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1021 Atlantic Blvd 953-975 COMM19-0017 LA Fitness `Q'''' COMMERCIAL PERMIT PERMIT NUMBER �S '6 COMM19-0017 CITY OF ATLANTIC BEACH ISSUED: B/1/2019 _ 800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 1/28/2020 MUST CALL INSPECTION PHONE • 1 + • BY 4 PM FOR + INSPECTION. ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF i ' + BUILDING CODE, AND OF ATLANTIC +CH CODE OF ORDINANCES . ALL i • 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: 1021 ATLANTIC BLVD 953- COMMERCIAL ALTERATION STUCCO REPAIR - LA FITNESS $18000.00 975 COMMERCIAL TYPE OF ZONING: :D • • • GROUP: 177602 0040 SECTION LAND • ■, .D• .� ELY BUILDERS LLC 8941 BEAUTYLEAF WAY JACKSONVILLE FL 32244 OWNER: ADDRESS: CITY: EQUITY ONE ATLANTIC 1600 NE MIAMI GARDENS DR NORTH MIAMI FL 33179 VILLAGE INC BEACH 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. w 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 $145.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $6.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $4.00 WORK WITHOUT PERMIT 455-0000-322-1000 0 $255.00 TOTAL: $410.00 Issued Date: 8/1/2019 1 of 2 r% Building Permit Application Updated 10/9/18 U City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED. Job Address: 1021 Atlantic BLVD Permit Number: C_0en ,, iq -Ub1 Legal Description 38sCASTRO Y FERpRER GRANT PT RECD oft 8130-2297RE# R-177602-0040 Valuation of Work(Replacement Cost)$ Bf -POO.On Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration pair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial ❑Residential • If an existing structure,is a fire sprinkler system installed?: Dyes ❑No • Will trees be removed in association with proposed roiect? ❑Yes must submit separate Tree Removal Permit ❑No Describe in detail the type of work to be performed: Stucco Repairs and Waterproofing LA Fitness upper Front Walls Florida Product Approval# for multiple products use product approval form Property Owner Information Name R?gpncV Centers I P Address nnIndependent Drivp Sijitp #114 city Jacksonville State FL zip 32202 Phone 904-598-7000 E-mail C7,PorgpWhetstonP reap=nom CPnters_rom Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Ely Builders,L LC Qualifying Agent ?'j�v k Address8941 BPat6leaf WaV cityJacksonville State FL zip32244 Office Phone _71 h-45nR Job Site Contact Number C1 oy- ?(0 -4i50ck State Certification/Registration# E-Mail¢Srangall364hnn rnm Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer OR Exempt VExpiration Date 7 _-&aD 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. 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 RECORDING YOUR NOTICE OF COMMENCEMENT. (Si gq to ure,o�Owner gent) (Signature Contractor) �Vf Signed and sworn to(or affirmed) before me this�day of Si edandsw to(or affirm before me thisay of elk. Q [CI , by e �( Y da 0 of*avrf§ nature o ig ture of Notary) r ;... 1 f1i4LR1DIALL CommIsslon#GG 240468 � •ow Expires November 20,2022 Personally Known OR 1�GAYLEF. L Personally Known OR 'Fofno BondedThruBudgetNotarySank#$ 1'A'� a ANGEL [ ]Produced Identification I [ ] Produced Identification �,; ...COnmilasi n/FF975311 Type of Identification:14/I''/� Type of Identification: 25,210 Boedl47%NTMyFAbWM=MX&M9 NOTICE OF COMMENCEMENT State of Florida Tax Folio No. 4— /7 / 6 0,� —b 0 YO 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: 38-28-29e-Castro y ferrer granot recd oft 8130-2297 Address of property being improved: 1021 ATLANTIC BLVD 953-975,ATLANTIC BEACH,FL.32233 General description of improvements: STUCCO REPAIRSAND WATER PROOFING LA FITNESS UPPER FRONT WALL Owner: REGENCY CENTER,LP Address: ONE INDEPENDENT DRIVE SUITE114 JACKSONVILLE FL.32202 Owner's interest in site of the improvement: 1001 Fee Simple Titleholder(if other than owner): Name: Contractor: ELY BUILDERS,LLC. Address: 8941 BEAUTYLEAF WAY,JACKSONVILLLE FL.32244 Telephone No.: (904)710-4508 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: GEORGE WHETSTONE Address: ONE INDEPENDENT DRIVE,JACKSONVILLE,FL.32202 Telephone No: (904)598-7000 Fax No: (904)358-9344 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 unl�er a differen4L specified): '• ° 1«GG240466 * Expiras November 20,2022 THIS SPACE FOR RECORDER'S USE ONLY OWNER a�reOF016 Bonded Thru Budget Nokry SWAM 2440 ;n 2 IC/�t S Date: Doc#2019179463,OR BK 18884 Page :fore me this day of in the County of Duval,State Number Pages:1 'Florida,has personally appeared (' a ��,trS w�D Recorded 08/01/201903:47 PM, s� ��o RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Aary Public at Large,State of Florida,County of Duval. COUNTY ires: it ��, \ A .1- RECORDING $10.00 rsonally Known: or uc�tification: N r 1. lCi.� J' CITY OF ATLANTIC BEACH BUILDING DEPARTMENT 800 SEMINOLE ROAD ATLANTIC r I , I BEACH, CERTIFICATE OF COMPLETION COMM 19-0017 COMMERCIAL ALTERATION COMMERCIAL ISSUED: • : err • ZONING: 9/5/2019 1021 ATLANTIC BLVD 953-975 177602 0040 DESCRIPTION OF • • STUCCO REPAIR — LA FITNESS • CONTRACTOR: EQUITY ONE ATLANTIC VILLAGE INC ELY BUILDERS LLC 1600 NE MIAMI GARDENS DR 8941 BEAUTYLEAF WAY NORTH MIAMI BEACH, FL 33179 JACKSONVILLE, FL 32244 APPROVED: T�t4 CHIEF BUILDING OFFICIAL VOID UNLESS SIGNED BY BUILDING OFFICIAL