583 ROYAL PALMS DR RES22-0310 SIDING Building Permit Application Updated 10/9/18
IE.4...., 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: 583 Royal Palms Drive Permit Number:
i' �S2Z - t3I v
Legal Description 30-94 17-2S-2E ROYAL PALMS UNIT 2 LOT 12 BLK 8 RE# 171285.0000
Valuation of Work(Replacement Cost)$$9,400.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial VResidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes 121No
• Will tree(s)be removed in association with proposed project?❑Yes(must submit separate Tree Removal Permit) 6dNo
Describe in detail the type of work to be performed: Peplace portions of siding and exterior trim on front entry wood framed room addition.
Florida Product Approval# ' 3( q Z (41 �p ,,CI
F-1-- j for multiple products use product approval form
Property Owner Information
Name Glenn T.Gallagher Address 583 Royal Palms Drive,
City Atlantic Beach State Florida Zip 32233 Phone 904-534-1893
E-mail gallagher1973.gg@gmail.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Tri-H Construction LLC Qualifying Agent Anton Harasz Ill
Address P.O.Box 331118 City Atlantic Beach State Florida Zip 32233
Office Phone (904)545-9978 Job Site Contact Number (904)509-2528
State Certification/Registration# CBC 022201 E-mail tony@trihjax.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt la Expiration Date 10-3-2024
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' IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CON ITH YOUR LENDER OR AN A RNEY BEFORE
RECORDIN • 0 R NO • COMMENCEMENT.
AL
(Signature of 0 •ner or Agent (Signature of Contractor)
Signed and sworn to(or affirmed)before me this/7 day of Sig ed and sworn to(or aff -.)befo e me this Z-7 day of
/VovE,vt,BE/, •2ocAa•,by 0-J 14 h M.24-i'S N CN 7,0Z-,-b ce r\ ::n A •tip_
9,?-X1,1,- 11',c.,� �6111�
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(Signature of Notary) T• -t , of No, r✓�V
64
JOHN MEEKS -----i'
Notary Publk •t;�G;P .,, TONT GINDLESPER n"
[ ersonally Known OR f' [ ]Personally Known OR i� ��� °= MY COMMISSION 1i GG 353178
[ ]Produced Identificatio-fifis ? State of Florida [ ]Produced Identification s iV..
• ... . Comm#HH279138 ,:�•.... es . EXPIRES:October 6,2023
Type of Identification: �b Type of Identification: �..,o.•, ,,, , ,L - •
-
Expires 7/2/2O2E i —`
NOTICE OF COMMENCEMENT
State of FLORIDA Tax Folio No. 171285-0000
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: 30-94- 17-2S-29E ROYAL PALMS UNIT 2 LOT 12 BLK 8
Address of property being improved: 583 Royal Palms Drive,Atlantic Beach,FL 32233
General description of improvements: Replace portions of r siding and exterior trim on front room addition.
Owner: Glenn T.Galagher Address: 583 Royal Palms Drive,Atlantic Beach,FL 32233
Owner's interest in site of the improvement: Fee Simple Owner-Occupant
Fee Simple Titleholder(if other than owner):
Name:
Contractor: Tri-H Construction LLC C/O Tony Harasz
Address: P.O.Box 331118,Atlantic Beach,FL 32233
Telephone No.: (904)545-9978 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):
Doc#2022287513,OR BK 20504 Page 150, OWNER
Number Pages: 1
Recorded 11!22!2022 11:41 AM, Signed: z Date: // /
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL Before me this /77t,' day of A/0 V",046 g_ in the Coun of• val,State
COUNTY Of Florida,has personally appeared
RECORDING $10.00 Notary Public at Large,State of Flora,County of Duval.
My commission expires: 7 I o9s a zia. JOHN MEEK
Personally Known: ✓ or
Produced Identification: i Notary Public
State of Florida
a Commis HH279138
cQ Expires 7/2/2026