124 SEMINOLE RD RESO23-0018 4, i,4, building Permit Application «tifctra,abg,,,e
City of Atlantic Beach Building Department ••atu'+rFaa�nanoN
, t, ' 8C0 Seminole Road, Atlantic Beach, FL 32233 •
NiCsHtiGHTEU 1ATIO Y
Phone: (9D4 247-5826 Email: E3uildinR-neptQ�cnab.us , $REQUIRED.
lob Address• t 1. E.�!t �!/ /Q 0/0 c/• Permit slumber: I\E- c-.)z 3-OCD t r
Legal Descr prion Nam •Zel l 0 r -
�S 1 1 � SF+�tr� � S�►lt4f � per :
valuation of Work ;Replacement Cogs:}$ I U 00' el 0 Heated/Cooled SF 1J f Non-Neatedltoaled /IV1/1
• a2sso1Work: ONew DAdditlon ►PPrat:on ORepair LIMove LUemo CPoci DW.ndow/Coor
• Uee of existineproposed structures is ❑Cornrner;ial litResidertial
• It an exist.nb structure,Is a fire sprinkler system Installed 1: LJYes JFlo
• '►iIl P PPS he rem 'I�� Rl -i I •. :, • ♦,4 ''r 11 r ,11 • •l ' " i.11"- ' 'll •
Ccscrthe N detail the type of w>>tc lu trs occ'u'rred: •
INS->�, I/Arai � rat VA .
r �!Z-�'�f�t Al!d 1 � � - �� yii 1
2 via"
Fiord Product Apl;rovo +1 A/0 ,r /f4 A-164 f O 4,1 1>a for multiple Froducb use product aFpmai form
Property Owner Information ��,
Name �7►l Pi/*' /i+1 ArZV l 4Address . rt .te a' - fate
s�.
C:tip Z i Ig State •' ZIP is Picone_ � fate
Owner or Agent i if Agent,Power of Attorney or Agency Letter Regt.irec'.
Cuntrattor Information .,
Warn*of Com m► 0titit V VI 2_i` Dual In rd!I
Address w j V a P IVC $1- city' Ail C- ' 4State`.- i• Zlu.3 kb
Office Doone " u ' _ lob Site Contact Juni.-r e
State Certifiwtiun,ReRistatian q /V A E-Mail_
1/ AIM' C e 1' 1ar[�ii re 0"'
A•chitectNamN e&Phone# l ri
Ergineer's Name&Phone 41 A 111 rr
Workers C.empersation Insure' _ 41 P e e-K -^oR beimrt a Expiation Darr ''_
Application is herehy made to obtain a permit to do the worst and installations as indicated.I certify that no wcwk us installation hes
:crnmenced prior to the aauance of a pegrrlt and that all wo*will be perfcrmrd to meet the standards of all the sftlbys regulating
censtruclon In this Jurisdiction.I understand that a separR►P permit ni..st be secured for ELECIRCA-WORK, PWMOIN3,SIGNS,
WELLS,POOLS,FURNACES,,BOILERS,)'EATERS,TANKS,and NR CONDITIONERS,err. NC TICE:in addlliun to the requirements of this
permit,there may be additional restrictions applicable to ti s property that may le found in the public records of this county,and
there may be additional per-nits required from other governrr•ental entities su:h as water management districts,stare agencies,or
federal agent kis.
OWNER'S AFFIDAVIT:I certify that all the foyegoing Information is accurate and that all work wail be done In complierce web ell
applicaole laws regi ating cunatruCtton and zoning
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAYOU N
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR R P o N� ,IF
TEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR
• EFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
{ \M '{
5ig'utu'e . :nnttadorl
..tgnatureofOwner nrAee' l n Xi
t 15Zz day of Si and sworn w for effirmcdg brju2-,P tht<.��dot'of
Signed and sa.'0m to(ur a ed, before� 1 /U ,..2_,,_23,by.. dei 0 ` '`4
11,
F----"-------. .
NIGINDLES'--•tea"4 , / -p�°c NotarylPu�lic,•tat.ofF'�-� I- ,;- Dtarrl „_„ " Commissionit HH 2'"s:,,.OMMfSSION#GG 353178 ►1�aicy comm.expires J s E' 20EtPIRES:October 6,2023 _ ,...,.�IdThruNo:aryPublicUndervrtllers Ider.fiutbn
Produ^.td
I I Prn•-uced Ise-t lice^nn I v �- 1 Ype of identification' . f Di�—
TYve twOn;
or iron:IR:a
ORDERED BY: � 5 .•.:, a <r w.F ars - .
The Law Offices of Rod Schloth ,� � 4.-4.•.u, i Ir i
2187 S Third St west 8 AA:
Jacksonville Bch, FL 32250
®, g ,°
it
904-372-9351
Lemon Bt i
beach@rod-law.com OceenwoodDrN '�°°"" -�� . =,-.c.:
1
PROPERTY ADDRESS: 124 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER: FL1306.2230
FIELD WORK DATE:6/26/2013 REVISION DATE(S):(REV.0 6/26/2013)
TABLE: P,G�,p
FL 13062230 L 15 1 5°00'00"W 625.00'(D) PqR K 57—R, 1./ I 'r�r
x BOUNDARY SURVEY L-2 S 14°°59'24"W 625.00'(D) AVLNUu �T
DUVAL COUNTY rk t ti/12-r
5 15°07'36"W 50.03'(M) ../ L.
L-3 5 15°00'00"W 25.00'(D*M) FCM , ( .r '
L-4 N 15°00'00"E 25.00'(0) w //..4')(4••
) Cy' �`
N I4°47'3I"E 25.01'(M)
r L-5 S I 5°00'00"W 25.00'(D)
S I4°53'55"W 24.85'(M)
r50
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id v
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for z6 -n �•
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a9 ter ;�
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NOTES:
LOT APPEARS TO Bt SERVICED BY CET'WATER AND SEWER
FENCE OWNIMSs1IP NOT Der ihI.RD
THE 15STRIP OF LAND ON THE N.W.SIDE Or P-E SUB., Cf
PARCEL' .5 IN USE AS AN EA50.101T POR ACCESS TO T'1E
eviSE NO DRIVEWAY AT THE REAR Or The user.NO INFORMATION
1 nerehy certify that thi- Ail ofi t ': --• described property has OTHER THAN THE RECORDING DATA SHOWN HAS BEEN
tt best of and beNef,ft IS REVIEWED DURING THE COURSE Of THIS SURVEY.
been made under myth,-••.n,.: i : nowledge
a true and accurate r that -= the minimum tedmicai pE*".,eTS TO MONUMEKTS AFC ON THE CARDIAL DIRECTION
Jr STATED.IN THE BEARING BASIS OF THE SURVEY,RECKONED
standards set forth• •- i ' a---, Land Surveyors as FROM me CORNER TO THE MONUMENT.
described in Chapter{ 17 of •=�� %i ,. Code.
_
F� ' FLOR1OA 4.1'.,,'cm44 sURvel°' 30 20' I O' O 15' 30 Oi
Wesley B.Haas `J .
Male of Floride Professional Smarr end Meow GRAPIH IC SCALE
,...
. liana No.3708 I inch = 30 feet
Use of This Survey for Purposes other than Intended,Without Written Verification,wiN be at the User's Sole Risk and WAhout Liability to the Surveyor.
Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified.