI r approveform
Describe is detail the type of work to be performed: Baa
Property Owner Information:
Name: A1rl K.tn jpl= P Lr Add,Css 7Y j !t
City A+I 170, i State/=/ Zip gita Phone - 5,
E-Mail or Fax#(Optional I
Contractor Wormati ia-
CompanyName: /20 /3ra,N..rt /1.°- Quah . gAgent: nrK ,»an-J
Address: City % t 4 ;A? Zip 39"XII
Office Phone �c - _r.-o I , Job Sity�o tact Number
Stets Certificmion/ltegislration'-i 1CG 1�3Sfl`I' ,
Architect Name&Phone+
Engiuoer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Addi ess
Mortgage Lender Name and Adthe is -
Applications hereby made to obain a P 't to do the work and butallmiom as indicated I terrify that no work or cru :on hw comme n:ed pria'to the
haI,ortce%apeme and thx,,Il work wif perforamdtomeet Nr rtandard.¢ofad Lmvms repegalating eonstraeaon in rods" 'ox Z7da permit becomevaall
and void llwwk is not eamnwnced wither P madtu,or tfcavmtcnon arwork is sal Wo�Pr ab., •ionadjor a elG,ekw, ofra f6)mwQhr a Healers
wa#is eonnn¢need f mrdnstand tnat arae ermva mart 6e seamed fa EleetrFc
ttrnlsnndAlr Candtdonew,eta
WARNING T® OWNER: YOUR FAILURE TO RECORD A N TILE OF
CON IENCEA5EN T MAY RESULT IN YOUR PAYING TWICE FOR ROV T NTS
TO YOUR.PROPERTY IF YOU INTEND TO OBTAIN FINANCING NSULWITH
YOUR LENDER O AN ATTORNEYOMI B FORE RECORDING YO NOTICE OF
ni d.
fharvbyorkwNlarl lraoeread end eraet Nris.apltcat/we and know the same to benneanit does not
prem+sf01--A
ns yr and ordinwwer Bar¢ »S
We.00lf.work will be cootpfeed wnh whet!!er ¢d herein a na. The gmming gio perms doe*rsot presanre to aufhwiry to vialote or cancel th
pronrtonr ofany otherfademl.state.or 11 Cal regalattn8cmu ,ucilon OP the performance ofconsmicam-
Signature of Owner " r^ SignammofCortractor
PrintN
t me • r, �M N.•� C
o� subs Cott I� morn el> sub i fo�' le
this .y of - / o
rn_ L / y
Public r r.. AMBER L HICKS (! �`^ A iL HI
y - �� Myco
1.1 gip..^7 My0oMMISSIONMFFo3S21a M� 9
\�:."y".�f EXPIFESouly22019 ^. E%PI 'Jaly 2.2011
Dec 161601:27p Romano 9042464810 p.2
L•�i1rY'&1c'L:::i 'c'i:� w•G��dF��'':t'L.`$ai F?A�a I
PertnS Wt�-. Rr�4.:iL at Mj�Jc:.12:�
State of k > TeK Fallo Nc
Courfy
7o whom mail concern:
77%undersigned hanaby informs You that ImProvemants x911 be matle m cenai n real
COMM arca MM SecUan 713 of Um goNda 9tatote;the Yollarvin9 inTotmarlon ti
C aftardanCEWEil S, antl in
stasad In this CT7CE OF
Lsgal descrpY,'lon of m - I
,T P Ptry being lmpmveQ _
Addms9 11prq)sry
3 b.a(n9 pa : e3a
STfLeer rP•2.,¢t,r;c. cty_F�
Geoarel daacdpdm dimptoreme------ a Dnd=
G
•�i f}j ti-�rmtr "
Adtlras
P. .,�, .
vnxsin'srsa,:n sin:orna irymvamam
' ,a Simple T tlaholdw Iff rho^t nomarPlan a••merJ
NameContra
Address
4 9fl-/9T4tly� � 9 r
Adarest ' Dir - ,
Ffiona N�r-, `L1` fST-
I -'1i
Surety(it any)l Fax No. >4
Acdrae;
phone ft. moron c7bond a
]'to.
(•tune and addre oorenY Garso�•rgyng afo
ararGrind
COnaaUCaan of the Im
MoxmenR.
•iuPoreis '
phone Nm
Jaz No.
from"otparenn 1.41nan the Soon,of Fladda,
aors mail ho11t°rgren former,"2—.td by a:rnarupon eam .....9noae
mant4 e aerYed: dlar �
Nems 5y
Address Y Mo 0
Phone Kb. ! L) K H g
Fax uo., = ZZ T a
7n eea6lon fo hlma±Ni,a:.ner designates the rmb-Ang parson to revive a copy of the
SecgLltnoYs,VAlba 0
pn 713'06 2)@I.Flodde a2tmes.(1`111 In at p11 N
A dad sn p] -• 9i
Manor '9
O;'rnxfso on;. ii
AtlWess >
'Fano Na 2
Fail Na
Exp:raiian dee - lti4"�e"•'Z.
alderalttlam is ap Mu}iCmrsnenLtmam pb"axp'ea'Jm dots isaMe(1JYoarfmmae dffiem,wrdIrg bse \'Z
i Ii I3 SPACL•FOR RECORDER'S USE ONLY
o vn et
Number Wes:1 ,JR BK 1752 ?age 15W, 1i r
Number Paaes:1 ""Fara-ee.a aweJo 2r.y
Romwe uooeiC 016 CLERK
IRC PM. ��*^mo .snNe;FU[ys h�Fe.+maNeanasise ,
Ronne Fussell CLERK CIRCUIT COURT OUVAL N—��—vim " h
a'Eme LtEeOa& t!✓
COUNTY wazm ,t11n"ra®dA«I'eRnmsasam
RECORDING$1000 1 :i
rca _
..h .Barn_ Sas Stlk C-Ay ( A
?irsa„yyKn6i:n$iea:
)+aauun L'e yIXf1'sa tt I
I
q ste ss3 65 �= I