469 ATLANTIC BLVD # 6 2014 BUILDOUT 1 , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
A JIM" COMMERICAL ALTERATION/OTHER
MUST CA' i BY aoM FOR NFYT DAY INSP.ECITO 1- 7A7-9R1 A
JOB INFORMATION:
Job ID: 14-CINT-78
Job Type: COMMERCIAL INTERIOR BUILD-OUT
Description: BUILD OUT ICE CREAM PARLOR
Estimated Value: $17,000.00
Issue Date: 10/10/2014
Expiration Date: 4/8/2015
PROPERTY ADDRESS:
Address: 469 ATLANTIC BLVD UNIT 05
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: TOUCHSTONE CONTRACTING SOLUTIONS INC
Address: 8654 Hilma RD
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $67.50
BUILDING PERMIT FEE $135.00
STATE DCA SURCHARGE $2.03
STATE DBPR SURCHARGE $2.03
Total Payments: $206.56
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION t' �
M L
CITY OF ATLANTIC BEACH D
800 Seminole Road, Atlantic Beach, FL 32233 OCT 0 9 J14
Office (904) 247-5826 Fax(904)247-5845
Job Address: V&9 C- &V Permit Number:
Legal Description '1°15 1 /L, p, 8/6 4,,,j 830 A Parcel#
Floor rreeaot Sq.Ft. Sq.Pt
Valuation of Work$ /9 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition tera Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Colffmer Residential
If an existing structure,is a fire sprinkler system install ircle one): Yes <t!nD N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: :n4e r'cr- &Jd .,)4-, 0A-,4LC- ol,vn�`�
Property Owner Information:
Name: D i G� rl;� (LUA 0��Z �cuf t(Y"{ r Address: (aSl1 l cV �rSw,c�
City State Zip 1- 6 Phone 90`1 `7e 3 "
E-Mail or Fax#(Optional)
Contractor Information: o�y S'Mw`'cJ'L 4* 9 , ( • ('` ^
Company Name: %oQc hsy-aXt C0g6X4J-15 Soju44cnS /-nc. Qualifying Agent: S-eA �Sfnv Y
Address: 96 i(i l4: )r. Ed City jt, State icz Zip S 22 yy
Office Phone 9 i y - 311- /G/3 Job Site/Contact Number 5 e c/- 3 2-Z -14-1,T Fax#
State Certification/Registration# CCS C / S/S-or) 9
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations t at I ork or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards o l s8ulq� ion in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or r e d d for a_period of six 6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Elec7ric Work, Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
Tanks and Air Conditioners,eta
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.
I hereby certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether sppeci ted herein or not. The granting of a permit does not presume to give autho ' violate or cancel the
provisions of arty other federal,state, or local[aw regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Print 5 .._. Print Name .5 _ ��
......................................................... _...._.._.........._........_._._._.._...
Sworn t and subs ibe befpre me Sworn t and subs"d__be_f�re me
thi ay of G-►'u-1jAj2- 201+ this&M FDay of c,--Iou �� .2014
1 P,
ReW �A ,
Notary Pubh : ' Mo�Pubk•llgdeol Notary Public ,`�
PW*-State ofHY&
.2 -2W"11._. wilices Jan 24,2018
i ff 183131 CMU4iM#EE 163138
City of Atlantic Beach APPLICATION NUMBER
Building Departmer; (To be assigned b the Building Department.)
800 Seminole Roadr_ p
r� Atlantic Beach, Florida 32233-5445 (� / e
Phone(904)247-5826 • Fax(904)247-5845
City web-site: http://www.coab.us Date routed: Z
APPLICATION REVIEW AND TRACKING FORM
# "5"'
Property Address: (0 �Qh� 41101 Department review required Yes No
uildin
Applicant: /p�(,(�h �^ Planning &Zoning
/ ) Tree Administrator
Project: L i 1O/ d A37 Public Works
Public Utilities
Public Safety
F' ervic
Review fee $ Dept Signature
CONTRACTOR EMAIL ADDRESS 10_�l�rAnAE (00� /'L h17)
CONTRACTOR CONTACT # 9'6`� - s
APPLICATION STATUS
Reviewing Department First Review Approved.A "A>� Denied. "CAI
(Circle one.) Comments:
BUILDING'
PLANNING &ZONING Reviewed Date:
TREE ADMIN. Second Review: []Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES
Third Reviev []Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
REVISED 09252014
LCity of Atlantic Beach Fr APPLICATION NUMBER
Building Department o be assigned by the Building Department.)
i800 Seminole Road .. C� ,�/�_
;j r� Atlantic Beach, Florida 32233-5445 V ,V
Phone(904)247-5826 • Fax(904)247-5845
City web-site: http://www.coab.us Date routed: Z
APPLICATION REVIEW AND TRACKING FORM
1 d/ Department Property Address: T(� �-14477 G 411 d Department review required Yes No
wild i�ng >
Applicant: /0 fit,eh�6. 6arwe,;ePlanninc 'i�Zoning
Tree Ac nistrator
l,,D/Y� /)')�,�Cii�L r'l pl d ��T Public 1 ks
Project:
Public l Jes
Public "Iety
F' a of
Review fee $ Dept Signature
CONTRACTOR EMAIL ADDRESS I
CONTRACTOR CONTACT #
APPLICATION STATUS
Reviewing Department First Review VfApproved. ❑Deni,.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: a*67— Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES
Third Reviev []Approved as revised. ❑Denief'
Comments:
Reviewed by: Date:
REVISED 09252014
BUILDING PERMIT APPLICAT i ON
CITY OF ATLANTIC BEACI
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1169- S /44L_ '6/1Permit Number: /L/—CI&T - 7,-
Legal Description S,,/I 4 ��,(.'� 3 -1615 j y /0 8/6 ?,j 83 c A P(Parcel#
Floor Area ot Sq.Ft. Sq.Ft
Valuation of Work$ 19 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition tera Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): mer ' Residential
If an existing structure,is a fire sprm)fcler system installe ircle one): Yes (�!UD N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: 136,jd ,,r4- P/edf.c_ ,maim
Property Owner Information: \
Name: �C:Y� �(�\ �•� c��`c art C14"f t l; ,Xr Address: (0s) iv
City "tom State 4Zip i-S- 6 Phone tel(`' 3 1
E-Mail or Fax#(Optional)
Contractor Information: Joe.y S+r r r j{ C-O^
Company Name: %oyc hzSy-wV. ��4 rc c irp. dob bans Mc. Qualifying Agent: �eSrp� S �
Address: ;iU V /.t!:Imci Ec City JLLLS-14 u,'14e State t�-t Zip -5-221/v
Office Phone 9 i Y - 322 /613 Job Site/Contact Number 9 e c/- 3 2 Z -/.�./3 Fax#
State Certification/Registration# 06 C / T1 S—o r) 9
Architect Name& Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address _
Mortgage Lender 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 to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void rf work is not commenced within six(6)months, or if construction or work is suspended or ab; tinned for a_period of six 6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plum +:;t>Signs, Wells, Pools, urnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc
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 hereby certify that 1 have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether speci red herein or not. The granting of a permit does not presume to give autho violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print NamePrint Name
���
Sc..,, ...t...Scow .r_5'�:...............................................................
Sworn.t land subs ibe befgre me Sworn to and subcbed before e
bay of 'U 1 rZ 201+ this RZ ft-Da) o: ?� Gk �'� 2014
Notary Publi"t Notary Public ���pP7"o�ary�
ft"PubNc-8t dPh* =;r 4''As Notary Public-State of Flodda
� Q MY 6 i s p y�rr+�it�xpires Jan 24,2016
'��„,rata•' C wk*n#EE 163138 •,���u• Cammission#EE 163138
)peiy-c//1,r-7�
NOTICE OF COMMENCEMENT
State of ` Tax Folio No.
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.
Legal Description of property being improved: 54Jul c,:r Sr c •'a,� _3 T Lois _ r/o -/-. ro, nk7e) P'3M�o r4/�
Address of property being improved: Y�' _ �tiK�
General description of improvements: „herr bJAef of mss` ey.,J JXY-e /u ,p/cry/�y
Owner: Dovyan) ke,( £s+Ax Pr,)Ia�c l%es 1z/ Address: 4- S f L o 0 2 Sush 32214
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
moo 2c o
Name: O c� o 3 0
z
o � C,
Contractor: o c,cit 5>4-,e C� { :mei 5�l •` 8 —'�c • o� „a o
Address: ts7r Sy 141,---A i � _
co
Telephone No.: Fax No: m o -1
Surety(if any) _
m
Address: Amc,,iA of Bond$
c_ rn
Telephone No: Fax No: " 12
0-
Name and address of any person making a loan for the construction of the improvements C
Name: o N
C
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other docun
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of tbw Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name: _
Address:
Telephone 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 SE ONL OWNER (�
�`I Signed: .Date: �/
I ' "l i
N Breland Before me IVr-k this LI � day of S "n the County of Duval,State
P�. N"Pu*-SwofF101ids Of Florida,hasersonall a SA(�i
P Y appeared
�y mExpmJan24,2D16 Notary Public at Large,State f Floida,County of Duval.
,•, ,F ,.�.• ��EE�63f36 My commission expires: Z 2 I fP
"'"�� Personally Known: Ior
Produced Identification:N VL11 iA LC;(� U( jkl C