298 POINSETTIA ST RERF22-0239 ibarreche permit appBuilding Permit Application
City of Atlantic Beach Building Department
800 Seminoie Road, Atlantic Beach, Ft 32233
Phone: (904) 247-5826 Email;
k. !At3 J
Job Addressr Permit Number
LesarDescriprr"^to-[ott "?S+,tE ShtdAlR SECJ E t++,50 Frpfgl&r* lloslab-o(xro
Valuation of Work (Replacenrent Cost! 5 UlrO0O ,.,,, Heated,/Cooled SF Non- Heated/Cooled
Cr.rssoi\\rr,ri iJNerv iAddition ,ilAlteration ilRepair i)Move tJDemo tlPool l-.lWindowlDarn ?-elvr.r<
UiI el Bxrslinillproposed structu -c(sJ. i]Commcrcral #ttsidential
lf ;n errstrng !tructure. rs a Irre sprrnkler system rnstalled?: ilyes lJNo
r},1 ASsOcJat ),--lYes lnrust submit se
F1oilia Frcduct Approval #for multiple products use product approval fornr
Prgpertv lQyv[er Information -
t,l a'r t {..*:1-..J-(,1 { s" *{-5.:-i f .r,.-:-{*state R Address 19V /r.^rctf,,/ 7-
zip / J r "? j pnone IdA;--b)6- gu-il --
updated 10/9/18
..AL[ INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
Describe in detail the type. of work to be perlormedl DJf tX
Re-grcF l.{r\ Shtn$Lt5
in ner or Ag,ent {ii Agent.
Contractor lnforrnation
5i,;'re Cer (r/,catron,/Regrstration fu
!.rhitrr: Naare & Phanr $
Povder oi Attorney or Agency Letter Requrred)
.iob Site Contact Number
E-Mail
Qualifying
City Stale
I r&ineer's [,Ja|ne & Phone d
,\'cr ie: s Cornperisairor. lnsurer OR Exempt O Expiration Ddte
aB$lti!!ror rs hereby rnadc to ob!arn a permit to do the work and rnstailations as indicated. lcertify that no vrork or rnstallation has
::mn:eice$ prrcr i6 f he rtsu;ncn of a permit and that ali work will be performed to meet the standards of allthe laws regulating
i:nrrrL:lic{. tr tn'! iurildrct;on. I understand that a separate permit rnust be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
\i.,[.!-5,p3cLs.FuR*AC[S.BOlLIRS,ilEATER5,TAl"]KS,irdAlRCON0lTlONERS,etc NOTICE: lnadditiontotherequirementsofthis
pprnlrt, tirerE rnay be additional restrictrons applicable to this proporty th;:l may be found in the public records of this county, and
there n:ay be addrt,onal perrnlts regurred from ol.her governmentalentrtres such as water mana8ement dislricts, state agencies, or
iecer;l agencres.
Or'!;iiit'5 F.ii I0AVII: I certify that all the'or{:gorttg tnlorm;lton rs accurate and th;rt all work wrll be done tn compltan.e wjth all
itcpir(iitrle r;*s reg*la!ing cc'nstruclron ond tonrflg
WARNING TO OWNER; YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. !F YOU INTEND
TO OBTAIN FINANCING, CONSUTT WITH YOUR LENDER OR AN ATTORNEY BEFORE
Srgned and 5worn to (or atfirmed) before rrc tt',s&fOav ofdgl"Jq ,J.:,r.l.,by
I j Pi:rso'rally K [ ] Fvrsonally Krown OR
I I Protlur eC lclentrirrationI I P:odrrec identrfrtat,cn
Tlpe of rrJer,trf rt "r,o, FLil f / bl )
fr*
lo{, ig'Fiafutfl ,U, p i Ulf"Mrcah EthrdoeMy Comm,sr,o-n HH 004093e,aeu wtlrzoi,is
(5ignature erf Notary)
{#
TypB ol Ide.nlr[]catlon:
a
Signed anel swo
Jqf" -)r '
RERF22-0239
Doc # 2022278956/ OR BK 20492
Recorded lL/08/2022 01:30 PM,
RECORDTNG $10.00
Page 2087 t Number Pages: 1,
JODY PHILLIPS CLERK CIRCUIT COURT DTIVAL COUNTY
NOTICE OF COMMENCEMENT
State Of FLO8toA
County of DUVAL
To Whom lt May Concern:
The undersigned hereby informs you that improvements will be made to certain
of the Florida Statutes, the following informat)on is stated in thls
LeBal Description of property being improved
Address of property being improved: 2
General description of improvements:
raxForioN. llbsi.o(, -OOOC
real property,and ln accordance with Section 713
T ra€c b 1-€(56
o*".,,L0.urelto I b0rreche Address;{O BsY Bn7^.{ 4r4'tf,nkrr Bncl-trc g}2&
Owner's interest in site of the improvement: 0tU,rS g.f,f . _ _
Fee Simple Titleholder (if other than owner):
Name:
Co ntractor:
Surety (if any)
LL
Address;
,1
r | \)te
Telephone No.:Fax No:
Ad d ress:Amount of Bond S
Telephone No:Fax No:
Name and address of any person making a loan {or the construction of the improvements
Name:
Address:
Phone No Fax No:
Name of person within the Siate of Florida, other than hlmself, designated by owner upon whom notlces or other documents may
be served: Name:
Address:
Telephone No:Fax Nol
ln addition to himself, owner designates the following person to receive a copy of rhe Lieno/s Notice as provided in Section
713.05(2) (b), Florida statue5, (Fill in at Owner's option)
Name:
Address:
Telephone No:Fax Nor
Expiration date of Notice of Commencement Ithe explration date is one (1) year from the date of recording unless a dlfferent date is
speclfied):
Personally Known:
o"rr' /o/tu/l t
ln the County of ouval, State
Of Florida, has personally appeared / ^.-rzff'.Notary Publrc ar l-arge, State of Florida, County ol Doval. 4y4
THIS SPACE FOR RECORDER,S USE ONLY
Produced ldentlflcatlon :
RERF22-0239