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BIG PINE KEY 1018 1026 JAXGIS Property In Page I of for -Ition Sft 4ft 44M 1034 1043 1026 103- 1027 -leis 1002 1 027, 10tj 1007 S43 947 3 'h Copyr' i fc) C RY af JaGksonvilk�Fl /0 E# 0 ddress Total cres Plat ap egal Flo Value Book nel odZone LandUse oningkNT a 0. )Oj [Bl"" 00 escilotfons 07 1-055 16-2s- LEN IG PINE KEY 9E Not in Flood 720275 L T 120176 .07 3000 556A1 - 06�ANE L 2 1 7-2S-29E one 233 9F1 VA n http://maps.coj.net/WEBSITE/DuvalMAps/toolbar.asp 6/1/2004 MAP SHOWING SURVEY OF LOT 30, SELVA LAKES, AS RECORDED IN PLAT BOOK 41, PAGES 55 AND 55A OF THE LOT 0 FCURREN;T' PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. /0-3 .Ax -Ole CITY OF 716 OCEAN BOULEVARD P.0.BOX 26 ATLANTIC BEACH,FLORIDA 32233 TELEPHONE(904)249-2395 December 29, 1986 Third Floor Pre-Service Section Jacksonville Electric Authority Building 233 West Duval Street Jacksonville, Florida 32202 The following final inspections have been made and are satisfactory: Permit #4839-40 - 1018-1026 Big Pine Key Permit issued to Adkins Electric Company. Permit #5084 - 464 Orchid Street Permit issued to Barkoskie Electric Company. Sincerely, Ren�' Angere Co munity Development Director cc:building file MAP SHOWING SURVEY OF LOT 30, SELVA LAKES, AS RECORDED IN PLAT BOOK 41 , PAGES 55 AND 55A OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORJDA. o' /7 10.1 -7 ±ic -z-D /c f D PLUNBING WOQRKSHEET SINKS SHOWERS DISHWASHERS CLOSETS BATH TUBS FLOOR DRAINS WASHING MACHINE WATER HEATERS DISPOSALS LAVATORY URINALS OTHER TOTAL FIXTURE COUNT FIXTURE 'UNIT 'BREAKDOWN FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT $10.00 PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. BATHROOM MOUP CONSISTING OF LAVATORY (1 UNIT) WATER CLOSET, LAVATORY, AND BATH TUB OR SHOWER STALL SERVICE SINK TRAP STAND (6 UNITS) (3 UNITS) DRINKING FOUNTAIN (11 UNIT) URINALt WALL LIP FLOOR DRAIN Cl UNIT) (4 UNITS) WASHING MACHINE RES. URINALP PEDESTAL? SYPHON (3 UNITS) JET BLOWOUT (B UNITS) Ll WATER CLOSETS, TANK-OPERATED WATER CLOSETS, VALVE OPERATED OUNITS) (8 UNITS) BATHTUB (W/OR W/O OVERHEAD SHOWER STALL, DOMESTIC (2 UNITS) SHOWER) (2UNITS) LAUNDRY TRAY BIDGET (.3 UNITS) (2 UNITS) DISHWASHER C2 UNITS) KITCHEN SINK (2 UNITS) KITCHEN SINK/WASTE GRINDER (3 UNITS) TOTAL FIXTURE UNITS 0 .$10.,OG EACH� PLUMB1NG PERMIT # ELECTRIC PERMIT BUILDING PERMIT WORKSHEET TEMPORARY ELECT. 1,,3 9 S— _@ e eated Square Footage $ r s q f t J�0 7y�7, arage/Shed @ s e r s q f t al d 0- arport @ ___per sq ft orcbes ___per sq ft eck ____per sq f t atio @ $ ____per sq, ft TOTAL VALUATION $ :)tal Valuation Data ist ,Lo—ot 7. mainder Valuation @ $ ;2.00per thousand or portion thereof TOTAL BUILDING FEE $ + k FILING FEE s FIREPLACE @15. 00 $ /1-5700 TOTAL BUILDING PERMIT $ c,?3 2 �7S ------------------------------------------------------------------------------ ,UMBING PERMIT FEE$ MECHANICAL PERMIT FEE$ ,ECT. TEMPORARY $ ELECTRICAL PER141T $ �TER METER SIZE ACCOUNT NUMBER :WER IMPACT FEE $ iTER CONNECTION $ (@10. 00 p.er fixture unit) 'PROVED BY: TOTAL BUILDING/PLAN FILING FEE $ C�3 1r7 TOTAL WATER METER CHARGE s TOTAL SEWER IMPACT FEES s /0,3S-- 00 TOTAL WATER CONNECTION CHARGE $ 670 BMISCELLANEOUS CHARGES $ GR"D TOTAL DUE: s- 13 9 5- Npr PERMIT WORXSHEET ELECTRIC PEPWIT TENPORARY ELECT. sq Address—) 0Q Heated Square Footage @ $ per sq ft = $ Garage/Shed @ $ per sq ft = $ Carport/Porch @ $ per sq ft = $ Deck @ $ -____per sq ft = $ Patio @ $ per sq ft = $ TOTAL VALUATION: $ Total Valuation lst $ Reminder Valuation per thousand or portion thereof --------------------------------------------I Total Building Fee $ ADDITIONAL PERMITS and/or FEES REQUIRED, I + k Filing Fee $ ) 55150 Mechanical Fireplaces @ 15.00 $ 30. 00 BUILDING!PE1(MIT FEE $ L-1 ge'. 50 Plurbing Electric/New ------------------------------------------------- Electric/Temp BUILDING PERMIT $ qq6. SL) Septic Tank WATER =R. CHARM $ 00 Well Swimrdng Pool SEWER IMPACIC FEE $ �0-70, 00 F-'A Sign WATER IMPACT FEE $ 53C Water Comection MISCEIIANEOUS $ Sewer Connection $ Water Meter $ Elevation Certificate GRAND TOTAL DUE $ ---------------------------------------------------------------------------------------------- CALCULATIONS and/or NOTES FLOODPLAIN DEVELOPMENT INFORMATION Type of Development : New Building Alterations to Existing Building Flood Zone Required Floor Elevation Actual (as built)Lowest Floor Elevation If located within a flood hazard zone (zone A) a survey must be made after the slab has been poured, certifying that the "lowest floor elevation" is equal o___o_r_`a1;_ove the base flood eleva7E'3-on established fo—r that zone. No Final Inspection will be made and No Certificate of Occupancy will be issued until the survey is on file with the Building Department. COMMENTS Applicant acknowledgement : I understand that the issuance of this permit is contingent upon the above information being correct and that the plans aind supporting data have been' or shall be 'provided as required. I agree to comply with all applicable provisions of Ordinance No. 25-7-11 and all other laws or ordinances effecting the proposed developemnt. Date ApplicantIs Signature ----------------------------------------------------------------------- ' Department Use Survey filed with the Building Department on Certified Lowest Floor Elevation Required -Lowest Floor Elevation Building Department Representative CITY OF ATLANTIC BEACH APPLICATION FOR B=ING PERMIT Owner lzeay Address Z' Phone...2c/i� Architec 1 40 Address L zip a A&24 -5�4x 17e,#e-A, Phone C an t ra c t o r, d SS Addre ;%r 5P ziplIW2 Phone Contractor's License Number Expiration, Date S�2 on-File, Lot #,2gy�a Block or Section # Subdi-vision Zoning Streea,,,,- Z&Z,�E: Xjc-:�� Between and _side Valuation $ Type of Construction Purpose of of Units Fireplaces Utility Service: Water Sewer if the City if providing water or sewer service, do we need to make-taps? Dimensions: Building......_____�Ot Size Footings ' Sz. Piers Sz.;-Sills Greatest Span Sills Sz. Ceiling Joists Distance on Centers Greatest Span Sz. Floor Joists Distance on Centers Greatest Span Sz. Rafters Distance on Centers Greatest Span Method of Heating ___________�olid-Filled Ground Roof Flood Zone If located within a FLOOD HAZARD couplete page 2 SUBMT: Two complete sets of plans, including a detailed site plan. Florida Energy Efficiency Code Sheets Recent Survey Inspections Required: 1. When steel is in place and ready to pour footings. 2. When steel is in place and ready to pour colums/lintel. 3. When steel is in place and ready to pour beam. 4. when framing, mechanical, plunbing, electrical, ,fireplace, is completed and ready to cover up. 5. Final inspection. SETBACKS NO INSPECTION WILL BE YAM IF WILDING CARD IS NOT POSTED ON JOB. In case of rejection, reLrispection 1-UST be called for after corrections are made. /018 0 Q In consideration of permit given for doing the work as described in the above statement, we hereby agree.to perform said work in accordance ' with the attached plans and specifications, 4WI 4ex)1 which are a part hereof, and in accordance rt rt with the building regulations of Atlantic Beach. Signature Owner -�O/W4 1-9 1/, r I 'll Signature 7 tor c7vilc 9tV1,,1W / Front ME Line DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO. 7570 PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date- March 12 19 86 Valuation$ 128.062,50 s 496.50 This permit not valid until above fee has been paid to City Treasurer,and is 496*50 T subject to revocation for violation of applicable provisions of law, 419K,50CI(T I A W! This is to certify that RP-2haliz Inc. 0,0034591 2S 2ri L 9760 1 A 3/13A has permission to buifd Thd3bouse Classification BeSidential _Zone PUD Owned by RC14 b2Zxxtiez Lot 29 & 30 Block I S/D Selva Lakes House No. 1018 & 1026 U& Pim Liu According to approved plans which ate part of this permit NOTICE—A CONCAETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING, PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 0 Building material, rubbish and debris 4 from this work must not be placed I -J in public space, and must be cleared U 10 J 6-`s]�O up and hauled away by either con- �t r i r or owner. lo Building Official. J FOR OFFICE PERMIT USE ONLY NUMBER DATE CONTRACTOR PLUMBING ELECTRICAL SEWER WATER AW BUILDING AND ZONING INSPECTION DIVISION "T-D CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections 1, 11. 111, and IV. Street Address:_ loz4p - tot cid za" PtMG ks'-y L-er 2a C) LOCATION OF Intersecting Streets: Between And BUILDING Sub-division Se L—v& Loicy=_-5 11. IDENTIFICATION — To be completed by all applicants, In consideration of permit given for doing the work as described in the above statement we hereby agree to perform said work in accordance with the attacked plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards of good.practice listed therein. Name of Mechanical Contractors Contractor (Priint) sKlpmoz Master Name of Property Owner 12 GP r)r\ Signature of Owner Signature of or Aafhorhad Agent Architect or Engineer III. 094RAL IN4!��TION A, Type of basting fuel: B. IS OTHER CONSTRUCTION BEING DONE ON ABeclivic THIS BUILDING OR SITE 7 (3 Cres—0 LP 0 Natural (3 Central UIHII+Y IF YES, GIVE NUMBER OF CONSTRUCTION (3 09 PERMIT 13 06W — Specify IV. k490WAIM 19161111111111illilliff TO U INVALLID NATURE OF WORK (Prev comPlaite W of compowts on bed of this form) X Residential or 0 Commercial LK,Heat C3 Space 0 Itec"sed A centae'l 0 PAW X Now Building BUi Cb"411flainiftv E3 Itoom )d C."firell Existing 14160 Dvc� 4-09m: MateriallbQGAM Thicinsel, C] Replacement of Maximum capacity :2-2_c>o ,existing system K Now Installation(No aysterin previously Installed) G Refr*ration C3 Extension or add-on to existing system (3 Cooliag tower: capacity C3 Other— Specify C3 Rro Wrinkfors: Number of has 13 Bevoter 13 Monliff 13 Ewalete THIS 11PACIII Poll OpF= US 014Ly C3 Gualino pumm —(nvmber) (Re"I"d) C3 (number) Remarks 13 LPG OWW# (number) 0 U"f1rW Preaure V*" 0 Permit Approved d otheir specify Permit Ulrr ALL EQUIPMENT AOL CONDITIONING AND nFILIGERATION EQUIPMENT Cl"dtY AppMvbg XUMberUnite Efteriputle Ko"NUMbar Manutseb"r !Cem.oforc uwamlock mkmiez 27 U1'_ IL tQ DC-MIA4 -21 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH.FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB 75U nor-A C 5026 -1 a r-/n-q/01 may 29 86 Date 19 1 Ono Valuation$_ - — $ 52.00 This pertnit not valid until above fee has been paid to City Treasurer,and is ubject to revocation for violation of applicable provisions of law. Ocean Stime Heat & Air �M-786 This is to certify that has permission toX=_Tnnt-_q1 I Heat A, Air Classification P-Sidenti'al Zone— Owned by— =4 - Lot 29 & 30 Block—S/D So 1va Lakes House No. ID18 & 1026 = RIM Ka According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE M 01 0 Building material,rubbish and debris 31 from this work must not be placed in public space, and must be cleared up, and hauled away by either con- tr ctor or owner. Building Official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBIN-G ELECTRICAL SEWER WATER 3S3"-) CITY OF ATLANTIC BEACH, FLORIDA ApprdvW by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: L IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRI13ED IN THE FOLLOWING, WE HEREBY AGREE TO PERFOR'M,4AID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF,'JANID IWACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. LAwf ELECTRICAL FIRM: MAkERjEL90RICIA_jIGNAWRE JOURNEYMAN NAME W02Qo-_Lt'2-ADDRESS: L02 I RFQ_8OX_ BLDG.SIZE BETWEEN: REL 14"" APT. ( COMM.( PUBLIC I INDUS.I NEWI�/ OLD( I . REW.I ADDITION I TRAILER ( TEMP.f SIGNS ( SO.FT. SERVICE: NEW t INCREASE I REPAIR FEE C."DUCTOR SIZE n AMps SO COPPERf ALUM. MT—CH OR BREA R AMPS PH 3 W 01-70VOLT RACEWAY EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY SIZE SIZE NO. SIZE fRS NO. LIGHTING OUTLETS 'CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL .SWITCHES 0-30 AMPS. M INCANDESCENT FLUORESCENT&M.V. FIXED -0-100AMPS. I OVER I APPUANCES I I I BELL TRANSF. AIR H.P.RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT OVER V �n MISCELtXNEOUS TRANSFORMERS: UNDER 600 V. OVERSWV. CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT 249-2395 JOB LOCATION 1018-1026 ,Big Fine Key PLUM13ING CONTRACTOR F. W. FAIR PLUMBING COMPANY LICENSE NUMBERS MP145 State RF0037503 OWNER R G M BUILDING CONTRACTOR R G M TYPE OF BUILDING Duplex 2 SINKS 2 SHOWERS 8 LAVATORY 2 WATER HEATERS 2 BATH TUBS 2 DISHWASHERS URINALS 2 DISPOSALS 6 CLOSETS 2 WASHING MACHINE FLOOR DRAINS OTHER TOTAL FIXTURE COUNT X$3- 50 + $10. 00 DATE 3/ 27/86 TOTAL AMOUNT $108 - 00 INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH.FLORIDA PERMIT NO.- 7571 0900 T PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB 11,10*OnCKT 1�86 1 A 4/15/8 Date 4/1S 9 86 7571 OrOr-AC Valuation$ ---- $ 108.00 This permit not vaW until above fee has been paid to City Treasurer,and is subject to revocation for violation of applicable provisions of law. F.W. Fair Plumbing RF0037 503 This is to certify that has permission to%�% Iwtall Plumbim Classification RWidMtlal Zone owned by RM F-r-PR992LIM Lot —Block S House No - 1018 & 1036 Big PIM &a -_ According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 94 111. 0 Building material,rubbish and debris Z_4 from this work must not be placed in public space, and must be cleared up and hauled away by either con. t a r Itor or owner. puildi.g official. 3 FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER CITY OF ATLANTIC BEACH, FLORIDA wd Appro by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM, SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF,AND IN-ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELECTRICAL FIRM: MALTtR ELECTFtIdIAN SIONATIJRE JOURNE I b4 1 2*4% NAM tJ996ADORESS:_Jo;(' N% I" RFD-BOX BLDG.SIZE BETWEEN: RESX. APT. I I COMM.( PUBLIC I INDUS. NEW>< OLD( I REW.I ADDITION ) TRAILER ( TEMP.( SIGNS ( I SO.FT. SERVICE: NEW INCREASE ( REPAIR FEE 22!R!LCTOR SIZE AMPS /,!�O COPPERf 11 ALUM.*bo "TCH OR BREAKER AM I PH jk C2,Z_,'O T RACEWAY EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY FEEDERS E NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN ITOTAL 0.30 AM a. 31-100 AMPS. SWITCHES INCANDESCENT FLUORESCENT M.V. FIXED 0.10 1 CAMPS, ovrR APPLIANCES BELL TRANSF. AIR H.P.RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS ICEIL HEAT] KW-HEAT OVIR .00 AV MISCELLANEOUS TRANSFORMERS: UNDER SW V. OVER 600 V. CITY OF ATLANTIC BEACH PE=T APPLZCATION PMTCDEZ, ADrITIONS, OR ALTERATIONS MOVING, DEMIGILITIONS Owner(s) : d7,,, Job Address: &P� Oki Phone: Lor- 31cck or Unit Subdivision: Contractor: State License 4- o Address: Sea II;- PLA—LIA No: 2c -- �YAK - -zo - F Stac:e Z4- :Cde ,qc--k :-o te dcne: Vf A-/s4 S i C4 Z64 �resen7: use of nz: va--4az:.cr. z:-f 7-:'o--C s ed '--5 e is t.�iis an ad,-4-4tion? If ves, what are the dimensions of the added Z� F7: . neated and space, x the added area be t N� ew eiaczr-� ca-' (or increase) �� New piumbi-ina -f-",ftu=as? New fi-renlace? New Heat/1'71 SUBMZZ' TR= (CowdMCZAL) TWO (RESZTENTZA_L) COjjFLET_%- SZTS OF PLANS, ZNC-'=-rNG CODE Fop SITE PLAN, SURVEY, MS, NOTZCE, OF CoMdENCM-ENT, AND owzq=1caNTRACTaR AET'ZDAV:r F aw wER is CONTRACTOR. n �7�, Signature OWN,ER.--4 Date: Signature CONTRACTOR: Date: hj AS TO OWNER: v-- 19 Sworn to and subscri-b)edibe"foree this john L RIIr NOTARY B I My COMMISSION#CC727756 EXPIRES AS TO CONTRACTOR: Match 24,2002 AIN INSURANCE INC 1BONDEDTHRU TROY F Sworn to and subscribed before me this da of ' 19 -47- ROTARY FUBLIC Martha B.Crites `q My COMMISSION#CC714063 EXP ES April 18,2002 U TROY FAIN INSURANCE INC BONDED THR CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877 m7 'Rg Permit Number: 19376 Address: 1026 EY Permit Type: SIDING ATLANTIC BEACH, FL 32233 Class of Work: NEW Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: SELVA LAKES Est. Value: Parcel Number: Improv. Cost: 1,880.00 �WM—02122 M�Mw�- Date Issued: 12/20/1999 Name: PIERRE BARON Total Fees: 30.00 Address: 1026 BIG PINE KEY Amount Paid: 30.00 ATLANTIC BEACH, FL 32233 Date Paid: 12/2011999 Phone: (000)000-0000 Work Desc: VINYL SIDING W. W. CRITES, INC. PERMIT 30.00 Otto!; S!111 NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. -- $30.0014 Date: 12/22/99 @1 Receipt: 0021656 A4TN—TRIC-�BEA� BUILDING�DEPT� CASH NOTICE OF COMMENCEMENT (PREPARE IN OUKrATE) Permit No. Tax Folio No. State of County of To whom It may concern: The undersigned hereby Informs you thin Improvements will be made to certain real property,and In a ccord or'ce w Ith Soallon 713 of the Florida Statutes, the following Information Is stated In this NoncEOF COMMENCEMENT. L.Kal Oewlpdon of property"Ing Improved: Z�I _2 Za 6-:57 Address of property being Improved: ,&:t (R General deactipoon of Improvements: Z�do,.50re__, Owner F17rre- ar&,, A Address D, Owner's Interest In site of the Imbalement F" Simp4e T'Itleholder(if other than owner) Name Address Convector Suntastic Inc. Address 9776 Beach Blvd Jacksonville FL 32246 Phone No. 904-M-1616 Fax No, VJ4-996-1414 Surery(11 any) AOdrem —Amount of bond$ Phone 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 not1ces or other documents may t>e served: Name Address Phone No Fax No. In addition to himself, owner designates the following person to receive a copy of the Llenor's Notice as provided in Section 713 06(2) (b),Florida Statutes. (Fill In at Owner's option). Name Address Phone No- -------—------- Fax No, Expiration date of Nodca of Commencement(the expiration date Is o par from the date of recording unless a arflerent date is spechled): n��, T'HIS SPACE FOR RECORCER'S USE ONLY OWNER Signed: Date:3-i-i-y2 Doc#2007168147,OR BK 13993 Page 472, itr Number Pages:1 Before me this day Of I-Cv;2 in the Filed&Recorded 05/22/2007 at 10:23 AM, County of Duval,State of Florida,has personalty appeared JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING$10.00 al-e4'ee Notary Public at Large, State of F"Ida,County of Duval My commission explres: Personally Known L11_11 or Pro(juced_L0entftation WCHAELKAUFMAN P V MY COMMISSION#DD 201 V9 P Bonc6d Thru Nota EXPIRES:August 9,2007 ry Public Underwriters Date: 3/25/2004 2004 -#41 Betterliving PATIO& SUNROOMS Page 5 Design Pressure (DP) Rating for Window.& Door Units (psflI Product Aluminum Unit Sizes* Type 33" —39" 45" 51 57" 63# 69"- 75" 81" 87" Single Glaze Door 20 20 20 20 20 20 Single Glaze Window 200 20 20 20 20 20 20 20 20 20 Single Glaze Door with Stiffener 35 35 35 35 35 35 Single Glaze Window 35 35 35 35 35 35 35 35 35 35 with Stiffener I Insulated Door 20 20 20 20 20 20 Insulated Window 20 20 20 20 20 20 20 20 20 20 Insulated Door 40 40 40 40 40 40 with Stiffener Insulated Window 40 40 40 40 40 40 40 with Stiffener 1 1 40 40 40 SELVA LAKES HOMEOWNERS ASSOCIATION REQUEST FOR ARCHITECTURAL APPROVAL This request form is to be completed by the Homeowner and submitted to the(ARC)prior to the commencement of work. DATE RECEIVED BY ARC: 3-a-7, THIS SECTION TO BE COMPLETED BY HOMEOWNER Date: NamR Lot# Address: C-)A(c) Home Phone: 1 Q —I Other Phone: Contractor:- S '�ej- (— ) C Describe the work to be done: (i.e. screen room, addition,fence,garage door,siding,outdoor lights, exterior painting, roof repairs/replacement,gutters, etc.) )0 0 y hk�n n U,Vv--' b kj�� Ck Location: Attach a copy of your survey indicating the location of the work to be done. Describe Location: Specifications: Attach a copy of the plans,drawing,picture, specifications(material,color,etc.) All exterior paint must meet SLA specifications. Estimated date of completion: u, NOTE: Owners are responsible for the conduct of the contractor. You are required to supervise the work being done. You are personally responsible and liable for any damage done to common property or adjacent property. When required by the City of Atlantic Beach,you are r uired to provide the A%ith a copv of the building permit. r Homeowners Signatur:V(1-11�YU (k)/) Date: (X Date Approved te— .1AJ4,n Date Denied F— F, ARC Signature(s): (q Comm 141 ( 1 ents or c4ftio"n k-t f�M6 4�47:bLu)I ri A S