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Permit Demo Interior only 2010 CITY OF ATLANTIC BEACH SS 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00001061 Date 8/27/10 Property Address . . . . . . 1923 BEACH AVE Application type description DEMOLITION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 8000 ---------------------------------------------------------------------------- Application desc interior demo ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ THE GELLATLY COMPANY P 0 BOX S1393 -@-H- FL 32233 PENMAN RD JAX BEACH FL 32240 A)6--S t (904) 993-5014 --- -- ----------------------------------------------- Permit . . . . . . DEMOLITION PERMIT Additional desc . . Permit Fee . . . . 100 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/23/11 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 100 . 00 100 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 100 . 00 100 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office(904)247-5826 Fax (904) 247-5845 Job Address: . 1923 Beach Avenue, Atlantic Beach, FL 32233 PermitNumber: /0-/D(,,z Legal Description Lot 5 1,North Atlantic Beach Unit 2 Parcel# Floor Area of Sq.Ft. Sq.1,t Valuation of Work S 8,000.00 Proposed Work heated/cooled 2,800 non-heated/cooled 690 Class of Work(circle one): New Addition Alteration Repair Move � emolition pool/spa window/door qEEE� Use of existing/proposed structure(s)(circle one): Commercial If an existing structure,is a fire sprinkler system installed? (Circle one): Yes (E) N/A Florida Product Approval# N/A For multiple products use product approval form Describe in detail the type of work to beperformed: Remove and dispose of the existing wall,ceiling, and floor coverings in preparation for the remodeling of the existing house. No structural walls are to be removed. Property Owner Information: Name: Melanie&Richard Hastings Address:41280 Rue Jadot City Temecula State CA Zip 92591 Phone 951-676-8850 E-Mail or Fax# (Optional) socalmelanie@msn.com, FILE C OPY Contractor Information: Company Name: The Gellatly Company Qualifying Agent: William R. Gellatly .. .........;.................................... Address: 1515 #13 Penman Road -City Jacksonville Beach Office Phone 904-246-9080 -Job Site/Contact Number 904- "RVODE COMPLIANCE State Certification/Registration#- CGCA21737 CITY OF ATLANTIC BEACH Architect Name& Phone# William A.Leuthold 904-389-5 5 SEE PERMITS FOR ADDITIONAL Engineer's Name&Phone# Chris Kathe 808-322-9494 ()U I RE7-()UIREMENTS AND CONDITIONS. Fee Simple Title Holder Name and Add-same as owner Bonding Company Name and Address N/A D A'IT-: rREVIE7WEDBY:.-etz� Mortgage Lender Name and Address N/A A co he e made b ai a d h work and n a a ndica or installation has commenced to the in e i t s s i ,r t prior Su a' s thisjurisdiction. This permit become tiF 0 k i s awl eriod of sixpull,months at any time after 0 e tom it '�r y ha a rk be it to d he ta 'i 'io 's r ' 0 0 t per t nd t ef r-h" or c st s c n w wi pp nce emi t ' 0 ' p ,d 1�,p k 0 co e ed thi ssu 0 'u r u oid 'Or is' t I u'I'c, wi ' ix ) 0 i Z 0 ut,edjoroElectrica ells,Pools, urnaces,Boilers, Heaters, is f c d de ta d that separate per,is mu t be sec o,k co me e s T s a jr Co tion , t ank ndA n,* e.'s e a 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 FINANCING9 CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereb certify that I have read and examined thi's application and know the same to be true and correct. All provisions oflaws and ordinances governing this 9.work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions ofany otherfederal,state, or local law regulating construct' the performance ofconstruction. Signature of Owner Signature of ContractorqLu%AP4\%.t, N-j 66Print Name mi I E /4AS-77 14 6 Print Name at� --..................... ...... ......................... ........................................-5.................. ... ........... Sworn and subscribed before me Sworn t9jand subscr e e re me Day of 44,�S�k 201-c> thiso&4c Day o 20/40 2A A6M I A -11dz e4 I UBUC-STATE OF FLORIDA Notar� Pifflicl— ASHLEY DARRAH TH N(taty Pflic Nancy M. augk .Commission#DD607879 Commission # 1743323 0 ft�§M,2010 z Notary Public -California z z Riverside County BONDED THRU ATLWrIC BONDING CO.,INC. MYCOMM.80UMMY3,2011 t PWWWV- - -I NOTICE OF COMMENCEMENT PermitNo. 16:�,1061 Tax Folio No. THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section 713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT. I.Description of property(legal description): Lot 5 1,North Atlantic Beach Unit 2 a)Street(job)Address: 1923 Beach Avenue,Atlantic Beach,FL 32233 2.General description of improvements: Remove and dispose of existing wall,ceiling,and floor coverings in preparation for remodeling of the existing house. No structural walls are to be removed. 3.Owner Information a)Name and address:Melanie and Richard Hastings 41280 Rue Jadot Temecula,CA 92591 b)Name and address of fee simple titleholder(if other than owner) c)Interest in property: Fee Simple 4.Contractor Information a)Name and address:The Gellatly Company(William R.Gellatly), 1515 Penman Rd., Suite B,Jacksonville Beach,Fl, 32250 b)Telephone No.: 904-246-9080 Fax No.(Opt.)904-246-9200 5.Surety Information a)Name and address: N/A b)Amount of Bond: c)Telephone No.: Fax No. (Opt.) 6.Lender a)Name and address: N/A Phone No. 7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a)Name and address: b)Telephone No.: Fax No.(Opt.) 8.In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(l)(b),Florida Statutes: a)Name and address: A//-A b)Telephone No.: I Fax No.(Opt.) 9.Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a different date is specified): 10/15/2010 WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13, 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 FINANCINCy,`I�ONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK��CING y7U N�tlq�rEOF C�OMMENCEMENT. STATE OF FLORIDA COUNTY OF DUVAL 10. Signature of Owner or Owner's Authorized Officer/Director/41"artner/Mana,��,� � E f-� --n (d Print Name The foregoing instrument was acknowledged before me this Eq day of 201D by M6L40:9-- as :S: (type of authority,e.g.officer,trustee, attorney in fact�for (name of vair-tv on behalf of whom instrument was executed). Personally Known OR Produced Identification Notary Signature Type of Identification ProducedC&,��— Name(print) OR Verification pursuant to Section 92.525,Florida Statutes.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. F0RMSN0C,rvsd201 0 Signature ofNatural Person Signing(in line#10.)Above Aml Wkhd&w" ASHLEY DARRAH THOMPSON Commission # 1743 23 Notary Public -California Z Z Riverside Coun My Cam.Bq*m MaV3.2011 City of Atlantic 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: http://vvww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Department review required Yes Ao Q u i I d iin� Applicant: Planning &Zoning Tree Administrator Project: Public Works Public Utilities Public Safety Fire Services $ 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: APPLICATION STATUS Reviewing Department First Review: EfrApproved. E]Denied. (Circle one.) Comments: �BUILDIN9�) PLANNING &ZONING Reviewed by: Date:2L) 6/ta TREE ADMIN. Second Review: F]Approved as revised. F�Di/nied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. [:]Denied. Comments: Reviewed by: Date: Revised 05/14/09