1804 Selva Grande Dr RERF19-0132 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
r � RERF19-0132
V� CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 9/23/2019
"�o;tivr ATLANTIC BEACH. FL 32233 EXPIRES: 3/21/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • '
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:
1804 SELVA GRANDE DR REROOF SHINGLE SHINGLE ROOF $17315.00
TYPE OF
ZONING: :D •
i • • '
169542 5002 SELVA TIERRA
COMPANY: ADDRESS:
ROMANO BROTHERS 155 E. Levy Road Atlantic Beach FL 32233
ROOFING, INC
•
ADDRESS:
EAKIN LAURA MCDONELL 1804 SELVA GRANDE DR ATLANTIC BEACH FL 32233-4526
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.
LIST OF . • •
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
i
r.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 4SS-0000-322-1000 0 $140.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.10
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
TOTAL: $144.10
Issued Date: 9/23/2019 1 of 2
20"''' REROOF SHINGLE PERMIT PERMIT NUMBER
RERF19-0132
r s, CITY OF ATLANTIC BEACH
8
ISSUED: 9/23/2019
00 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 3/21/2020
Issued Date:9/23/2019 2 of 2
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED GRAY
IS REQUIREE D.
Phone: (904) 247-5826 Email: Building-Dept@coab.us IR
Job Address:-1-6 I 5Jyo, ai'nd t_ d r• Permit Number: G" ` 1 ( 3 Z
Legal Description Cil "2S - a9 ; ��'/�"ci 1t.'�ti /Of L RE#
i
Valuation of Work(Replacement Cost)$ _Heated/Cooled SF �9s�Non-Heated/Cooled
• Class of Work: ❑New ❑Addition KAIteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial CIresidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes CNo
• Will trees be removed in association with proposed ro'ect? ❑Yes must submit separate Tree Removal Permit ❑No
Describe in detail the type of work to be performed:
)-) .:"cam.r,
Florida Product Approval O!dN. ^1 _ J ; f for multiple products use product approval form
Property Owner Information
Name lk"N r A, Address ,-M
City }Ic.r�•c Rr�c�. State r=1 Zip 1 33 Phone qe I//I/10
E-Mail _
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company II2-ccr•c; E"4vrS l�x�'r-�1 Qualifying Agent ',A ""
Address ISS jr-)e _4e C City Al .,.,1�c, �� tate zip 3�)33
Office Phone 4CY `3yS
6 6Job Site Contact Number //.,4A V %d -o1/7C
State Certification/Registration# C,tC /33G$9-3 E-Mail
Architect Name&Phone#
Engineers Name&Phone#
Workers Compensation Insurer w 1? L -0 ' 2 OR Exempt❑ Expiration Date ",oP �'
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
rmit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
ere may be additional permits required from other governmental entities such as water management districts,state agencies,or
so deral agencies. s (U
o CO NER'S AFFIDAVIT:1 certify that all the foregoing information is accurate and that all work will be done in compliance with all U. co
I' o plicable laws regulating construction and zoning. y°M 0 N
U)
N Eo ARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY U o N
�LE m ESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND zo 0
z°zSw O OBTAIN FINANCING CONSULT WITH YOUR LENDER ATTORNEY BEFORE
z2�w
ECO ING YOU NOTIC CO MENCEMENT.
• e
°48
(Signature of Own14
er or A t 38
( g g ) / F.�Q} (Signature of Contractor) �.
Signed and sworn toor affirmed)before me this day of Si ned and sworn to(or affirm before m this day of
s CP_r by lea,.l Cc>,- by
(Signature of Notary) (Signature of Notary)
[ ]Personally Known OR Oersonally Known OR
Kroduced Identification [ ]Produced Identification
of Identification: D11 Type of Identification:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 17245-00831
State of FL County of Duval
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.
Legal description of property being improved: 38-28 09-2S-29E SELVA TIERRA LOT 1
Address of property being improved: 1804 SELVA GRANDE DR Atlantic Beach FL 32233
General description of improvements: REROOF
owner LAURA EAKIN
Address 1804 SELVA GRANDE DR Atlantic Beach FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor ROMANO BROTHERS ROOFING INC
Address PO BOX 330337 ATLANTIC BEACH FL 32233
Phone No.904-246-5649 Fax No. 904-246-4810
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 ROMANO
Address 155 LEVY RD SUITE E ATLANTIC BEACH FL 32233
Phone No. 904-610-0476 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. ho
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a u_ o m
different date is specified): m` N
THIS SPACE FOR RECORDER'S USE ONLY NER t 9N
y O_
Signed:
ITrT l a `?
Before me this day of In the m E o
Coun of Duval.State of Flo, ,has ers mall a a E a
herein by Z o rj m
Doc#2019218751,OR BK 18940 Page 485, hims i rseif and affirms that all statements a declarations herein o 2 � x
are true and accurate Z Z$w
Number Pages: 1
Recorded 09/20/2019 02:35 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL _ —
COUNTY
gp
RECORDING $10.00 Noary Public atLarge,State oi Countyot
My commission expires:
Personally Known or
Produced Identification