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30 W DUTTON ISLAND RD RERF19-0005 SHINGLE ROOF REROOF SHINGLE PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH RERF19-0005 800 SEMINOLE ROAD ISSUED: 1/9/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 7/8/2019 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. 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. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 390 W DUTTON ISLAND RD REROOF SHINGLE SHINGLE ROOF $5500.00 TYPE OF CONSTRUCTION: GROUP: 1723410000 LEWIS S/D ADDRESS: ROMANO BROTHERS ROOFING, INC 155 E. Levy Road Atlantic Beach FL 32233 • ADDRESS: ' CHURCH OF THE LIVING GOD PILLAR & GROUND OF C/O MEHARRY H LEWIS TUSKEGEE AL 36083-0384 TH E TR WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR 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. CONDITIONSLIST OF Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $80.00 STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00 TOTAL: $84.00 Issued Date: 1/9/2019 1 of 2 Building Permit Application Updated 10/9/18 f, City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904)247-5826 Fax: (904)247-5845 ail: Building-Dept@coab..us IS REQUIRED.. Job Address: ��° 17wJ�Cn Z1 - Permit Number: PC—,P\1`—(q — OwS Legal Description -iXi'4O) 17-as"$t ,fib t .yv /o' y S dk RE# /7a)34J+ —bOcj O Valuation of Work(Replacement Cost) "O Heated/Cooled SF 91400 Non-Heated/Cooled • ClassofWork: ❑New ❑Addition 441teration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): QCommercial ✓aesidential • If an existing structure,is afire sprinkler system installed?: DYes ❑No • Will trees be removed in association with proposed roiect? es must submit separate Tree Removal Permit ❑✓No Describe in detail the type of work to be performed: Florida Product Approval# CA W. l TWO,VI S3;)- or multiple products use product approval form Property Owner Information o� Name 6�► ,,Ck O-r +ke- I1v ' 4 Address C� D"4,4, City A)l a,k,4_ 90E-Ch A`- State F/ Zip 37 Phone 10 Y-3 q E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) n/a Contractor Information Name of y QualifyinAgent Company Romano Brother Roofing Inc. Daniel Romano p g Address 155 E Levy Hd City Atlantic Beac State Zip Office Phone (904)246-5649 Job Site Contact Number State Certification/Registration# E-Mail romanobrothersroo ing gmail.com Architect Name&Phone# Engineer's Name&Phone# WBS WC 90-0081806 Workers Compensation Insurer - - OR Exempt❑ Expiration Date Exp. 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 regulating 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. NTNG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY [,mR E LT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN4of � 0BTAIN FINANCING, CONSULT WITH YOUR LENDER RAN ATTORNEY BEFORE7 DING YOUR NOTI OF COMMENCEMENT. zmN (Signature of Owner or Agent) (Signature of Contractor) vNi ed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)be ore me this 9 �„w an )4 by �a/1 �� by m o�g nature of Notary) (Signature of Notary) a4CD ]Personally Known OR personally Known OR Produced Identificatim [ ]Produced Identification Type of Identification: (_ ,4 Type of Identification: a v � 017 CSO 1►' 'cm-'�a-VT i - (PREPARE IM DUPLICATE) pett'f'iit No. state of FI Tax Falio;tae. /7dj q/ OountyO7.��i+..rr.. r ) �Q in3idu d EE r3 0mcam; Yflee s rrder�) © taeraoi�!'ilfor 75 y9L'di3HE 9 kprorst M0y%a t4U))9 he Made a rar Fra>To�i Ami ty,at 3 )? eeoar6as�ce r�i83��a:sti®rr?13 of the F+la rld Rimes.-dza fri)JOWIng iw5�»►aQi®�is�d i�i37'se N��fl��n F®i{ltf MCL--fllaEWT. Legal description O property being iMlMved: alk 2 s •a�_ .a�� / s i�� Address oS tar a. yy L-eing)rrrpraueci: fill D4 441 a'se;9�eri desseripLjo i Of imprelrements:Pierooi Owner C)eu7ter`s iriiarest in siL?of Me improvemen,- Fee Simple i iiieh®)der(if other than owner) Name t Address I COWLMOtor ft-a-M Brauer i2ooing ine f Address 1-15°1 r euya?d.tLanUr Beate.1 3?233 Phone No.(904)24S-5649 Surety(if arty) Pa"No. Address Phone No. Amount of bane)e Fax No. Name aild add'-ass Of aryPersOri raking 2 loan ftrhi e t CrriSG73CtlrJ7i 0r1h8 T3fr Name Address [ Phone N0. V7 Fax NO- m3Zz Name of Person-Within the&We o7 F)arids,other than hinisei€,designatcd by Owner upon Whom notim-s or other dOCUigiEYrty-mEy iS�served: 0 Dartny3.Romano 0 N g nlcliTta Yn o n Is5 13.L S• ul Address Itd,Ati?.mac Bw, ,�E 32233 9 (9119)2�M ! w C)phone No. - S Fax No. in addi8on to hirnstslf,owner desigrlatt:s tiie Fol{o,Lj=rrr 00 G-oct)cr1 7,13-06(2)(b),Florida Statutes.(Fill in at ow er5 Optione�ive a Copy of the Liencsr's Notice as Provided in � Name Address Phone No_ t Fax No. ftlwauorl date 8f Noerca 10MOMM11cament different dare is spec-iFred): (the errpiratiorr date is a9fle(i}year it om the date orf rewrding trnte�s a TH98 WAGE FOR€ECORDER%USE i�bt3i•� �'ASY Co' �,y MOD Z BsF r ne iris OAYF 0 3(A c Caw�iy�P19 a1.ita fl da.has FSflaa]I N 3 Q [gip (a Lite o W o 0 'ily Yappau5.0 iilrit9smneretrand<fdmts titai all snF Foments i tt dec arstiorisEPe �by o'c m Doc#2019006969,OR BK 18653 Page 2284, -refPue�idarxuare N Number Pages:1 m o Recorded 01/09/2019 12:41 PM, ""+� F o RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL m 2. COUNTY c RECORDING $10.00 °�YP1tBt °wry iffy comrr�sslo»Ares: ParsanallyFtnc.:,�_ Pr -12Idcn9&iptlor