1841 Selva Grande Dr RERF19-0146 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0146
,� ISSUED: 10/25/2019
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233 EXPIRES: 4/22/2020
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:
1841 SELVA GRANDE DR REROOF SHINGLE SHINGLE ROOF $15375.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169542 5032 SELVA TIERRA
COMPANY: ADDRESS: CITY: STATE: i ZIP:
ROMANO BROTHERS
ROOFING, INC 155 E. Levy Road Atlantic Beach FL 32233
OWNER: ADDRESS: ZIP:
LOCKLAIR MATTHEW R 1841 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.
a. : LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455 0000 322-1000 0 $130.00
STATE DBPR SURCHARGE 455 0000-208-0700 0 52.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$134.00
Issued Date: 10/25/2019 1 of 2
r`',,vir.),, REROOF SHINGLE PERMIT PERMIT NUMBER
=-�'s� :.. RERF19-0146
�1,r s,, CITY OF ATLANTIC BEACH
�� 800 SEMINOLE ROAD ISSUED: 10/25/2019
`wO';"r ATLANTIC BEACH, FL 32233 EXPIRES: 4/22/2020
Issued Date: 10/25/2019 2 of 2
;t''f=,% Updated tE'C�1� )Building Permit Application /�. 18
.lJCity of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
`ni19)- Phone: (904) 247-5826 Fax: (904)247-5845 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: I8 ti/ SC/c/". Gf q C el r'. Permit Number: R IER I" I� UV4 G2
?R
Legal Description -L2 coco-,2S 'a /'9 -S I'- 7'<(/'u. /al- /t RE# I LAIN-L9-- " 43-
Valuation of Work(Replacement Cost)$..."/.37.5— Heated/Cooled SF St Non-Heated/Cooled
• Class of Work: ❑New DAddition alteration ❑Repair [Wove DDemo DPool OWindow/Door
• Use of existing/proposed structure(s): DCommercial ✓E esidential
• If an existing structure,is a fire sprinkler system installed?: ®Yes Palo
• Will tree(s)be removed in association with proposed project?LIYes(must submit separate Tree Removal Permit) IJNo
Describe in detail the type of work to be performed: C I
Florida Product Approval#'_ /D/d ii. / ` .1. 1,D.ag.L' for multiple products use product approval form
Property Owner Information
Name M..•1' t /rXI " -' y;- Address / i// St/g./ g(A.--a( Sr'
City ,•+j.te.1-t'c &u.i-/i State P Zip 3) Phone `ka y—c/o---61/76
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) n/a
Contractor Information
Romano Brother Roofing Inc. Daniel Romano
Name of Company Qualifying Agent
Address 155 E Levy Hd. City Atlantic Beach State FL Zip 32233
Office Phone (900246 5649 Job Site Contact Number
State Certification/Registration# ( C C 13288Y3 E-Mail romanobrothersrooting@gmail.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer WBS WC 90-00-818-06 OR Exempt❑ Expiration Date Exp. 12/31/p
411
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. j
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all s 41 V o
S
applicable laws regulating construction and zoning. o m o
d ON
•ARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY y=ON
sm SULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND -,9 o Eo
'am-N ►• OBTAIN Fl ` • NG, CONS WITH YOUR LENDE AN 2 07. -ATTORNEY BEFORE � �e.
�_'_� ' CORD /I
••I.•_ 1! COMMENCEMENT. zZ2W
�.NN \
Zoom C ignature of Owner or Agent) (Signature of Contractor) .
03LU,
OP
Z Z W
Signed and sworn to(or affirmed)n, before me this day of Si_ ned and sworn to(or affirme before met is 23 day of
'"� t uck- .r, �1C1,by 1 j`-et_Ri.J (6 la(f — 6, ZD 141 ,by UAA V`.0-4Aa.
d
.fe Signature of Notary) (S ure of Notary)
[ ]Personally Known OR Versonally Known OR
gProduced Identification [ ]Produced Identification
Type of Identification: - Type of Identification:
NOTICE OF COMMENCEMENT
PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 169542-5032
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 16
Address of property being improved: 1841 SELVA GRANDE DR Unit Atlantic Beach FL 32233
General description of improvements: REROOF
Owner Matthew Locklair
Address 1841 SELVA GRANDE DR Unit 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. 90461040476 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.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY • ° a
Signed: i/ ^DA , I�' 1/// L N
Before e thi .`A.' d1
day of E , . OLD / in p ,�o
Cou f Duv)a1.State of Flop.has personal)y apppearedd 3 N
pjrH cy�/ rid Le L/� (•..// herein by 3 y E13- O
himself herself and affirms that all statements and declarations herein Zoo
Doc#2019245646,OR BK 18979 Paga 483,
are true and accurate t
Number Pages:1
Recorded 10/24/2019 10:40 AM, z Z Se w
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL __. •
COUNTY
RECORDING $10.00 •• -• Public at Large.State of t . County of aarC..k
My commission expires: - - •
Personally Known or
Produced Identification `f