2209 ALICIA LN BATHROOM REMOD PERM RESIDENTIAL PERMIT PERMIT NUMBER
r �, CITY OF ATLANTIC BEACH RES19-0002
V 800 SEMINOLE ROAD ISSUED: 2/14/2019
~�art ar EXPIRES: 8/13/2019
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' DA BUILDING
CODE, ' OF • 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:
2209 ALICIA LN RESIDENTIAL ALTERATION INTERIOR REMODEL $25000.00
RESIDENTIAL
TYPE OF
• • GROUP:
169519 0705 TIFFANY BY THE SEA
COMPANY: ADDRESS: CITY: STATE: ZIP:
MATHIEU BUILDERS 38 W 9TH ST ATLANTIC BEACH FL 32233
• ADDRESS:
JONATHAN AND SANDRA
FLASCHNER 2209 ALICIA LN ATLANTIC BEACH FL 32233-5979
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 4SS-0000-322-1000 0 $180.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $90.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.05
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.70
TOTAL: $276.75
Issued Date: 2/14/2019 1 of 2
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Fax: (904)247-5845 Email: Building-Dept@c}oaab.us IS REQUIRED.
—
Job Address: a?ot04j /� ! G %a L It"I - Permit Number:
Legal Description 07-.7-5 ,2%j 5 -/-/x,5" 4r S°gLorCo RE# O
Valuation of Work(Replacement Cost)$ ADoo- Heated/Cooled SF Non-Heated/Cooled_
• Class of Work: New ❑Addition 'NAlteration ❑Repair ❑Move []Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): J "ommercial INResidential 100
• If an existing structure,is a fire sprinkler system installed?: IYes 1nNo 0 0
• 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: /,� �( ( [�� k J,jr
7e-lod(a /utasFe•da��, rle�✓ 7u6/ 5kvciv t/it�, ><;esr door'r✓t_`I, doc✓vt * S7'uds
Florida Product Approval# /VA for multiple products use product approval form
Property Owner Information
Name`0o A a���a� F(F4 G�"�� Address 02.201 Al!-kc ra Lam
City 0-Han4 -,.- 604c�t,- State Fzip 3Z7_33 Phone at of 75$ So IU
E-Mail )oh& , COAA l
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) n/a
Contractor Information �1
Name of Company !'1'la_f L"e" r3 1,S Qualifying Agent �)u 5k, bre"-,
Address 31 IJ G(+�k St city A0 Stated—zip �zZ� lei
Office Phone 6t o y S/3 3 C r Job Site Contact Number ��`t' 13 3 G e,
State Certification/Registration# C 3 cl-(Z 3- 7 S 9� E-Mail �)U 5 f-i N 0 MA+(2', e- ,t_ b u i ( e J- 5 � C 0✓►a'\ -
Architect Name&Phone# _
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt}' Expiration Date (Ila L0 rf,
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, Ct]
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this W
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and ;9:
there may be additional permits required from other governmental entities such as water management districts,state agencies, or W
federal agencies. UJI
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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
RECO DING YOU OTICE OF COMMENCEMENT./�
(Signature of Owner or Agent) �y, (Signature of Contractor)
Signed and sworn to( affirmed) before me this�'aay of Signed and sworn to(or affir ed)before me this t144day of
�0�,by ,Dcq jcl a�c/tct�� �ec� 7,01y by 44?A,, 13"')i'' '�
—r-
( t e of Nota (Signature of Notary)
Notary Public State of Florida
Heather Brown MR
State of Florida
( ]Personally Known OR
Personally Known � �p� My Commission FF 239144 wnProduced Identifica on °i^ Expires 06/09/2019 [ ]Produced Identificationion FF 239144
Type of Identification: Type of Identification: 9/2019
NOTICE OF COMMENCEMENT
State of r z-0 4"9/1,- Tax Folio No.
County of D✓t/,+L
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: //
Se 14
�-� gel d�
Address of property being improved: o?�o� H �r � � `< �'���� � _
General description of improvements: ` s r 6 ✓a,Pi o n 3
)
Owner: , 1�., •r Sirto�� los�b/�� Address:—Z ?-�
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
t Contractor. i -r"�: -+� q" 1 a� f' P
Address: 3 �j L) 1 1 Sd– r/4/l ic. I? e� c. IGe, 2 2 3 3
Telephone No.: clo If F 13 3 G Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone 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:
Address:
Telephone No: 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 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 USE ONLY OWNER
Doc#2019036665,OR BK 18691 Page 2138, Signe • C Date: blfc—1 Z/ l
Number Pages:1 Before me this day of G2 in the County of Duval,State
Recorded 02/14/2019 09:37 AM, Of Florida,has personally appeared nd !jjziwe✓ _
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of Florida,County of Duval.
COUNTY
RECORDING $10.00 My commission expires: b
Personally Known: x or
Produced Identification:
srr� Notary Public State-,monud
Heather Brown
J., my Commission FF 239144
-xpires 06/09/2019
iJr�. City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 — oz
Phone(904) 247-5826 Fax(904)247-5845
~r�/���;• E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z Z(1j� ('1 C �A ) Department review required Yes No
i
Applicant: PVT H l E Q BLQ� anning &Zoning
Tree Administrator
Project: I� �E Q/ pQ� Public Works
Public Utilities
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: Approved. ❑Denied.
(Circle one Comments: ^
BUILDIN /l'v D
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN. Second Review:
[]Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
Building Permit Application Updated 10/9/18
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.
Job Address: -�ac/q % c i a L a rte_. Permit Number: / _000
Legal Description i76- `7'f 697-,2_5 .2`�,e:%a ny �j�f��Seg Lo7"�v RE# /(01 S<9 ` D x-1/0
C—)
Valuation of Work(Replacement Cost)$ a 000.� Heated/Cooled SF Non-Heated/Cooled
• Class of Work: New ❑Addition 'NAlteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door U
• Use of existing/proposed structure(s): ommercial InResidential LL
• If an existing structure,is a fire sprinkler system installed?: _ "Yes blNo LI
• Will trees be removed in association with Proposed roiect?' iYes must submit separate Tree Removal Permit No
Describe in detail the type
of/work to be performed: 1 ,;r,I ( he k-'n9
2rr^OUe� aSrY/ 6aTli/ �er✓ /cC61S�4JVJ v/"L"/;,J( �/o0r11��1 19(oWl' fd S7/ucfS
Florida Product Approval# IVA for multiple products use product approval form
Property Owner Information
Name�'o/,, a��{ Sa��Y Fl FI4J-g�fAddress o1ao`i 141 tkc-ra ( ogA
City "a/0 6eC L-k State Fc- Zip 3 ZZ 3-3Phone `[o`- -755 So IQ
E-Mail_JohnFla5cl+ner(d P9a,Touv ci , CoM
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) n/a W
Contractor Information 1
Name of Company MI!-,,t'c, �j Ic�s Qualifying Agent D'O", 17rDu n` .0 .-1 Z '
Address 31 LJ 4 St city fr0 State�y Zip Z Z
Office Phone R o y 8 f 3 3 G (e Job Site Contact Number qo_Y5 13 3
State Certification/Registration# 0 e_(2 s 7S- $6 E-Mail O S f i N 0 M A k ( e.r k', er-_lot-0 S Co 41.1E:Z a
C
Architect Name&Phone# U C1 LU I
V p
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt)6 Expiration Date -Jy J Q
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or instategancha
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws rFAUI1Mr4 Z
w
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING l(*S,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS,etc. NOTICE: In addition to the requirenMpt�ofthi'�
M
permit,there maybe additional restrictions applicable to this property that maybe found in the public records of this cdghty'.and 0
there may be additional permits required from other governmental entities such as water management districts, state a'onewigs pry, w
federal agencies. cc W
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance nth all w
applicable laws regulating construction and zoning.
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
RECO . DING OU OTICE OF COMMENCEMENT.
(Signature of Owner or Agent) ��yy,, (Signature of Contractor)
Signed and sworn to( affirmed) before me this /,2 ay of Signed and sworn to(or affir ed)before me this t-2-Xday of
IV rc �O by SCAt-1c� r(asc jI-e-f Dem Z�l byIII
( toe of Notary) (Signature of Notary)
�ow'v4_ Notary Public State of Florida
7.. Heather Brown RaEl
c State of FloridaPersonally Known p My Commission FF 239144 Personally Known ORrownProduced Identifica on °f ti Expires 06/09/2019 [ ]Produced Identification sion FF 239144Type of Identification: Type of Identification: 9/2ot9