Permit 1930 - 1932 Mary Street 01h it
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
11 Mr
Application Number . . . . . 10-00000094 Date 2/01/10
Property Address . . . . . . 1930 MARY ST
Application type description SIDING PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5000
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Application desc
repair repace siding
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Owner Contractor
------------------------ ------------------------
ADAMS, CHERYL UPC CONSTRUCTION, INC.
1930 MARY STREET 9771 COUNTY ROAD 121
ATLANTIC BEACH FL 32233 BRYCEVILLE FL 32009
(904) 6S1-7017
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Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee 37 . 50
Issue Date . . . . Valuation . . . . 5000
Expiration Date . . 7/31/10
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2007 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total 37 . 50 37 . 50 . 00 . 00
Grand Total 112 . 50 112 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
*444 4�Xeoli /--PooC-�
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 10-
OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845
WWW-COAB.US
BUILDING PERMIT APPLICATION
2.VALUATION 0 DUVAL COUNTY
LIN WOO�F
Pce-V S7
4.LEGAL DESCRIP 5.CLASS OF WORK: 00
0 NEW 13UI 6.USE OF STRUCTURE:
LOT3LBLOCKq SUB DIVISION A Q�LQ �5 N 11 RESIDENTIAL
7.DESCRIP ION 0 ADDITION 0 CONVERTING USE 0 COMMERCIAL
0 REPAIR 0 ACCESSORY BLDG. 8.FIRE SPRINKLER:
e- arc.( I<e 10 k*-c 11 POOL/SPA
PROPERTY OWNER: 0 MOVE El YES 0 N/A
9.NAME. CTOR` El OTHER D
15.CO PANY NAME:
a po ti ` G , �, -S 4, VC_ 23.COMPAN
16.NApq: 24.LICENSEE NAME:
10.ADDRESS. ��t k_v-l;LVV it
17.S EO FLORIDA LICENSE NO-: 25.STATE OF FLORIDA LICENSE NO.:
/ 9,1( G_ S019 C)I
5�11' Lwxsdl'ft�e X–'-firt 18.ADDRESS- -L- 26.ADDRESS:
a
I I-OFFICE PIt- ![4i 7N—O.---L�'rCQ V,J N- 32001
J ................................
19.OFFII 1 111 11 1,1
?(:;Z/ �/5 T20 FAX--NO 27.OFFICE PHONE
11 ELL HO-NE: 0 6,y-I' >,O I') I J 0�_3�J �JS_
1:S_—0 2 CELL PHONE- 29.CELL PHONE
14-EMAILAPIZR S' 70-y- 63-il'- 20f
22.E AILAIDPRESS:
eca"A's - � %_lvi, p (.�, 30.EMAIL ADDRESS:
—FEE SIMPLE TITLE HOLDER:
31 NAME: (IF OTHER THAN OVVNERY ONDING COMPANY:
33.NAME: 35.NA.ME: MORTGAGE LENDER:
32.ADDRESS:
ki a 34.ADDRESS: 36.A
Application is hereby made to ob I tain a per lit to do the wojK ano 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
ork,Plumbing.Siamn wii. n__
abandoned for a period Of six (6) months at any time after work is commenced. I understand that separate Permits must be secured'for
Electrical W Is,Furnaces,Boilers,Heaters Tanks, Air Conditioners,etc.
OWNER'S Ar rIUAVIT-I certify that all the foregoing information is acc 'rate and that all wOrK VAII be done in compliance with all applicable
laws regulating construction and zoning. I Will not occupy or use the refer u
prior to obtaining a certificate enced building or any part therof, until all in i
Of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN ?010
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
LENDERrID A111 A 1-rORNEY BE RE REC
FO
OR ING YO
OWNER do rQ7r.,1, J-0 NOTICE OF COMMENCEMENT.
5PTRAC
(If Ag ent,Power of Attorney or Agency Letter Required)
Signed, (Qualifier Only),',
ate Signe
Before me thi day of <T�IAL)AEA/ 1.2010 in the county of Before me this day of Date:
Duval,State of Florida has personally ap eared
to ??– ,2010 in the county Of
/ npttr\, Duval,State of Florida,has perso Y appeared
henn by himself/herself and affirms that all Statements and declarations are :5 - JL
true and accurate. herin by himself/herself and affirms that all statements and declarations are
Notary Public at Large,State of true and accurate.
11"Personally Known 0 ry to Of Notary Public at Large,State of County of
Piroduced Identifimt J_Udith Q 0 Personally Known
Note , It r $rproduced Identificati
RE
C I ANTIC BEAC
SEE PERMITS FOR AD V,
REQUIREMENTS AND FILE CO DEBORAH A.WHITE
Bldg Permit Application 2010
MY COMMISSION#DD 634126
[REVI; BY: DATE�Z� 090*�- I., EXPIRES:May 21,2011
4-10-- . I't - T
Bonded Thru Notary Public Underwriters
LAY
I en-nit No. NOTICE OF COMMENCEMENT
Tax Folio No.
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance wii
Chapter 713, Florida Statutes,the following infon-nation is provided in this Notice of Commencement.
1. Description o�'Rroperty(legal description of property and address if availa le).
-3Q 111Pgy6T. A-T/,qnTk-, "2
L�� da , A,::�T 3
2. General Descripti f* )rO
:Tq 0 iml )Tments:
1 ()�5 R, e- /a le-/y,�e-Al-
3. Owner Information:
a)Name and Address: rnPn ,)
b)Interest in property: 0"i n
c)Name and address of simple titleholder(if—othertlan owner—). --�
4. Contractor Information:
a)Name and Address: red
b)Phone Number: Tc-,
Surety Information:
a)Name and Address: Doc#2010021439,OR 6K 15140 Page 1041,
b)Phone Number: Number Pages:I
c)Amount of Bond: $ Recorded 01/29/1201 o at 12:17 M
JIM FULLER CLERK CIRCUIT COURT DUVAL
6. Lender Information: COUNTY
a)Name and Address: �Jo�j RECORDING$10.00
b)Phone Number: /11\i a
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)(a) 7,Florida Statutes:
a)Name and Address: Iq e /c,::, jq n n [-7
74-) R'� CT' 1A 3.�,
b)Phone Numbers of Designated Person: rL
8. In addition to himself/herself, Owner designates
a copy of the Lienor's Notice as provided in Sectio 14y";A]e- Of LOJ/I fj'�- to receiv
a)Name and Address: n 713.13 (1) (b),Florida Statutes.
VA.�-�T -,Z)X_ Aj. aA S/ FJ)* ajog�s-
b)Phone Number of person or entity designated by owner: ( 01-U �5-oq—S-q t'�-
9 Expiration date of Notice of Commencement(The expiration date is one (1)year from the date of Recording unles
different date is specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF TH1
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PAR-
1, SECTION 71-3.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOI
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED ANI
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 RECORDIN(
YOUR NOTICE OF COMMENCEMENT.
Awl /65JA
Signature of Owner or Owner', al�El Q3
er/Manager Signatory's Printed Narne& ritle/offic
Judith D Caffam
C. ff My Commmim DDSM781
The foregoing instruinent was d a y 0 f 20 1,0v by
as
for
City of Atlaritic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: hftp:/Atvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 19 90 -jz 2 jr .-Departniqlrit review required Yes( No
CBuilcling,---, V
Applicant: it Mining &Zoning
Tree Administrator
P roj e c t: ?,C-P A, Public Works
Public Utilities
Public Safety
Fire Services
qy IRV
Other Agency Review or Permit Required Review 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:
APPLI CATION STATUS
Reviewing Department First Review: Da/Approved. ElDenied.
(Circle one.) Comments:
BUILD19
PLANNING &ZONING Reviewed by: /? 7 C),_ Date: -Z—
TREE ADMIN. Second Review:
]Approved as revised. F�Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09