211 Pine St roof & truss permit I�L`l
CITY OF ATLANTIC BEACH
11� 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-2772
Job Type: ROOF PERMIT
Description: RE-ROOF AND REBUILD 2 x 6 TRUSSES & BEAM,
REPLACE SHEATHING
Estimated Value: $9,000.00
Issue Date: 12/12/2016
Expiration Date: 6/10/2017
PROPERTY ADDRESS:
Address: 211 PINE ST
RE Number: 170564-0010
PROPERTY OWNER:
Name: ALLAN, GEORGE G & LINDA L, '
Address: 211 PINE ST
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
,CCC1328893
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
Phone: -
FEES:
PLAN CHECK FEES $47.50
BUILDING PERMIT FEE $95.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
WORK W/O PERMIT BUILDING $95.00
Total Payments: $241.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax (904)247-5845 _ 1�m�OF - Z-7 7?—
Job Address: I Permit Number.
Legal Description e-/e - if Sec 3 /efS36 parcel#
Valuation of Work S 4000 Proposed Work heat d/cooled 97i# non-heated/cooled
Class of Work(circle one): Nvv Addition Alteration Repair Move Demolition pool/spa window/door
Use of
ease ' pppsed straetu a Wrcle one): Commercial
eIfanexistinstrnre,isafires mr system installed?(Circle one): N/A
Florida Product Approval# .3 r3 s-/
For multiple products use pro a approv orm
Describe in detail the type of work to be performed: 2 nd f- d" p.e 1iw^l IdI F 1.24 2,4w - ,53~ k
AS #f, IA LOU f, O 1 ,0 r.XNN't
Proeerty Owner Information:
Name: !a/"nn Address:,?// /he 9f
City A L SmM6L p -T2j3i Phone er 3468t1LAC
&Mail or Fax 9(Optional)
Contractor Information:
Company Name: omr.a A.Pfr. Qualifying Agent: Ar State P
Address: o city
�/ Zi ?3�J�
Office Phone 9rY -�4f-Stv9 Job Site/Contact Number
State Certification/Registration# O 9
Architect Name&Phone 9
Engineer's Name&Phone ii
Fee Simple Tide Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Addre$s
hae
the
uspualnce+faPernereiit amidst wi all�votrkv a aromdio rn ee�J>'e�ttadv ofalf lmrsu respegid cnHnB cohirzwctiwonint/rp0irru�icd�:cno1ermp ntt be oomu�anH}er
oral void t (vork+t not commenced within 6�mamhs, or ijcoraH'ncHmr orwmk is sal Work,Ptu l j»atVdla Pools Furnaces,access,Heaters,
work is commenced I wrderrtmul that s ate Pemrits must be secured for Electrical
Tantrs arafAir Condi6aners,etc
WARNING T OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT Y RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
YOUR PROPER IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
TO
YOUR LENDER OR AN ATTORNEY� EN�RRREECORDING YO'IJR NOTICE OF
f her�(�v certify that f have read and esu red thts app/iraHort and know Hre sm�to be tore aad correct All provisions oflmvs and ardinm+css8ovenan this
We of work will be complied m+rh whet spac+Ped>'�+n mn�rfof an ojcoratrunerton me to give authority m vitiate or mmol the
pravrnons ofarry wharjedeled state,orf Iaw mgWattiins a st
Signature of Owner Signature of Contractor
Print Lam. 1J(is-'. Print e
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To whom It mal concern:
Tile undersigned hamby Informs you that Improvemama\Viii be made to certain real ro e
COMMENCE With Section 713 of me Flotlda Stahnea,;he following Information is stated In this NOTICE OF
COMMENCEMENT. P P rty,and in
Legal des p"m of pmpe ny byng inio.ad:
Address CIPropeny being impmV d.-
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Caneal tlasedpnon of Morovammts_g a.j
Addressll
Own.'imars3"M and orthe finmema_
Fse SimPle Titleholder(f otho tha m.r ,I
Names
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Phone No. tint of bond$
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Fax No.
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dacum_y 5may be served: tlby miner upon tom notices or tithe! '�
Name L':;k�iPhone Nb. Fax NaIn addition to h,lsaf.ownertlesignatesthenDparson to acflve a Copy otthe Lienors NWoe as wovidedM Saodon 713A6(2j @).Florida Statutes.(RDInatOmelsoPadn;.Name
Addass •`c i =
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Phone No. Fax N. c T 0
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Expiation date of Notice ofConnam etnam(tiff expireiron data a one 'm
different date is spec79ed): til Yaarfrom me data of acordtng unless a
THIS SPACE FOR RECOROER•S USE ONLY
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Doc 1112016283022,OR BK 17807 Page 956, u°"tu P"a dzFinmsat.n siwna casamdmtlenh ._
Number Pages:1 w
Recorded 12/12/20/6 at 03:53 PM,
Ronnie Fussell CLERK CIRCUIT COURT OUVAL
COUNTY
RECOROING$10.00 f?n catLaEa N-b i p�avy
Camnsstenercrss