491 WHITING LN RERF17-0104 el
ts+ CITY OF ATLANTIC BEACH
0 800 SEMINOLE ROAD
:)� v ii
ATLANTIC BEACH, FL 32233
"Le A `' INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0104
Description: re-roof- FLI83551 & FL13857.4
Estimated Value: 7720
Issue Date: 9/25/2017
Expiration Date: 3/24/2018
PROPERTY ADDRESS:
Address: 491 WHITING LN
RE Number: 171432 0000
PROPERTY OWNER:
Name: CRUZ JOSUE A
Address: 491 WHITING LN
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
11 Phone:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST QA DANIEL JOSEPH ROMANO
JACKSONVILLE BEACH, FL 32250
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
I-AI' % Building Permit Application Updated 5/5/17
J ,
't'.' City of Atlantic Beach •
,�y� 800 Seminole Road,Atlantic Beach, FL 32233
�J Phone: (904) 247-5826 Fax: (904) 247-5845
Job Addres ' a41 I . , r . &_i .. . Permit Nu er: Ke�PC
ok
B -ft, 11 --c). _- 1-1 0 ty C ''''Cl_ ,,t�S A.
Legal Description `D}- l 1 I•e\ (
Valuation of Work(Replacement Cost)$--1-:\ -CD Heated/Cooled SF ,g,..C.-
Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Mo of Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
D tribe in dp.tail the type of work to be performed:
LZ tl7a
Florida Product Approval# 18355 -4111010.1 I,5�'�, ---)•1T for multiple products use product approval form
Pro•ert Owner Info 'nation f ,
Name: CSV e lX l Address: '7 A , '
iii.CitY pt State' I Zip- D Phon•,4411) j' __
E-Mail
Owner or Agent(If Agent, Power of Attorneybr Age y Letter Required) _
Contractor InfeFina '•n f i
Name of Company:• e rt.r5 .�' • (4 �M-, 11 Qualifying Agent: t aro v.f)C '1
Address 1imi '' City t i ` State • Zip J c_c�`'`v
Office Phone Ltrek Job Site/Contact Number D 1 li. • ft_
State Certification/Registration# VI a'7 • "' E-Mail G nE -_AO 1 _ a I
1
Architect Name& Phone# . 1 k .
Engineer's Name&Phone# .1 h
*lk Workers Compensation OuiI a. _
k , 1 ' — 1
Exemp Insure ease Employees/Expiration to
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOU • 'TICE OF COMMENCEMENT. fre_______________„,
•
(Si . e'. Owr r or Agent)
(Signature of Contractor)
(inclu•ing ontractor)
s-Sign % and sworn to(or . •• r th. day of Sign11ed and sworn to fibefora m: t is day of
, ( CAS, 1/ ,.. . /_
(S,s . ,u ta,/) °o,,•, (Signa'^ . .
.••'••,�. ;,.p' AMBER L HICKS
:=o. • •,�•, AMBER L HICKS
"I MY COMMISSION#FF033216 t! ,,,:a.1cr) MY COMMISSION#FF033216
• ':e►►LQ"�'` EXPIRES 2,2017
-.'• aro: EXPIRES July 2,2017 =071306... July
[ ]Persor�116 ..99Aa6H59R rlgndoNotoiyservloe.00m ]Personally Know Fioridallo;aryservlce.com
[ )Produced Identification ` ] Produced Identification
Type of Identification: _ Type of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE•
Permit --y Th
Tax Folio No. ''4�� CX
' 00
State of _ County Of { '�
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
COMMENCEMENT.
• description .f property being i • •ve.. 1 I —1 - - �,g 1---)
Address of property being improved: ( t3 \, 1 hi i 1/'1 n Lv'
Gener. 'e cription of impr,vemer �11
iiss A . .' sir .....ii, • ,�
,._
Owner StlW1.11f L .
.-
Address i ^ L ir>
O'.vner's interest in site of the improvement 1 T
„.______1 Fee Simple Titleholder(if other than owner)
-me
Addres
Y, p ^ Contra ��i1i) ' r\j
Address !��.i'
cRt
�!'� "` LLL"' 1 I '� �
Phone Noe , Fax No.
Surety(if any)
Address Amount of bond S
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida,other than himself.designated by owner upon whom notices or other
documents may be served:
Co
Name
1
N
Address N r,.-.: o
Phone No. o
Fax No.
= N
In addition to himself,owner designates the following person to receive a copy of the Lienor s Notice as provided in -1 0 R
f
Section 713.06(2)(b).Florida Statutes.(Fill in at Owners option). W -- w
Name m a
Address Q w ,°
Phone No. Fax No.
• Expiration date of Notice of Commencement(the expiration date is one(1) 'o�c......NI
,:it'
year from the date of recording unless a ;„: s
i4: t`;z;t-
different date is specified): gt�
THIS SPACE FOR RECORDER'S USE ONLY OWNER ”"'
Doc#2017210903,OR BK 18117 Page 907, Signed:"- I' 'Pr—
DATE
Number Pages:1 Before met day of In the
Recorded 09/18/2017 at 11:08 AM, Co 'o. %uvpt.S1atz ot�t. as personally appeared
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Thi err pd Lyrein �tl��-pr t 4
COUNTY �eacc a affirms that all statements and declarations herein i'
,_are-frue and acc to
RECORDING$10.00 /
4A► (
Ile=ry Public at Large. t= gi 15;;' • Qpnry of ���F�
61y commission expires: 1 1 - 1
Personally Known .—..,_ or
Produced Identification `