860 Amberjack Ln re-roof permit ITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERN IT
MUST CALL BY 4PM FOR NEXT DAY NSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ROOF-3166
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated value: $7,200.00
Issue Date: 2/3/2017
Expiration Date: 8/2/2017 _
PROPERTY ADDRESS:
Address: 860 AMBERJACK LN
RE Number: 171145-0000
PROPERTY OWNER:
Name: WALTON, NEOMI L & EUGENE,
Address: 860 AMBERJACK L
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
,CCC1328893
Address: 1188 N 12TH ST Qjk DANIEL JOSEPH ROMANO
Phone: -
FEES:
BUILDING PERMIT FEE $86.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $90.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL MY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERhUT APPLICATION
CITY OF ATL IC BEACH
800 Seminole Road,Atlardic Beach,FL 32233
Office (904)247-5826 Fax(904)247-5845
t, dPermitNamber:
D a tion ' t�zParcel# 1
t
Valuation of Work$ —)Z) UI Proposed Work hea ed/cooled I.;,- _ Boa-heated /woled
Class of Work(circle one): Yelly� Addition / 1°+Ome 'R "mon poolfspa window/door
U o£e�aiing/proppoossed strocta ts)((�arcle one): Comm �Restdeaml�
Y£an eafsting stractnrq s a n s rmkler system mYt9llp�. (C a one): Yes No N/A
Florida Product Approval# I 1 t'1 J� . 3�rj1 .
For multiple products ase pron, approoro -
Describe in detail the type of work to be performed: - t E
r •Inf rmasian: e�
Name. r rv. t \Y? O✓1
City 2; one
E-I%W or Fax#(Optional)
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Company Nam . ✓' eIAB° t S _•Zip
Address: 1 ity
b N Fax#
Office Phone
State Certification/Regishation%
Architect Name&Phone
Engineer's Name&Phone#
Fee Simple Title Holder Name andlAddmms
Bonding Company Name and Add>ess
Mortgage Lender Name and Address
me s the
consbvanaa m thtsJvrisdicriort iTG Penntt becomes null
Applicvtion u/wreby made to obtain a peter m do rhe work and insmllmimle irdimted I cerdjy that ro work or instdladon has P
fanlance oja permtt and that afl work ural!beperjorrned to meetNe stanem'ds all hues reguladag ' Poohg uraaea.Banal,Homers,
asuance jwork is not commenced"I'=dX(6)mambo.or rf'mrutmcnan ort ork is..nuPeWan dPlnntbt n fam,alYrltrPWIS a mantha ar at"nme ajer
or lean
workis commenced I mlderaand tltm repmme permits must 6e secured f
'. 7trnla,m1Air Condldonms,etc
WARNTL Nuy O OWNER: YOUR F URE TO RECORD A NOTICE OF
TO1,XOi R PROPER1Il� YLF YOULIN IIN YOX It E O OBT�G FINANCING CONSULT WITH
YOUR LENDER OR AN ATTO®NIiVY i FORE R II,CORDING Yr NOTICE OF
this
u does not xsvm age, Mrity to tddme the
fM1eopere6Y certify rbmlhoe read and examined tics plieryinand ol. diesmeto0 true mrd cdmwe All pr tore ! vs an
work will be complied wah tvhetha.spit ted hereh t ton a t e p FFyorman�afem strucam
piivw'sime ojany odrer federal,state,or local law reg-Lniag
Signature of Signa Co
Owne
Print Name — -Sw o1�
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AMBER L HICKS e• rev corn
MV COMMISSIONAFF,n216 �p a EXPIRES July 22017
�aaM16y 1EXPIRES July 2.2017
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To whom it may concern:
Tile undersigned hereby Informs you that improvelmenk will be made to certain mat property,and In
accordance With Section 713 of the Florida SUMM",the following information Is stated in this NOTICE OF
COMMENCEMENT. J
legal escripean of property being improved:
,
Address of property being Improved: n lry O XFrn Rn2 �9Ue� LAS
Gemara!description oflmprovements: iL.efC_C bd-� W1"j-1'} -M/&�
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Address Nf e,(L K Lr��.� A i✓17L ✓Se f•+ �L�1?3�
0%mer's Interest in site of the improvement 1^�o11 X12
Fee Simple Titleholder('d other than ovmer)
Name
�. Atltlress
CanAd
Address
Phone N� Fax No.
Surely(if env)
Address Amount of bond 5
Phone No. Fax Mo.
Mama antl address of any person masking a loan forma construction of the Improvemanfs. -
Neme &
Address y c
U u T?hone No. Fax No. _ 22�
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Name of person hdmin the State of Florida,Omer than himseH,designated by owner upon whom notices w other
y
documents may be served: m rc yas
Name O x §
Q u w e
Address
Phone No. Fax No. • ':'-; r1
In addition k himself,owner designates the folloviing penman to receive a copy of the Lienors Notice as oroVidatl ill (a tl
> Section 713.06(2)(b).Florida Statutes.(FlII in at Uvnefs option).
a Name
w Address , .
a 0 Phone No. Fax No.
Expkaton tlak of Notice of Cammencemeit(the expiration date le one(1)yearfrom the date of re=Mhv unless a
di w different date is specified):
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k 8 TRIS SPACE FOR-RECORDER'S USE ONLY 10 1�
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