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2213 ALICIA LN RES22-0066 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 `II ur IS REQUIRED. Phone: (904) 247-5826 Email:� � Building-Dept@coab.us Job Address: /3 kgrA a. /i/t:twi--- I. eh// 33 Permit Number: E5 — Legal Description 4-W 37-,25' ef .,� LOTg RE# /6gc/9 -07c0 Valuation of Work(Replacement Cost)$ /lY a J3. ` Heated/Cooled SF 38gag Non-Heated/Cooled • Class of Work: ❑New ❑Addition Alteration ❑Repaiir ['Wool❑Demo Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial Residential • If an existing structure,is a fire sprinkler system installed?: ❑Yes No • Will tree(s) be removed in association with proaosed project? ❑Yes (must submit separate TreeRemovalPermit) CSNNo// Describe in detail the type of work to be performed: k�/J�pt/� A�Q �C,�( (E TSL �G. O!'i2 J�GYS� `�.7,Kk Cov w '6R6 5V &Or/ Tt Kra/.v 440 P©aa eel/ anbic ,do leat‘ icAs ui e/M(fs. Florida Product Approval# for multiple products use product approval form Property Owner Informationn /� I/ Name [ (j ,�Eit/f1.�S Address /00 gardaiC & . City 30044 State iy Zip 74,99,2 Phone gi7) E-Mail Sfildt.E aeA)4. Z3 EG/nIl-L.CD/1f Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company 07,500 p(40-1,k a3drai ,„1-kQuali ing Agent „__VO Address alsg ft Par o#0 City �. f3C(eft State Zip ?33 Office Phone C� a9'/ p3h20 Job Site Contact/�� N mber—/ /) 837-55‘o State Certification/Registration# G/.�CIa5Oo?/v2 E-Mail AKAR CpL56 •Lpi►f Architect Name& Phone# Engineer's Name& Phone# Workers Compensation Insurer smiC JiotK-, 1j ?LWL Gt7.OR Exempt ❑ Expiration Date 17/40,23 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 Y.) R NOTICE OF COMMENCEMENT. igna I e of owner or Agent) i ure ontractor) PH ylic 4{., r pe.ez; Fl�1s��,4�� t ,:u,�-� r Signed and sworn to(or affirmed)before me this 34 day of Signed and sworn to(or affirmed) before me this qday of /7- , by S 7 Air/.e y D ', /?,'j /A/''N 3' .`);by 10_0.3 C (Signature of Notary) (Signature ofNotary) '''pY'''''' WILLIAM L.POPE ;otj3 ` WILLIAM L.POPE /Al Personally Known OR f,• ;,,; MYCOMMISSION#GG 348645 [i Personally Known OR ; ,a. ;,s MYCOMMISSION#GG 348645 [ )Produced Identification 4di•p; EXPIRES:October 19,2023 [ ] Produced Identification '"�r.��� EXPIRES:October 19,2023 Type of Identification: "•••',OF,"•°' Bonded Thru Notary Public Underwriters Type of Identification: �4F,F`.o• Bonded Thru Notary Public Underwriters NOTICE OF COMMENCEMENT State of 4ea Tax Folio No. 76? -1q County of ON4L 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 COM!ENCEM NTS. Legal Description of property being improved: 6-9/ X37-075-a9E � f�1�� Q i ( ' COTB Address of property being improved: �2 /3 ALBA LA) ArZ9.�u gad t33 General description of improvements: QE/ll0✓E f1uU ?Vac( -SLE l 1 (-of)L)r e i f St) ( rd -fik ,f�r�i/th ASD Pie On10✓E lDOfzAk a ; i Owner: .-(At�CE4. G Oe A)f3 Address: /40 6 c '/ Pie �I9,ct/A, Owner's interest in site of the improvement: 1JAA/( Fee Simple Titleholder(if other than owner): _ Name: Contractor: XD G,itt&A./6 a:IA- a0,5i���• — Address: als8 /1100i&2 Arz,94A 116-4c.h Telephone No.: (9D) 07V/("3. 19 Fax No: 1E/0401W Obi 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): _ ll�/f/C�t`L/ f/?e�e n r Doc#2022058479,OR BK 20169 Page 2093, NNER / Number Pages: 1 • Recorded 03/03/2022 01.25 PM, ned: j / Date: "3/3/ JODY PHILLIPS CLERK CIRCUIT COURT DUVAL fore me this 1111 day of /v)a Ac / V427-- in the County of Duval,State COUNTY RECORDING $10.00 Florida, has personally appeared itary Public at Large,State of Florida,County of Duv. WILLIAM L.POPE commission expires: -57. ._Dr7/4"/ „ •„,, a, __348645 Personally Known: =,`;�i�� o EXPIRFS•OctotlerPg 2023 Produced Identification: '.,, FF� � BondedThruNotaryPublicUnderwriters