205 N OCEANFOREST DR RES22-0102 HANSEN PERMIT APPLICATION_1RES22-0102
.}-:}~''.'''\·.;, Building Permit Application
€ ~ -J't City of Atlantic Beach Building Department
.. ~ 800 Seminole Road, Atlantic Beach, FL 32233 ,-_~!:Ji!1~~
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Updated 10/9/18
**ALL INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
JobAddress: :Jo5 oc.eo.~ro✓t ~+ Dr . .AJ , A-tlvf\~;(' f3ee;;c..h PermitNumber: _________ _
Legal Description La ~ ½ 'i OC:<AN . .vC. \ \(, \) "~ \-Df\( &c t 4 i {)46 I, IA r IF RE# I b9 Lft.,3 -6 \ OC>
Valuation of Work (Replacement Cost)$ 11 5. DD t>. 00 Heated/Cooled SF l-1 \ SI,., Non-Heated/Cooled S.SoS ·h kl
j
• Class of Work: □New □Addition ~teration □Repair □Move □Demo □Pool □Window/Door
• Use of existing/proposed structure(s): □Commercial ~esidential
• If an existing structure, is a fire sprinkler system installed?: □Yes ~
Describe in detail the type of work to be performed: (h i" C)✓ r..v c \\ ( ~ Co() ; 'jvrC \; 0 "'-IN t lJ ~:\,
/v (~ ~ \e>or J \~ / Q,r L-t'->-''--'\ <T"P "~rj }Pti-,1\l,.:re,,
Florida Product Approval # __ ..,__-+'--_.__ _____________ for multiple products use product approval form
Property Owner Information
Name ~Q~~ ) L flt \-I t{cr-~tn Address JO~ De.ta r-f°<>,,,.~}-0--. µ.
City A "T \o..,,.J :C.... S ,c t..h State ft
E-Mail ;:tho.fl~ (.,1.f Q L/G.hos::, .co""'
Zip ~ Z. 2. 3 3, Phone 'JD 't ~ Y5 I .,, Y503
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) _'$,=o~a~+"\-\=°'~0~'.S~t~r-_____________ _
Contractor Information
Name of Company :Sc ffr-c'1 A. K <-rr lbl\6¼,..-vd : or'> ::tr\<'. . Qualifying Agent _Jt_(~f_r_~K_c r_/ __________ _
Address Po 8D ~ Ci "\ City .S\v c \<:e , State PL. Zip 32 0Ct I
Office Phone C\D '::f' l,,\a'l..-6 'l &,S Job Site Contact Number qoy ~ lA.l,-;313$
StateCertification/Registration# we. 1'5 \'\i'1 S E-Mail :l''<,V$S03,S e ttd-'@• c o--
Architect Name & Phone# ~Ct""'< 0,. ") Ent,; ,..,,.r
Engineer's Name & Phone# F"o/' r 1 · ·.,,.1 :
Workers Compensation Insurer 60,/\:b14~\ f ""P\ov, < l't'C.S1 "'1 OR Exempt □ Expiration Date ~2,~l,~'!)~Z."-'-' __ _
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 NCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
R NOTICE OF COMMENCEMENT.
Sig e and sworn to (or affirmed e this ;).
t--l~ JO ;}-:> by __,,~d:Y.....~~~~-1.:::~rl'
Type of Identification: U,/\v< C l __.\(, ( O >,:L,.
Signed and sworn to (or affirmed) before me this ~ day of
~l l,,r(_,~ :).e) .> 4 by r;_-Jg;_ ~ r
.__ ...... ,-·-~ i ,.:;•~;·,:,.~i··. OL: HICKEY '', i."f ~-·,'>, MY COMMISSION# HH 203374
[
~-~-'o'f EXPIRES: November 30, 2025 [ l Personally Known OR I -.,_~?;,·,;;,'?r·· Bonded Thru Notary Public Underwriters
,f11'roduced ldentif1cat1on L~--~ ... ~ .. •iiiiiiii_.;;;;;...:. .... ;;;;;;;.: .... ;.;;;;;;;;;;;;;;;~
Type of Identifi cation: 'j)('\v -V-' Un \.Z
By Mike Jones at 9:36 am, Apr 13, 2022
REVIEWED FOR CODE COMPLIANCE
RES22-0102FREY A. p
CONSTRUCTION I NC
State Certified General Contractor CGC 1519875
PROPOSAL 1/31/2022
TO : JOHN HANSON
205 OCEAN FOREST DR. N.
ATLANTIC BEACH, FL. 32233
JOB DESCRIPTION : KITCHEN, LAUNDRY,½ BATH REMODEL
WE PROPOSE TO FURNISH PERMIT, MATERIALS AND LABOR NEEDED TO COMPLETE THE FOLLOWING :
1. REMOVE EXISTING KITCHEN CABINETS, FLOORING, DRYWALL, TRIM, AND WALLS AS NEEDED PER
P,LAN.
2. FRAME NEW WALLS PER PLAN BY FORTRESS ENGINEERING.
3. INSTALL NEW ELECTRIC WIRING AS NEEDED PER PLAN.
4. INSTALL NEW ROUGH PLUMBING AS NEEDED PER PLAN. [EXTRA CHARGE FOR SLAB CUTTING IF
NEEDED FOR TOILET].
5. INSTALL NEW DRYWALL AS NEEDED AND FINISH MUD COAT AND SAND.
6. SPRAY KNOCKDOWN TEXTURE IN ALL AREAS TO MATCH.
7. INSTALL NEW FLOORING [PROVIDED BY OWNER).
8. NEW GLASS FRAME AT BAR AREA.
9. NEW TRIM, SHELVES, AND DOORS AS NEEDED TO MATCH EXISTING.
10. PAINT ALL NEW TRIM AND DRYWALL AS NEEDED.
11. INSTALL NEW CUSTOM MADE CABINETS PER PLAN . INSTALL NEW BACKSPLASES.
12. INSTALL NEW COUNTER TOPS, BACKSPASHES, APPLIANCES, LIGHT FIXTURES, PLUMBING
FIXTURES, AND CABINET KNOBS AND PULLS, ALL [SUPPLIED BY OWNER].
13. RE WORK HVAC VENTS AS NEEDED.
14. HAUL AWAY ALL DEBRI AND CLEAN UP DAILY.
TOTAL:$ 115,000.00
$25,000.00 DEPOSIT/ $25,000.00 UPON FRAMING INSPECTION/$ 25,000.00 CBINET BOX INSTALL
$ 25,000.00 SUBSTANTIAL COMPLETION/$ 15,000.00 FINAL INSPECTION
P.O. Box 991 Starke, Fl. 32091 Office 904-662-3735
jkf3503S@yahoo.com
RES22-0102
NOTICE OF COMMENCEMENT
State of _--'-F~\_o_,,_~ _oc._ ______ _ Tax Folio No. I ~q '-I 1p3-0 \ DO
County of O\Jvv,.\
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: Lo± 4<{ QUC.t"\\JJJ\ \<. U <1~\.. Oo<: po \ &c:x2\'..., Lj 2.
~~t5 \ , \ A -I E
Addressofpropertybeingimproved: dt:>S CC-,(6:."""~or.,.5\ Or . /J . A!\an \iC f>rco--. f'L. 3zz33 J
General description of improvements: A)<w K:-\-c..h·U\ 1 l'.'O~f\Q/ !(JG.\\ rr C C>n!'oq vrc. ..\.-:Of\ 1 Cloo.,,. i l"C:),
~o. ~ ~ c3 Dr'11!-&:\\
Owner's interest in site of the improvement: __ _,_€f....:,,_.s..._,.,_,' d..__P ___________________ ..=3:;_-z.,=-z.,-'3,,.____3.._
Fee Simple Titleholder (if other than owner): _--->L:::......J..:...A_. ________________________ _
Name:----------------------------------------
Contractor: ~ ££ ('-(~ A. ~.frr C.oost rv c...+-, Of'\' ti\(..
Address: P· D . ~ OX '1 q \ j.\~d<r, FL. 3'2-D~ I
Telephone No.: ~O'f -lclc,2,.3735 Fax No: 'j'Dj -ll/,;,L( -tDOZ...
Surety (if any) ___ .L..><;_,_A_. __________________________________ _
Address: _______________________ Amount of Bond$ ________ _
Telephone No : _________ _ Fax No: ___________ _
Name and address of any person making a loan for the construction of the improvements
Name: __ __,,__LA_, _______________________________ _
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: ---------------------------------------
Te I e phone 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: :S°t"•\-f ~i'/'
Address: P. 0 • 60)( Ci' 4 \ S \-G.< K", J:.L. ~2-oti l
Telephone No : g() lf r ~-,5, ~_$ Fax No : '10'1 · q l,y -100-Z...
Expiration date of Notice of Commencement (the expiration date is one {l) ye r f
specified): ----------------------.--lh~~ei!------..!,tl,ll,l,l,,.liill..J.llil.!:l!:..!.. __ -11-__ _ n.~,v-----
TH1s SPACE FOR RECORDER'S USE ONLY ·!..•l~f.i.;'?i BondedThruNotaryPublic ~c...,-rU'Q
'--"l!~~ ....... ;;;;;;;;;.;.---~-~ ~ 1o '2.. '°2.__
Doc # 2022077918, OR BK 201 99 Page 11 48,
Number Pages: 1
Recorded 03/28/2022 01 :47 PM,
JODY PHILLIPS CLER K CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00
-....t::.....il.------'---day of T'-'lfv:•c.,h :>-o)-;> in the Count
Of Flo id , has personally appeared Jb.r-\v,. -~ 4'0 ½C
Notar blic at Large, State of Florida, County of Duval.
My commission expires: ".,_)0-J<..,~ ':?:v:: 30 ,.) Q ;.}.<;:
Personally Known:-------~------------or
Produced Identification: ::Do if< C l <, U'>\,Z_
205 N OCEANFOREST DR RES22-0102
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