351 Seminole Rd RES21-0353 framing revision 1 of 2Revision Request/Correction to Comments ALL INFORMATION
HIGHLIGHTED IN
P i City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT# 2 I-05S 3
I' I Revision to Issued Permit OR Corrections to Comments Dater 27 2
Project Address: ( rl//JD L_12-0
Contractor/Contact Name: V212J & 6 YC.i2J(iC. , -r COI ACO y
Contact Phone: i.:3 / 2(2— Email: 'T`U! 1nCO(O( C11-- \en*Y1Q.CCEY-r
Description of Proposed Revision/Corrections:
10((. .L''- - 01 Cid I,c)(4 F 2AlcrA(,_
SC O 1 J Cs
I affirm the revision/correction to comments is inclusive of
Y tprintedname)
II
DEC 21 2021
proposed revision/corrections add additional square footage to original submittal?
No Yes (additional s.f.to be added: BY
Will propos d revision/corrections add additional increas- .:. 'Idin• v. . - • original submittal?
No Yes (additional increase in building va i: .111W,0-03 ) (Contractor must sign if increase in valuation)
Signature of Contractor/Agent: h._
Office Use Only)
Approved Denied Not Applicable to Department Permit Fee Due$
Revision/Plan Review Comments
Department Review Required:
Building
Planning&Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services updated/0/17/18
i
Revision Request/Correction to Comments ALL INFORMATION
HIGHLIGHTED IN
1 City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:/2 2 l(-03'53
Revision to Issued Permit OR Corrections to Comments Date:1211112 f'2_
QPnn Project Address: C G C
Contractor/Contact Name: b(Q.L b(..) < "DEk-S. /ti C_
lContactPhone: Email: Q,,
f,
U I .ti
Description of Proposed Revision/Corrections:
ipirr affirm the revision/correction to comments is inclusive of the proposed changes.
printed name)
Will proposed revision/corrections add additional square footage to original submittal?
No Yes(additional s.f.to be added:
Will proposed revision/corrections add additional increa - ' • il.i : - original submittal?
No *Yes (additional increase in building val , Contractor must sign if increase in valuation)
Signature of Contractor/Agent: "
Office Use Only)
Approved Denied Not Applicable to Department Permit Fee Due $
Revision/Plan Review Comments
Department Review Required:
Building
Planning&Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services Updated 10/17/18
NOTICE OF COMMENCEMENT
State of Ca_ Tax Folio No. I10'134—" ODDS
County of V
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 NOT CE OF COMMENCEMENT .,
Legal Description of property being improved: LO`1217/ i 0/x.0 C t 'i'/2
Address of property being improved: 5.511 dCE:T(/i-IOL Z (4,
r0,-,
General description of improvements: ' ' T 17'47oe`{ T/`/ 26'Q41'. O JC_. S(0(606
t=m21 NCsQ
Owner: COAYSL,L)x dpt l)1'7 8J S Address:
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: (4c.v /(_4
Address: (SSS 141G611 4-LE
Telephone No.:50 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 No 'ce of ommencement(the expiration date is one (1)year from th .=--",:77t,77--;- is
specified): l \25 2022
Y;°
a'',, TON,G'NDLESPERGER
MY uuMMiSSiON#GG 3o3 i78
vj Lmi ; 5
EXPIRES:October 6,2023
THIS SPACE FOR RECORDER'S USE ONLY WNER FOKF,oP' Bonded ThruNotary PuwlicUnde 'tern
Signed: Date:1 ) Z Z
Before me this t— day of OP in the Coun y of Duval,State
Doc#2021316603,OR BK 20035 Page 353,
Of Florida,has personally appe. - Fin D
Number Pages:1 J
Recorded 11/30/2021 03: 26 PM, Notary Public at Large,State of . 'a,Cou ! I
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL My commission expires:
COUNTY Personally Known: 4 or
RECORDING $10.00 Produced Identification: t_ L.
Building Permit Application: .....( Updated
City of Atlantic Beach Building Department ALL INFORMATION
J
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: D5 SEMot.)cCE (20 Permit Number:
C Legal Description 277 70 2_ f.- RE# i 701434-"coo5
Valuation of Work(Replacement Cost)$ 009,CD Heated/Cooled SF Non-Heated/Cooled
Class of Work: New 4dition Alteration DRepair ove Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial Residential
If an existing structure, is a fire sprinkler system installed?: DYes 13No
Will tree(s) be removed in association with proposed project? DYes(must submit separate Tree Removal Permit) .No
A
Describe in detail the type of work to be performed: •A l/v A., //(571 r '-r?c z.oO'-'( 17(,
j
1 ootc AJ (etre_ I
c > r
Florida Product Approval# for multiple products use product approval form
Property Owner Informationf( 2
Name (,ri{oQaX S°\kf,o '^Address 133 ("Lk i. ctAcC-t tL1,a . .(t.k
City Toc\,e_SQ j iRt State F( Zip 32.221.& Phone 9ti ( 321 6 41-Z. '$
E-Mail 7 e is Z Cy" \o•Rv.y._ • C0.,.
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Corn any k-C- Qualifying Agent 0'f2- z.A-A- -Qc
Address C j' `77 t-k-t011iefl City Q it>6 '-State 'Ft_-- Zlp . 2_"2-5T
Office Phone Q
Job Site ontact Number 2
State Certification/Registration#C1, j p E-Ma QUt 21! Ul (7 ' 1X rC€ '
Architect Name& Phone# CJJ
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt Expiration Date
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 PRI 'Ef TY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LEND OR A A, r ORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.I
Signature of Owner or Agent) ign. - . ractor)
ySigned and sworn to(or of irm d)before me thZ- day of Sigped and sworn to(o .' d)be ore me.t d y of
1 O ,z0Z )
wir:_,,y,
Pt N 0 c! , /• ='041" my 1r /Cy
Ns w a .
o<YP a TONI GINDLESPERG
115e rso n a I ly Knouiin OftNv.p. .,, TONI G!NDLESPERGER Personally Known OR ,*i i .c MY COMMISSION#GG 30
Produced Identificati•Produced Identification ^..o` EXPIRES:October 6,2023c, MY COMMISSION#GG 353178 1 4P' Bonded Thru Notary Public Underwriters
Type of Identification:,.,-.A::cEXPIRES October 6,2023 Type of Identification: `
q;?: Bonded Thru Notary Public Underwriters
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