Permit Firewall 1079 Atlantic Blvd Unit 1 & 2 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
R
Application Number . . . . . 12-00001218 Date 9/28/12
Property Address . . . . . . 1079 ATLANTIC BLVD
Tenant nbr, name . . . . . . UNIT 1 & 2
Application type description COMMERCIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1000
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Application desc
2hr rated wall
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Owner Contractor
------------------------ ------------------------
HARBOUR PLACE PROFESSIONAL RADON PROFESSIONAL SERVICES
PARK COMPANY 336 14TH AVENUE NORTH
13133 PROFESSIONAL DR STE 100 JAX BEACH FL 32250
JACKSONVILLE FL 32225 (904) 246-8970
--- Structure Information 000 000 2 HR FIREWALL
Occupancy Type . . . . . . RESIDENTIAL
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Permit . . . . . . COMMERCIAL ALTERATION/OTHER
Additional desc . .
Permit Fee . . . . 69 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 1000
Expiration Date . . 3/27/13
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Special Notes and Comments
PER MIKE GRIFFIN NO FIRE REVIEW
REQUIRED
2010 FLORIDA BUILDING CODE, FLORIDA FIRE PREVENTION CODE
2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 69 . 00 69 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 73 . 00 73 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BuILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH @
ILE COPY 800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904) 247-5845 SEP
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Job Address: 10 7 1 A f I A-Aj Z /'7>Vk, Sk- I + 7-- Permit N o
It"t-E-
Legal Description b T)eCA4f0_4_j /L#q_Aj Parcel# 19) -77 q i (a)o
-Ax-ea of -- Sq.Ft.
7 Floor, Sq Ft
'� 3 on-heated/cooled
Valuation of Work S 3 8 Proposed Work heated/cooled-, Y17— n
Class of Work(circle one): New Addition Iteratio Repair Move Demolition pool/spa window/door
Ei�,
Use of existing/proposed structure(s) ircle one):. t ornmercia Residentiai----,
ste
If an existing structure,is a fire spriWer sys em ins �a�. irc e one): Yes
Florida Product Approval #
For multiple products use product approval Morm
Describe in detail the type of work to be performed: h s tg=�L
!>N i Agj_ 1,A )2 Q c 2- L4 -W�,tt
Proper-ty-owner Information:
Name: 1� A-10 0 u-ce. ate-. PfD � P&JtAddress: 1-3 13 Rb -e 5 S f-(P- 19 0
city —State--XZip phone Qm 5� — 2 72,0 — �Oki
E-Mail or Fax (C;ptional)
ContractoE Information: 121,0
Company Name: 90-"0 em Qualif�ing Agent: D - —
Address: �3(g &-_�� 4ve City--JA_,�r, �9r_J4 —State-4�_' zip32zsz
Office Phone 11�o y-2. 4-4 - 9 170 .Job Site/Contact Number c(Dy- ZLt 6 - F4q 77,o Fax# '�b V - 2-Y 3 V(o
State Certification/Registration 05 -7 -7 9 3
Architect Name&Phone#
Engineer's Name& Phone 4
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage 4ender Name and Address
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 tothe
issuance at all work will he per
0 wi-mit and th . formed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
and void ifl�allrk is not commenced within six(6)months, or ifconstruction or work is suspended or abandonedfor aWeriod ofsixiio)months at anv time after
work is commenced I understand that separate permits must be securedfor Electrical Work, Plumbing,Signs, ells Pools, urnaces, Boileis, Heaters,
Tanks and Air Conififloners,eir—
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 YOUR NOTICE OF
COMMENCEMENT.
1 herehv ce that I have read and examined thisia lication and know the same to be true and correct. All provisions oflaws and ordinances governiqr this
P
cf
'"I 'I
ope p�work- ill he co�nplied with whetherlfe eg herein or not. The granting of a permit does not presume to give authority to violate or callcP the
provisions of ny otherfederal,state, or loca aw regulating construction or the pe�fbrmance of construction.
Signature o Owner
Print Narne, Signature of Contractor A-
Print Name
d. A4.3A=1 Jt7i.R................................... ..... T.........
Sworj�to and subscribed belore me Sworn to an subse
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this �%"f 2012- this 2-Co D T 0 tz__
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FILE COP Y
CONS TRtFCT10-N'S1TV-"M'X A"N"A GtMENT PLAN 1+ 7-
2. All work will be inside the structure and no construction trailer will used. Only one delivery
will be made to the site for drywall. No materials will be stored outside.
3. There are two operational restrooms in the structure, therefore, a chemical toilet will not be
necessary.
4. There is a dumpster currently at the site. However, the limited drywall waste will be hauled to
the Old Kings Road Landfill by contractors truck.
5. Site has a commercial parking area large enough to avoid any difficulty with traffic. Ste # I &
2 have at least six parking space directly in front of the structure.
6. All work will be inside and no debris will be seen on the exterior of the structure.
7. There will be no earth disturbed.
8. None
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CITY OF ATLANTIC BEACH
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REQUIREMENTS AND CONDITIONS. c 3 m
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,J. DOUC5LAS SNEAZ-.) JR., A.I.A
ARCHITECT AR 0002albi
105 CENTURY'21 M,WTE 20q JACKSOWILLE,Fi-ORIVA 52216
(,qo4)124-e,740 FAX(qO4)'720-026q
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road Ap - /C9
r" Atlantic Beach, Flodda 32233-5445
.j Phone(904)247-5826 - Fax(904)247-5845 �Ild
E-mail: building-dept@coab.us IL Date routed:
Cityweb-site: http://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
n I
Property Address: & 79 Ai7aoh' ,4_ R�q�nt review required Yes No
Building _,>
-TTa-nning&Zoning
Applicant: Tree Administrator
Project: jr Public Works
Public Utilities
Public Safety
/74, FLm�ices -Z)!�r
f
Review fee $ Dept Signature
-�P'A] Aid
Other Agency Review or Permit Required Review or Receipt Date Ar,
of Permit Verified By p26
Florida Dept. of Environmental Protection h e, V Jjk)
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants 2—
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: RA/pproved. FIDenied.
�Circle one.) Comments:
(:BU I DLDI NG
PLANNING&ZONING Reviewed by: ni Date:
4
TREE ADMIN. Second Review: E]Approved as revised. ElDeVied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
Py!BLIC SAFETY Reviewed by: Date:
FIF�E SERVICES Third Review: DApproved as revised. FIDenied.
Comments:
Reviewed by: Date:
Revised OV27110
Doc#2012210384,OR BK 16084 Page 701,
Number Pages� I
Recorded 09/27/2012 at 10:40 AM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00
NOTICE OF COMMENCEMENT
Permit No.
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section
713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT.
I.Description of property(legal descrip&n): 7h 9C-4ASTR�P C A6P-124Et& C-PAI-VT' 1)-:Jp j 49 Zee
a)Street(job)Address: 079 Ax,A,%M)C-�- $ALA013 dL,1-M rj-
2.General description of improvements:
3.Owner Information
a)Name and address: HAgA0jji2 aAW
b)Name and address of fee simple titleholder(if other than owner)
c)Interest in property FEr- - a-,c- -
4.Contractor Infon-nation Gl�,Atl,'Ces- - Zd) *7- D,41 -7-
a)Name and address: A3 1" 21 Fax No.(Opt.) Z,Y,� 41
b)Telephone No.: 2!46-- V-70
5.Surety Information
a)Name and address:
b)Amount of Bond: Fax No.(Opt.)
c)Telephone No.:
61ender a)Name and address: 6,11A Phone No.
7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
51 2
A-) fl �2 -
a)Name and address: "v;g -7 902
b)Telephone No.: 9DA A Le,3 Fax No.(Opt.)
8.In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(l)(b),Florida Statutes:
a)Name and address: Fax No.(Opt.)
b)Telephone No.:
9.Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a different date
is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13,
FLORIDA STATUTES,AND CAN 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 YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA F1]id
i.=w r or Owner's A ized Officer/Director/Partner/ManageT
KERRICARA of or &I -
to 27i 2015
j
COUNTY OF A#XEbEzkS
Notary Public-state of Florida ;,ig
My Cam.Expires Ad 27,2015
ComnUssion#EE 116227
rint Namme
The foregoing instrument was acknowledged before me this day of 204-,by
11cer,trustee,
as (type of authority,e.g.offi
attorney in fact)for AAJZA3,pjLAP- EkAi=
pAj*-, fy (name of party on behalf of whom instrument was executed).
Personally Known OR Produced Identification Notary Signature