Permit 701 Beach Ave CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000306 Date 3/18/10
Property Address . . . . . . 701 BEACH AVE 104
Application type description PLUMBING ONLY
Property zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 500 ------
---------------------------------------------------------------------
Application desc
SHOWER PAN
-----------------------------------
Owner Contractor
------------------------
------------------------
MERRELL RYAN D AND KAREN OWNER
701 BEACH AVE # 104
ATLANTIC BEACH FL 32233
(904) 642-9636 ------------------------
- --------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc SHOWER PAN 0. INC.
Sub Contractor NELSON PLUMBING C
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . - 9/14/10 ------------------------
------------------------------------------- --------
Fee summary Charged Paid Credited ----Due---
----------------- ---------- ---------- ---------- ---
Permit Fee Total 62 . 00 62 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 62 . 00 62 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH /0 .- 50('4
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904) 247-5826 Fax(904) 247-5845
0 PERmrr#ILD rid.—
JOB ADDRESS:
$ 50c). 01)
NEW OR REPLACEMENT INSTALLATION: Project Value , QTY
TYPE oF FIXTURE QTY TYPE OF FIXTURE
Septic Tank&Pit
Bathtub Shower
Clothes Washer Shower Pan
Dishwasher Slop Sink
Drinking Fountain Three Compartment Sink
Floor Drain Toilet
Floor Sink Urinal
Hose Bibs Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray Water Heater
Lavatory Water Treating System
Other Fixtures
RE-PIPE; TYPE oF FIXTURE QTY TypE oF FIXTURE QTY
Septic Tank&Pit
Bathtub Shower
Clothes Washer Shbwer Pan
Dishwasher Slop Sink
Drinking Fountain Three Compartment Sink
Floor Drain Toilet
Floor Sink Urinal
Hose Bibs Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray Water Heater
Lavatory Water Treating System
Other Fixtures
MISCELLANEOUS:
• Sewer Replacement o Back Flow Preventer Ei Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
• Lawn Sprinkler System-Number of Heads Ei Well
** SJR WD Well Completion Form. Complete&—form to be submitted to the—Building Department for final inspection.
o Other
is suspended or abandoned for six months.I hereby certify that I have read
Permit becomes void if work does not Commence within a six month period or work work will be complied with whether specified
this application and know the same to be true and correct. All provisions of laws and ordinances governing this
or not. The pernift does not give authority to violate the pr ions of any other state or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
� I bt 0 �J C- OfficePhone Fax.
Plumbing Company
StateFf ZiPT-Za5(a-
Co.Address:
License Holder(Print): S qyertification/Registration 4 0 S-7q
11
Notarized Signature of License Holder
I 'a '/�'day of 20—L)
LISA P.BASS Sworn and subscribed before e thi
hIDTARY PUBLIC-STATE OF FLORIDA
COMMISSION#DD726213 Signature of Notary Public
EXPIRES 11/16/2011
BONDED THRU I�688-NOTARY'
CITY OF ATLANTIC BEACH
S-) 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000143 Date 2/17/10
Property Address . . . . . . 701 BEACH AVE 104
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 50000
----------------------------------------------------------------------------
Application desc
WINDOW CHANGE OUT - IMPACT GLASS
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
MERRELL RYAN D AND KAREN REED BROTHERS CUSTOM HOMES &
701 BEACH AVE # 104 REMODELING INC
ATLANTIC BEACH FL 32233 11700 PHILLIPS HWY
(904) 642-9636 JACKSONVILLE FL 32256
----------------------------------------------------------------------------
Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . . DOUBLE PERMIT FEE
Permit Fee . . . . 600 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 50000
Expiration Date . . 8/16/10
----------------------------------------------------------------------------
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/ - 05- 106 SUPPLEMENTS .
2007 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 600 . 00 600 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 600 . 00 600 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road 1-�Z3
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 1 /0
E-mail: building-dept@coab.us Date routed:
City web-site: hftp:/AAN=.coab.us &I-_- I
APPLICATION REVIEW AND TRACKING FORM
Property Address: 70 x d Ave ='Old V Do
Radw,ent review required Ye�z No
-K-ilding, ) -
Applicant: -S 4�z �'-Plamfrn—g&Zoning
Tree Administrator
Project: A)/ Public Works
Public Utilities
Public Safety
Fire Services
U
Rqvie'w, f6e' $ 0 Asignat ro
Other Ag ency Review or Permit Required Rev le w or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: EA"'pproved. F�Denied.
(Circle one.) Comments:
'____7�_
BUILDINW
PLANNING &ZONING Reviewed by: --/Vrl Date:c;? /7-/0
TREE ADMIN. V
4
Second Review: ElApproved as revised. FlDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ElApproved as revised. FIDenied.
Comments:
Reviewed by: Date:
Revised 05114/09
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 1 o
OFFICE:(904)247-5826 9 FAX NO.:(9G4)247-5S45
WAWCOAB.US
BUILDING PERMIT APPLICATION DUVAL COUNTY
MOW
Aly
70 1710
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13 NEW BUILDING 0 DEMOLIT11 N MESIDENTIAL
LOT BLOCK SUB DIVISION 0 ADDITION 11 CONVERTING USE 0 COMMERCIAL
�AQT�,01 WALTERATION 11 ACCESSORY BLDG.
11 REPAIR OPOOL/SPA N/A
A to Q MOVE 0 OTHER
Ql R
9.NAME: 15��NAME: 23.COMPANY NAME:
bAlt- 4 AIII44A.L/I —1 Ne 24.LICENSEE NAME:
6, 4..,
A
10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
--4 14 113-2 EY I
18.ADDRESS: 26.ADDRESS:
11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE�, 20.FAX NO.: 27.OFFICE P -"8 FAX NO.:
,4/
4-fi 5 1-is,-ST 6 J 2--t-tril FN/9 M
6 CELL PHOI�: Z, 4 21.CELL P?HNE- 29.CELL PIr
0 S rrgs,
14.EMAIL ADDRrS: 22.EMAIL A9DRESS: 30.EMAIL�15DRESS:)17r�
2
MR
�14
31.NAME: 33.NAME: 35.NAME:
32.ADDRESS: 34.ADDRESS: 36.ADDRESS:
I
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 laws regulating construction in this
jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced, I understand that separate permits mut e secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
n
OWMER'S AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in complian I ic
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspe are fi e nt
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
P'ia
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ins 41era're 11 24 r V-
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL YOUR 201,
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YO
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Signed: AA4&:� Date: �i 0
- - _,,ol Date: 27A �10 Signed:
Beforernet is �-2;701h7f Before me this C) day o aA.& gni
"A fffty
3 D
Duval,State of Florida, a low appeareWODY ART Duval,State of Florida,has pe 4ofared
ON#DD568 ")MMISSION#DD568.546
_46
�RRS�J,nc26.2010
herin by himself/herse and all tate'M'99:ah�&69�aVl6ns ar herin by himself herself and E 1imn4W;**,qlements arAdwWakawson
wkq�� 'orida S!et s ar
vtop,col,
true and accurate. Notary Ser true and accurate.
Nota/Public at Large,State o nty of N.etPublic at Large,State of County of
i��7 C u P.r� !MXJ A t,—
[De'Personally Known Personally Known
13 Produced Identificat 13 Produced ldentificatk,---Z�Z Z* Z
Notary Signature:1 A Notary Signature: J
D FOR CODE COMPLIANCE
T
IT
Bldg Permit Ap�li CITY OF ATLANTIC BEACH
SEE PERMITS FOR ADDITIONAL
REQUIREMENTS AND CONDITIONS.
"of X E
REVIEWEDBY.—ZV
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DATE:2ZL�
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Jan. 5. 2010 12:36PM CITY OF JAX BCH No. 6758 P. I
NOTICE OIF COMMENCEMENT
ParmltNo. Tax Folio No.
Stec of Florida,County of Duval
THE uNDERSiGNED hereby give notice that the improvement will be in&&to certain real property In accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legal description of and addren if available):
—201 #ACAL4 04-6fe- 7
2. General Description of improvements:
A/o*&-yu
3. Owner Information:
a)Name and Address:
b)Interest in property: gn~
c)Name and address of simple titleholder(if other than owner):
44. Contractor Information:
a)Name and Address: 111919&n i.7J
_ _4 4
J
b)Phone Number: (4 ett JUS—' V-W
3. Surety Information: L)oc#2010032W4,UR BKI!D'I�DZ Hagel 2U9.
a)Name and Address: NUmber Paqes: I
b)Phone Number: Recorded C�2,'!O�201 0 at 03�06 PM,
c)Amount of Bond;5 1A JIM FULLER CLERK CIRCUIT COURT DUVAL
6. Lender Itiftmation: COUNTY
a)Name and Address: RECORDING$10-00
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 713.13(1 Xa)7,Florida Stidutes'
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to himselghersoI4 Owner designates -of toreceive
a copy of the Lionor'sNot.L'ce asproyided- Sectioa1713.13(1) ).F StatultelL
_nck&c aldift -4
a)Name and Address: J- wr 111 41. J1 Or
b)Phone Number of person or entity designated by owner
9 Expiration date ofNotice of Commencement(rho expiration date is one(1)You ftom the due Of Recording unless
different date is specified: SA-4,0- 4 a A— -
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAMR 713.PART
4 SECTION UIL3, FLORIDA STATUTES. AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOU NOTICE OF COMMENCEMENT.
WAA-iL toveo Mara
Sign1idura of Owner'6r owner's Authorized Ofter/Dirsclow?~/Manamor Signatory's himed Now A Tide/Office
. i+) (t
The foregoing instniment was acknowledged befom me this jL day of li'by'j C'Y� 20 0
by
as
(Natee of Pemn) (AutluirityT*,i.e.Officer, am of In was Execaoill fbr)
JODY HART
MYCONIMISSION#DD568546 )NWAR�,"LIC STATE OF FLORIDA
�"eoi, '11PIRES:June26,2010 Print Name: i1314 - :ULVOT
(407) la Notary ServiCaCOM
dlp�sonally Known
0 ldentificationrrype:
Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I declare that I have read the
fbragoing and that the facts stated In It am true to the best of my knowledge and belief,
Sipature of Natural Perm Signing Above
Revised 1011/2009
V
Reed Brothers Custom. Homes, Inc.
6437 Greenland Industrial Blvd Jacksonville,FL 32258
(904)545-5565
License Number: CBC 1252544
Date: February 17, 2010
To Whom It May Concern: With the City of Atlantic Beach
From: Reed Brothers Custom Homes
Justin Reed/Owner
6734 Greenland Industrial Blvd
Jacksonville,FL 32258
Reed Brothers Custom Homes will be installing/replacing the following at 701 Beach
Ave,Unit 104:
• Installing new cabinets
• New flooring
• Repairing sheet rock
• Centering drains for new cabinets
• Replacing the water heater
• Replacing all light fixtures
• Painting the interior, new trim and doors
• Replacing exterior windows and rear sliders
(This form of notary block to be attached wherever notarization is needed:)
State of: T-L On this -�Iin dayof F-e-&u�ivV 20),),personally
appeared before me Q,)tii �AAVZT who
County of. V),jVA�_ stated that (s)he is the -U%ji-v-er of
?4--d a corporation, and that the
instrument was signed in behalf of the said
corporation by authority of its board of directors
and acknowledged said instrument to be its
voluntar ore me:
,y o4 and depd.Bef
Notary Public for Florida
My Commission Expires: Zi u u
JODY HART
MSS
.7-IRES
My COMMISSION#DDW-46
'tOF VV 'XPIRES:Junc26,2010
[(407)39W"153 110.4cia Notwy Serwmcont