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900 SEMINOLE RD RERF23-0048 fL., S LAry.o,., ,t1 INSPECTIONS REQUIRED FOR BUILDING PERMITS ;I To verify compliance with building codes,inspections of the work authorized are required at various points of the construction. The following inspections are typically required for residential projects: Date: Initial: Date: Initial: Power Pole Final Plumbing Silt Fence Final Electrical Piers/Stem Walls Final HVAC Underground Plumbing CC Final • Underground Electric Final Building* Foundation/Footing 'For new living space:When all construction work including electrical,plumbing, mechanical,exterior finish,grading,required paving and landscaping is complete Slab** and the building is ready for occupancy,but before being occupied "FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION Swimming Pool Steel Retaining Wall Footing Swimming Pool Safety Driveway Electrical Grounding& Bonding Sewer(Building Dept) Swimming Pool Final (Bldg) Sewer Tap(Utilities Dept) Swimming Pool Final (PW) Additional inspections may apply to your project if your project Rough Electric* contains these elements: Rough Plumbing/Top Out* Formed Columns/Beams* Rough Mechanical* Masonry Cell Fill 'When all rough electric,plumbing,mechanical are complete but before any work is 'When forms and reinforcing steel,anchor bolts,sleeves and inserts,and all covered up. electrical,plumbing and mechanical work is in place,but before concrete is poured. House Wrap Structural Steel* Wall Sheathing 'When all structural steel members are in place and all connections are complete, but before such work is covered or concealed. Roof Sheathing OTHER: Tie-down Framing Connections OTHER: Rough Framing OTHER: Roofing In Progress OTHER: Window/Door In-Progress OTHER: Insulation Ceiling Insulation Wall S 14' Exterior Lath '� Roc � Permit Type Stucco Scratch Coat Exterior Siding In-Progress RrrZ I 0 o4 Brick Flashing&Ties Permit No. Early Power 9OO SRo Gas Rough Job Address Gas Final* Resev• 'When all gas piping is complete and wallboard is installed but before gas is RooFilQq attached to any appliance.All outlets must be copped and pipe pressurized at a minimum of 15 lbs. Contractor POST THIS CARD WITH PERMITS AND PERMIT Building Department Public Works/Utilities Fire Department DOCUMENTATION IN FRONT OF BUILDING Phone:904-247-5826 Phone:904-247-5834 Phone:904-630-4789 Fax:904-247-5845 Fax:904-247-5843 Fax:904-630-4203 INSPECTION L(NE: 904-247-5814 MUST CALL BY IPM PREVIOUS MY FOR NEXT DAY N!PICIDON Construction Hours per City Code:lam-/pm Weekdays,yam---/pm Weekends ?1'''''J%, Building Permit Application R cq 23•- DQ4 /'8 ty j City of Atlantic Beach Building Department **ALL INFORMATION 7_5 ~ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY -on 91' IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: goo SPv'rli/-47/f xd affeb,hc bea.c,L Permit Number: Legal Description c a- 4 -/( - .1-S- A9 S el v /f7a. cL r�#7a R E#3 ill-UI OC Valuation of Work(Replacement Cost)$ /3,7-6)° Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool [_:_Window/Door /22p/4G2-172«•t • Use of existing/proposed structure(s): ❑Commercial [residential • If an existing structure,is a fire sprinkler system installed?: ❑Yes ENo • Will tree(s) be removed in association with proposed protect? EYes(must submit separate Tree Removal Permit) ❑No Describe in detail the type of work to be performed: S` 714 - /2,, Florida Product Approval# 64f /v/06 4y— 1— /l for multiple products use product approval form Property Owner Information /J Name C�u.ct c(i vi 4...a- v4 e&&Pt c.- Address 35-30 I014-t/"e4---) 3 City JCt x State Ft- Zip 3 -da-V Phone cf0 ' • g 8 c s8/y E-Mail Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) Contractor Information �� //''-- Name of Company /ccSa-et P ' tJJ G9n4h'• Qualifying,Agent / ft u• CI*i/14--1 42-------- Address c4 n a /L -3,)`j/ �l— Pc, City 77aX atetZip V6„ Office Phone c-ic gpt. • '2l 9 4- Job Site Contact Number State Certification/Registration# CCC 05-6676 3 E-Mail /'eS Gu e/� 9/( ffn74.-"// 4-`177 Architect Name&Phone# Engineer's Name& Phone# / / Workers Compensation Insurer -51.111/2- l(� c OR Exempt o Expiration Date 1/ / 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 YOUR NOTICE OF COMMENCEMENT. (Signa re of Offer or Age t) (Signature of ontractor) Sig d and sworn to r affirmed)before me this O2 7 -Oay of Signed and sworn to(or affirmed) before me this c9 y d y of Cl__t_ a 3 ,by /I LI/� . V/ v ��1 C-, , by �l�r� U v1"Y • •. ture DICHEV L__________:f1Y -NIKE p�HEy .•. MYCOMMISSION#HH182457MYCOMMISSION#HH18 as 2457 ;���'a`, EXPIRES:January29,2028EXPIRES:January 29,2028 :;f��"'�; Boi de T�"'N k�ndenKKera[ ersonally Known ORndedTMrNotaryPublicU [ ] P rsonally Known OR � , [ J Produced Identificati. nderwdten-II [ Produced Identification Type of Identification: Type of Identification: Permit Number Tax Folio Number ;' +- l9 :� / oe-c0 NOTICE OF COMMENCEMENT STATE OF FLORIDA COUNTY OF DUVAL . THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement. 3 C' 1. Description of property(Street advdress): v ', i 1�1.! 1 _•. .- 5 : .FL 32266 Legal Description: .L'7- .)- ./(0— - 9— 2/rf�//7C4r+n w /1-. LU 7 !3/lam?-- _ ,l Ct, I $. �(btC/I l,l,w (, ' p 97C' ', 1 2. General description of improvement: 1 �c, �6 i / 3. Owner information: v el_4A-• v-/A _Je4i6„4 . a. Name and Address: --.J:2,-)k.--) C17/0140..61.4) � ){�1�l F. 71%L- ie 1 ��• ��2.2 Z 9 b. Interest in property: J c. Name and address of fee simple tirhhrlder(other than owner):I- xx 4. a. Coutactor's name and lir, 5 LC.l c 1v J G ��i ,-- � � "�' d 4/V ©G b. Phone number: c1e7(q Fa ,er Ft 3 3.?'/ 5. Surety Information: a. Name and address: _ b. Phone Number: Fax Number. c. Amount of Bond: 6. a. Lender's name and address: b. Phone Number. 7. Person within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by 713.12(1)(a)7.Florida Statutes. a. Name and address: b. Phone numbers of designated persons: S. a. Lr addition to himself/herself,Owner designates —__ of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b).Florida Statutes. b. Phone number of person or entity designated by owner: 9. Expiration date of notice of commencement(the expiration date is one(1)year from the date of recording. unless a different date is specified) WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNERRFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,FLORIDA STATUTES.AND CAN RESULT LN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB 31TE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF,1 a COMMENCEMENT. //�y ' 0M (r,•-I• >Da Signature of Owner(Owner's Authorized Officer/Director/Partner/Manager: ��,t Wt�(1 2� °�- co ct d D rn O n 0 (Signatory's Title/Office) u� 1- N a 3 The foregoing instrument was acknowledged before me this / �P day of,A(6-4-6— .20 3 2) m v L,�-�' i T e 731c&.,K 4 r.✓/Le,-- ;•''v..-- ANNA NIKOLAEVNADICHEV cc -w o by L `''`� as for :. ; v' OMMISSION#HH 182457 O co J o inn :*: v o t) o ` w,^.. EXPIRES:January 29,2026 z-,-, 0, 00 N �' Notary: r'i-2Lc� --'Fo `?:/ Bonded Thru Notary Public Underwriters up N— J 0 el a = p Personally Known /or Produce Identification Type of identification Produced: oN E o a z O My commission expires: / ,--)1 /)-(.,,-• N ` o o v O O w azcc — Orr Under penalties of perjury,I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. American Land Title Association Final ALTA Settlement Statement- Combined Adopted 05-01-2015 Rock Solid Law & Title ALTA Universal ID: 220 Ponte Vedra Park Drive Suite 280 Ponte Vedra Beach, FL 32082 File No./Escrow No. : JM23-004 Print Date & Time: March 10, 2023 8:17 am Officer/Escrow Officer : Walt W. Unfricht Settlement Location : 220 Ponte Vedra Park Drive, Suite 280 Ponte Vedra Beach, FL 32082 Property Address: 900 Seminole Road Atlantic Beach, FL 32233 Borrower: Jason Robert Leblanc and Claudivina Soares Leblanc 900 Seminole Road Atlantic Beach, FL 32233 Seller: Jacqueline Bailey Fairbairn Living Trust dated 8/5/1993 and as amended 2/11/2021 925 Turner Camp Road Inverness, FL 34453 Lender: Alliant Credit Union Settlement Date: March 10, 2023 Disbursement Date: March 10, 2023 Seller Description Borrower Debit Credit Debit Credit Financial Loan Amount 135,000.00 Loan Charges to Alliant Credit Union Lender Origination Fee 350.00 I -- j --- Title Charges and Escrow/Settlement Charges 2nd Mtg Closing Fee to Rock Solid Law&Title 150.00 Government Recording and Transfer Charges _ Recording Fees 61.00 • 2nd Mtg Post Closing Fee to First American Title 25.00 Insurance Company Intangible Tax 270.00 Mortgage Stamps 472.50 Miscellaneous File#JM23-004/78 Copyright 2015 American Land Title Association All rights reserved Page 1 of 2 Printed on 03/10/23 at 8:17:51 AM by lisa.krevo