Permit Bldg Kitchen, bath remodel 115 Fleet Landing 2010 0 4 , 4.L. µ # e,} CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
} s ATLANTIC BEACH, FL 32233
„...." INSPECTION PHONE LINE 247 -5826
Application Number 10- 00001341 Date 11/05/10
Property Address 115 FLEET LANDING BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 20000
Application desc
RENOVATE BATH SHOWERS
Owner Contractor
NORTH RIVER BUILDERS AND PROPE
PROPERTY MANAGERS
6771 SHINDLER DR
JACKSONVILLE FL 32222
(904) 838 -9179
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . . 150.00 Plan Check Fee . . 75.00
Issue Date . . . Valuation . . . . 20000
Expiration Date . 5/04/11
Other Fees STATE DCA SURCHARGE 2.25
STATE DBPR SURCHARGE 2.25
Fee summary Charged Paid Credited Due
Permit Fee Total 150.00 150.00 .00 .00
Plan Check Total 75.00 75.00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 229.50 229.50 .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
b Address: / 1 r t . F ( z T L J I J l,VD. Permit Number:
:gal Description Parcel #
Valuation of Work $ So 000
ass of Work (circle one): New Addition Alteration Re 'air ►A - I olition pool/spa window /door
m of existing/proposed structure(s) (circle one): Comme ' esidentia
an existing structure, is a fire sprinkler system installed? (Circle one): • - s No N /A
orida Product Approval #
>r multiple products use product approva orm
:.scribe in detail the type of work to be performed: V...‘140JM- 13pMkC‘ct,MS I Staotri -S ���46.rJ
CA6u4 (o` ! ! St L; 614
- opertv Owner Information:
ame: /.J CCig F Address: 0tl16 GanlbiA1 C- 1 -/t
ity Peru A P, .A / - 1 State Fl—Zip 1 27.- - 2:5 Phone 4.0" - #2..L AD 900
-Mail or Fax # (Optional)
ontractor Information:
ompany Name: 4n4(. tt oe 44:dierS elpt,42 /11..40,9r, Qualifying Agent: ,../SAM A M. 00evi
ddress: (0 - 111 .Shin Jlef fir City 'Pic kso.iii State FL Zip 3Z2tt
ffice Phone *4- 133Q .1/11 Job Site/ Contact Number a }oc1- 1333 -13! "7`"t Fax # `1,D - ve3. 0 - 748
tate Certification/Registration # C G C l'j 18q ( $
rchitect Name & Phone # r.)//4
ngineer's Name & Phone # s
ee Simple Title Holder Name and Address
onding Company Name and Address
lortgage Lender Name and Address
npaccation is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
suance 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 months at Id
ork void if ommenced. 1 understand that separate per ts t be secured for Elec I Fork , tPlumbi n g abandoned for a Wells, Pools, x F u r naces, Boilers, t H eat e rs,
anks and Air Conditioners, etc.
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 BE OMERECORDING YOUR NOTICE OF
COM MB
hereby certify that I have read and examined this a placation and know the same to be true and correct. All provisions of laws and ordinances governing thi.
rovisions of any other federal, state, or local a w regulating construction or the performance of constructio,esume to give authority to violate or cancel the
/ . Signature of Contractor
>ignature of Owner
'rint Name 3 C&A Print Name Fi [ , ac>.
;worn 7 A/<><:./ tp and subscribed before in Sworn to and subscribed before me 20 /v
his Day of cwt bJ . 20 / G' this q Day of /t/c. .�
Vo`Cary P — — Notary Publt
A
�'' Public
, ELIZABETH TESKE Notary ...,bt I H TESKE
• State of t ed 01.26.10
FI�F1
i l 4�y Notary Public - State of Florida l -
;
,• _ My Comm. Expires Apr 5, 2013,6 •= Comm. Expires Apr 5, 2013
No a ,= Commission 1 00 867829
N 00 887129 �••
dam, Commission ° °, `�' Bonded Through National Notary Aria.
t. ' ��a` Bonded ihrousA National Notary Assn. �
• 4DJ -4 -2010 12:06 FROM: CLERK OF COURTS 904 270 1512
T0: 92475845 P: 1
NOTICE OF COMMENCEMENT
IPRCPARC I M DUPUCATF)
•
Permit No Tax Folio No.
Slate of county of
To whom It may concorn:
The undersigned hereby informs you that improvements will be made to certain real property, and in
accordance with Section 710 of the Florida Statutes. the following Information is stated In this NOTICE OF
COMMENCEMENT.
tspat description of property being improved:
Address of property being Improved: 1 l kF.G,T 1-44 It3 C■ SLAV' •
orteros 151401.4Qx • ► General desolation of Improvements: Q� �l�- %� .
Owner AlCC1Z F .
Address OA) eG LMDIAA Ze.JD.
Owner's interest in site of the improvement
Fee Simple Titleholder pf other than owner)
Name
Address
' Contnal Jr . - ..• , .
Address 1 x' Ci, .14er f - n -w- -c..nui)1P 1 F` -- 32tz2.
10 L A ' Phone No. Qou - �3 3 R - °I I1' Fax No. Rio - (0 8A — 2 8
l Surety (R any)
A einliss Amount of bond 16
Phone No. -- Fax No. r
Name and address of any person matting a Joan for the construction of the Improvements.
Name
Address -
Phone No. Fax No,
Name apeman within the State of Florida, other than himself, designated by owner upon whom notices or other ,.
documents may be served:
Name
Address
Phone No. Fax No.
In eddlUon to himself, owner designates the tbtlovAnp person to twelve a copy of the L1eno► s Notice as provided In d Section 713.Oe (Z) (b), Florida Statutes, fFai to at Owner's option).
Name
Address
Phone No. Fax No.
Exppotion date of Notice of Commencement (the expiration data is ono (1) year from the date of recording unless e
different dote to spacipod):
THIS SPACE FOR RECORDER'S USE ONLY r / �_ . o t ! 0
sig ned: _____,-56� , 1
eer•n�mee0 dq•t [201:17Z1.-11" -r • •
County of Drivel, Crete rR Meth~ hoe pooenally e - simrnw .9
IZA • • ^ XE
Newel herolf end eters - e 9Ut mates ind n • �M '''
pro duo and a60trob tiiir Notary Politic - State of florid. )
•• f Myr Cerro. Expires Apr S, 2018
• Commission • CO e67820
l ncPe� r
HMO Dinh ll MOON Notary IStI.
Doc w 1u tut :0 4. OK dre t rj4I rage 453, NAY a at tmpa, side •t J c
ReCardecardOd 11/0 at 12 10 PM. My oaMmi.ebn ewer
Pi,•onety earner
JIM FULLER CLERK CIRCUIT COURT DUVAL Produee err
FOeGae
RECORDING SIO.00
4 51..Aw rir , City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
sy 800 Seminole Road /Q f /.
•« Atlantic Beach, Florida 32233 -5445
Phone (904) 247 -5826 • Fax (904) 247 -5845 ��
�= !3
l')14 Date building- dept @coab.us Date routed:
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM�
Property Address: 15 1/ '/ ittn/ D rtment review required Yes No
Applicant: a ,4 K' ViA. XrK +/ 104/5 Planning & Zoning
.4) /,_ b' Tree Administrator
Project: Ld jyft- 3N- / /no Public Works
Public Utilities
-• it Public Safety
p Fire Services
T '"�4� ira �� e �� � �yy rPS� � �� ��y�(�f ���° :�i��s
H „ tq'�' .!7;1�+, 4. �,�Dep SigII Mature I:: LI T ( � h _ "6`�' w Fes` it 4 b�'IS ��1.g '' t ,G
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: ❑Approved. Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by: Date:
TREE ADMIN. Second Review: Approved as revised. ❑Denied.
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
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
t:.)V ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 10- 00001341 Date 11/12/10
Property Address 115 FLEET LANDING BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 20000
Application desc
RENOVATE BATH SHOWERS
Owner Contractor
NORTH RIVER BUILDERS AND PROPE
PROPERTY MANAGERS
6771 SHINDLER DR
JACKSONVILLE FL 32222
(904) 838 -9179
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 83.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 5/11/11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 83.00 83.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 87.00 87.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 08 10 12:54p Information SystemsCITY 0 904- 247 -5845
p.1
PLUNGING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: //6' - Ligt 6LVO PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $ •
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub l Septic Tank & Pit
Clothes Washer ShBher /
Dishwasher
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavator Water Heater
`
Other Fixtures 4 Va -VA / Water Treating System
RE -PIPE:
TYPE OF Fa'TU E QTY TYPE OF FIXTURE Qry
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain - _ :._ . _._
Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Presenter ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System Number of Heads ❑ Well **
** SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
❑ Other . .
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read
this application and ]mow the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name 1LE�I 11101Q Phone Number 26 -- f fe 0
Plumbing Company Ravi G ray Plumbing, Inc. n
8850 Corporate Square Cuutt Office Phone /�1 - ��� Fax 7 -5 e�
Co. Address: Jacksonville, Florida 32216 City State Zip
License Holder (Print): 7)Iv:O / ( Iq1 State Certification/Registration # Cc' c)02
Notarized Signature of License Holder 1.700.11- )i
,
Sworn and subscribed before me this lZ da of Ziftflacv 20 /6
Signature of Notary Public iftkie t i
+l. `�` Y ' Notary Public State n of Florida
Neal R Major
s ,` My Commissio EE032510
OF ft Expires 12/20/2014