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675 ATLANTIC BLVD - REMODEL RESIDENTIAL PERMIT PERMIT NUMBER Ps,14 RES18-0387 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 12/4/2018 ter `" EXPIRES: 6/2/2019 t ATLANTIC BEACH. FL 32233 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: 675 ATLANTIC BLVD RESIDENTIAL ALTERATION INTERIOR REMODEL AND $4000.00 RESIDENTIAL NEW DOOR TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170659 0010 SALTAIR SEC 01 COMPANY: ADDRESS: CITY: STATE: ZIP: JLS BUILDERS LLC 144 S AZALEA POINT DR PONTE VEDRA FL 32082 BEACH OWNER: ADDRESS: CITY: STATE: ZIP: SHORELINE PROPERTY 675 ATLANTIC BLVD ATLANTIC BEACH FL 32233 MANAGEMENT INC 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 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 455-0000-3224000 0 $75.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $37.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 $2.00 Issued Date: 12/4/2018 1 of 2 .S%:t -J, ,� RESIDENTIAL PERMIT PERMIT NUMBER r RES18-0387 CITY OF ATLANTIC BEACH \15vISSUED: 12/4/2018 J,; , 800SEMINOLEROAD EXPIRES: 6/2/2019 � ATLANTIC BEACH. FL 32233 i TOTAL: $116..501 Issued Date: 12/4/2018 2 of 2 rt1.A4rj, City of Atlantic Beach APPLICATION NUMBER ri0 tillo"c Building Department (To be - signed by the Building Department.) 800 Seminole Road S 2 ii 1111, Atlantic Beach, Florida 32233-5445 ( r _ 0J 7 Phone(904)247-5826 • Fax(904)247-5845 J;; !%' E-mail: building-dept@coab.us Date routed: l Rfft i City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM G7 5 Property Address: ((Aid--i C ( V,t D .ment review required Y74slo _II Buildin. Applicant: J L S Eot l CA er s I A ( i _ - an Zoning Tree Administrator Project: ��Q_(-(Q nRe__„--, �(`�L l Public Works Public Utilities U0 ( 0$f) Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District , Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: pproved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILD) PLANNING &ZONING Reviewed by: � � Date: Joh'3c9Q TREE ADMIN. Second Review: Approved as revised. ❑Denied. (J ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by:_ _ Date: Revised 05/19/2017 JFFICE- COPY ,(!--7„:.,i, Building Permit Application Updated lo /18 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 Email: Building-Dept@coab.us IS REQUIRED. R C f n� Job Address: (o� t� � S 1qkiC. &VCS_ +"�T,4K6[ �o- gS.C— Permit Number: ->i a O3P,-7 legal Description (0-57 ri-2S-�4F •3iS S4144•C SEc I Lots 75_3 76-se mcg-v.) ocT REM fl-0 1059 OCA l 0 L-04 75(, (.v7 a7.2 C pt."../ 3p'1-)w 3 Fir Lea 7-4-4,3 Valuation of Work(Replacement Cost)S ODU Heated Cooled SF Non-Heated/Cooled • Class of Work: New OAddition OAfteration =Repair ❑Move XDemo CPooI Window/Door • Use of existing/proposed structure(s): Oommercial [}esidentiiaallL' • tf an existing structure,is a fire sprinkler system installed?: I ]Yes C3 o rt • Will tree(s)be removed in alsoCiatiQfi with_oroposed project? }Yes(must submit separate Tree Removal Permit] 134o LDcribe in detail the type of work to be performed: D. r cc EX rs 7./.,..6- -1--../7--6-,-/,l• r„i Ac c.S 4A`;7 �/.0v/ /ft-` ' ' - i(Te r/c/-' '/'i /.E.HT D�c E' Florida Product Approval A C4-- /6 3.51 '-7" :2 63 7 S for multiple products use product approval form Property Owner Information it_ c Name C ..r Y_=s)\-cg:1--(Sbnot'tL..{Vta ter tN-s Address L�S 14c_ ?,\.,,k_ci City r (1%."A.L. r oc State V-L_ Zip .��Z Phone E-Mail-51- --4" \ Tom! �(Y\cx‘\. C-pv-- Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) n/a Contractor Information .---, Name of Company :1-L.-5 3l,'ILt)t(L.S i--,,_ '- Qualifying Agent am- LCMy SC NCI-C?iEtZ Address/j`i7See/rr..;, (lc c,rc 5 . City j,Ax State /"4- bp 3L-2-Z Y Office Phone 44-ti-&t-.;r- 875 Z lob Site Contact Number c/CY- V/—e f'S-'L State Certification/Registration N C6C(Si z.3 E-Mail i•'-- 'k��1c-s 3 c_ (.2=0 T L.C c J C o•h Architect Name&Phone M e Engineer's Name&Phone M Workers Compensation Insurer OR Exempt$,Expiration Date PIZ c/0 v Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installatihas CI commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regul g construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIG M WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDm0NER5,etc. NOTICE:In addition to the requirements•40 _i 3a . —I z 1 permit,there may be additional restrictions applicable to this property that may be found in the public records of this coun Q 0 v•1 there may be additional permits required from other governmental entities such as water management districts,state ag Z F- "' federal agencies. O m H Ztii OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance witt� p l 0 U Q applicable laws regulating construction and zoning. Ell 5.. d 0 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT M Z O a al RESULT IN YOUR PAYI •G 'ICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INT cn TO OBTAIN FINANCI G, C. LT WIT YOUR LENDER OR AN S •NEY BEFORE 0 ., RECORDING • R OTI MOM' E CEMENT. ... 1 p 0 w 2 m 14 l�r`nair:u ' nen or t) ignature of Contractor) L7 V N 0 W c, CC W Signed and sworn to(or affirmed)before e this 1 day of Signed and sworn to(o affirmed)ybef�ore me this- of Vta a,Sor . 2013 ,by • •V !. V1 h elriM 20 id,by cam""-" ya- ¢ (Signature of 0 ary) (si otary) (1,,P‘so nally Known OR - a'-" 1�arsonally Known OR •:n'. .'• ELLEN R.THIGPEN / Produced Identification ( I Produced Identification ' .' , Tvoe of Identification: MY COMMISSION GG 144796 p.pe of Identification: A' EXPIRES:October 23,2021 ..•f:°!: " ' banded Thru Notary Public Under , ,s jpr.c Notary Public State of Florida Amanda Potatty ` My Commission FF 938415 or r‘Sr Expires 11/23/2019 NOTICE OF COMMENCEMENT OFFICE COPY (PREaA.R N ti'PltC+i7E; �} Permit No. ,Vec`/F ^0 3 F7 -ax Folio No. t 0 lOS_I�)t U State of TwS,&a County of �L \IC\ 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 descrpton of property being unproved' \t -? t'-i^. -a 9 E .3I. SAL-CA. SEG t Lch-5 -53 SS's v4 l' F-t-_ Lc' 4•sla LOT --A--;D (EX vJ - --ACT Loi Address of property being improved: La-t .--- t-tK-ko. It-(- as/ES. A cct,A;i:. , FL-- as 3 General deserpton of improvements'111 2c (,.X i S ii 1'1 Ci ",i R to r2 1,,i t>,--�.L S A.,11-Di r} �),t3t_c: (o E b L'K1"(_(t tc n_ "Dc< ,L �i,1ST �4 OwnerC)cei le-CcAzita, - S\r‘G"4"`�-�v . T.(7-p-'�* v V kc.aV�e3.ge_w,,e.v,-�. Address t©I Ptactcc-,.-1,;c. 6 --4A. .?v.. M.Qc-c�f. czPGY1..,` FL - 7 Owners interest in site of the mprovement 5l mP1p Fee Supple Titleholder(:t other than owner) Name Address Contractor y"teE ht 1 s( i-, E)€e Address /37v 7St-ii,n treed( C .5. TA>., -1-_cr • 3azz-f Phone No (kg-6)6/- - 2- Fax No. Surety(i1 any) Address _Amount of bond S Phone No Fax No. Name and address of any person making a loan for the constructon of the improvements. Name Address Phone No Fax No Name of person%warn the Sate of Ronda.other than himself or herself,designated by owner upon whom notices or other documents may be served Name Address Phone No Fax No In addition to himself or herself,owner desgnates the following person to receive a copy of the Lienor's Nonce as provided n Section 713 05(2)(b),Florida Statutes (Fill in at Owner's option). Name 6 Address Phone No Fax No. Expiration date of Notce of Commencement(the expiration date is one year fr. date of record ng unless a different date is specrfedi. THIS SPACE FOR RECORDER'S USE ONLY ` lAr ERS•r (� 8•r�rtwpis O aay a/ 1_ Wig nh• Ca�srtyn C0.ai Act - as rets. acp•ared C.._ • a'r nsr•n by Panni r� ane aft• at an Orient:13 and*Maala+l harem ars k,H aid L n Doc#2018275028,OR BK 18605 Page 484, Number Pages: 1 49I, y Recorded 11121/2018 12:07 PM, --'-:.�,,,r s,,rKSARf_• county ot RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL tttyccrrmraaicne*oc•n V icy (-2Z1 COUNTY Pennnayhnown✓ RECORDING $10.00 Pre„a•d'° ` `on :v- ELLEN R.THIGPEN fl ....., MY COMMISSION#GG 144746 .':• EXPIRES:October 23,2021 ''.f s R°,• 6,xxi d Ttw No(uy Pubic Ur d rwritecs