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670 SHERRY DR - ROOF18-0082 CITY OF ATLANTIC BEACH - 800 SEMINOLE ROAD \ V ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ROOF NON SHINGLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: ROOF18-0082 Description: FL5211.2 & FL12328.4 Estimated Value: 22920 Issue Date: 8/3/2018 Expiration Date: 1/30/2019 PROPERTY ADDRESS: Address: 670 SHERRY DR RE Number: 170398 0000 PROPERTY OWNER: Name: VAN KEKERIX JILL CHRISTA Address: 670 SHERRY DR ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: ROMANO BROTHERS ROOFING, INC Address: 155 E. Levy Road QA DANIEL JOSEPH ROMANO Atlantic Beach, FL 32233 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. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. * 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. f;I.=,;7 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) nJ 800 Seminole Road �/� r? Atlantic Beach, Florida 32233-5445 I P /¢--U a v Q L v~ Z Phone (904)247-5826 • Fax(904)247-5845 F!,J;l9r --7r E-mail: building-dept@coab.us Date routed: [ /2-op 1 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: (010 VV‘. ae Y ent review required es No ildi Applicant: O V\O_t1° 'BrO5 Planning &Zoning c �/ Tree Administrator Project: ?ec.A. JCJI�- ()P Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ❑Denied. El Not applicable (Circle one.) Comments: CBUILDIN) PLANNING &ZONING Reviewed by: r. Date: '! ? TREE ADMIN. Second Review: Approved as revised. (Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 �Y Building Permit Application OFFICEUpdated O12/8/17 j City of Atlantic Beach :_; 800 Seminole Road,Atlantic Beach,FL 32233 <--, Phone: 247-5826 Fax:(904)247-5845 RoO f ••''LO c' Q 'r Permit um P Igoogz Legal Description i L' � I L.-a C 'KLA( d12_e__. RE# 1 Valuation of Work(Replacement Cost)$,DcDfo1 Heated/Cooled SF SC' Non-Heated/Cooled • Class of Work(Circle one): New AdditionIteration Repair Mo Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial Resi entia • 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 /Descri 'n detail the type of/o`~<taligie performed: 41 Q n YDL--4-- -vLtD.-1 1 . -T•i.., vt ‘Q_ ,D. i:5.Li Florida Product Approval# for multiple products use product approval form Pro•ert Own-r nf• m•tion /� - Name: ' )t G> e_u�e( 1 V Ad. -s • _\''� /_ • i I City ua\!� State' Zip - • l� Phone ill Ili_ I r r E-Mail Owner or A:- •:-nt, Power of At . ney or Agency Letter Required) ' Contractor Informa '•n i Name of Compan•: 0 V��, c Qualify,�ng-4gent: 1 .. rr P ' n() Address �\i Wg. City �� State Zi Office Phones L,- if �� Job Site/Contact Number State Certification/RegistrationC (° I ' r)(t C6 1 BE-Mail Architect Name&Phone# Engineer's Name&Phone# Workers Compensation � S )L.Ti l' •---'1C�to Ca -i-)y I nn V.P �Lla a �y jC � -cc), I t� Exempt/Insurer/Lease Employees/Expiration Date ' I Application s hereby m taobtain a perYn7it to do the work and installations as indicated.I certify thatYto work r innssta�I1bon 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.NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and there may be additional permits required from other governmental entities such as water management districts,state agencies,or federal agencies. 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 RING YOUR/NOTICE OF COMMENCEMENT. E . ignature of Owner or Agent) ,3— (Signature of Contractor) (including contractor) Signe nd sworn to(or raaffirmed) efoie m- this day of Sign and sworn to(or affirmed bef re e this 2-day of �Y , Z0) Dby �IC`VD(A� ![A2.( clI , 26[46,by �I QL5 (VbtiPi - Y (Signature of Notary) (Signature o Notary) [ j Personally Known ORPersonally Known OR Mot roduced Identification [ J Produced Identification Type of Identification: •� Type of Identification: �� 1 zzoz/lo/zo sandx3 I4 4.M"Nts, Notary Public State of Florida 9L6L8t JD uoisslwwoC Airy Nicholas Joshua Brower iamoie enysop seloyo!N +� • My Commission GG 181978 apuold m a3EIS ollood kmoN Ate' �/..._d� Exoires o2iatnm� I . NOTICE OF COMMENCEMENT ®F F I PY J (PREPARE IN DUPLICATE) Permit No.--40,01l -Co R Tax Folio No 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. Leegaj descr pt on of prop rty kanprove, I , Lam' Address ocpre_ing improved: ` General description of improvements: Reroof Pvlt Owner 1 l V kUP f _KAddress U\D i' rr Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address Contractor Romano Brothers Roofing inc Address 155 E.Levy Rd.Atlantic Beach,FL 32233 Phone No. (904)246-5649 Fax No. Surety(if any) Address Amount of bond$ 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: Name Danny S.Romano Address 155 E.Levy Rd,Atlantic Beach,FL 32233 Phone No. (904)246-5649 Fax No. In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option). Name Address Phone No. Fax No. o a) Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a LL o Fo different date is specified): f o m THIS SPACE FOR RECORDER'S USE ONLY /y r /Pd g o * 9.1 Signed war 2..I n `8 Before a •s j/ day of in the • o_ m E o r� County o Duval.State of Florida. as p- sonatly appeared ,�c U °' therein by #201 himselri herself and affirms that all statements and declarations herein Doc 8168801 OR RK 18480 Page 190E Z Z w are true and accurate Number Pages: 1 v I 34‘. c•°4{� Recorded 07/18/2018 10:50 AM, 1.1) t RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL �- E 41,47, COUNTY • . RECORDING $10.00 Myt ommisslontexp e.Stateof • . County of /311/17 -.2 — 11:111r Personally Known or Produced Identification }