Permit Siding 1972 Beachside Ct 2010 4 E ;' CITY OF ATLANTIC BEACH f.
., - P z ip
800 SEMINOLE ROAD
t: 4 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
4 on 9
Application Number 10- 00001433 Date 12/03/10
Property Address 19 BEACHSIDE CT
Application type description SIDING PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 4000
Application desc
SIDING
Owner Contractor
HAINES REMODELING PROS
1972 BEACHSIDE COURT 2763 MANDARIN MEADOWS DR N
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32223
(904) 545 -4638
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . 70.00 Plan Check Fee . . 35.00
Issue Date . . . Valuation . . . . 4000
Expiration Date . 6/01/11
Special Notes and Comments
need noc
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 70.00 70.00 .00 .00
Plan Check Total 35.00 35.00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 109.00 109.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
` o tAki ; � J , City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
r "Iriti 800 Seminole Road / //d -11/33
1 � Atlantic Beach, Florida 32233 -5445
Phone (904) 247 -5826 Fax (904) 247 -5845 Date routed: /���
t rt �' E -mail: building- dept @coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: / 9 / &11 Chi- i £ r.-~ Department review required Ye w No
L Building„)
/ Planning & Zoning
Applicant: ' « �? Tree Administrator
Project: �`" Public Works
1 Public Utilities
Public Safety
Fire Services
R I �^+w` �k , 3`! r � � " � ��a� i � � r.,r n' �^ i�il � � ".„� ���, r i "�`�' td � !�� n� ��; �
ww ...,,,. df �I ' �' 1 q9 rmk„ �; r� f `I� e t � '�+ �,' •
Review or Receipt Date
Other Agency Review or Permit Required 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: no C
BUILDI
PLANNING & ZONING Reviewed by: - 1 / 71 Date: /»3
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
•
BUILDING PERMIT APPLICATION
k CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: /9 72. ,6e,.4_45/-.6_ e! Permit Number: /7 //53
Legal D escription Parcel #
/ Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ OA Proposed Work heated /cooled non- heated /cooled
Class of Work (circle one): New Addition Alteration CRep_aj Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercia
If an existing strucure, is a fire sprinkler system installed? (Circle one): Yes (i N /A
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed ft' e.� ® S �.�'� %� sue e ,
t. -/rk� ,9 O G / ll. /7 a /4•11/ .14, 6 e ,L .b ' c e e/? '-el NJ, f it J E'7 e
Property Owner Information:
Name: 4M l7•'t /■ &5 Address: /9 7 ee ,,, s /e c
City .9 f'/1 /i ,t5e e- 4 StateJZip Phone
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: /) at CA.-, eeCI- Pa Qualifying Agent: f •Ge 7° c> / t- t-s-
Address: 2 7 / l i 6,- / i MG ‘4,- .0',-- ,mot- / City ,T‘ e elk� State ,,c Zip 5-1-2-2-i Office Phone b 1 ( �S �/ 6 3j Job Site/ Contact Number��, / - 6 D
State Certification/Re g istration # C-.66- - /.3- 5 a-,? ` /7
Architect Name & Phone # 1 Y 0 = 11. ' ' ' - - I
Engineer's Name & Phone # SEE PERMITS FOR ADT)(TTONAL
Fee Simple Title Holder Name and Ad ess .41 REQUIREMENTS AND CONDITIONS.
Bonding Company Name and Address 4,/,1 REVIEWrll BY: e
Mortgage Lender Name and Address . DATE
Application 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
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 must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo Heaters,
Tanks 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 BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereby certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of 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 of any other federal, at r ocal law regulating construction or the performance of construction.
s,� .`M�.....
Signature of Owner °'mil -.A. ,',<S ature of Contractor
I
Print Name 7' briV 9 s ...,.k' r Name , r
_ - 'fy i
Swo S 4 -,, o . n a subscr J ? -- fore me
rxio s ubsc ' . d b ore �� e , 20/
this 'S ` , o 20 . Frith, ' i i a :• f av
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r , .r ' , _ • IRLEY L. 0 t+ try P
Notary 1 „ M COMMISSION # DD 957760 ' ,, s n MY COMMIISS ONN d l M7j$ed II .26.10
�„�,,,r` „` E_ FIRES: February 14, 2014 1 . � AO� ? . �= EXPIRES: February 14, 2014
-, v �� T N
° Bonded hru Notary Public Underwriters = ... oQ
Rf ,� P , 'k ,; Bo nded ,_, N otarY Public Underwriters
DEC -3 -2010 16:36 FROM:CLERK OF COURTS 904 270 1512 TO:92475845 P:1 /1
NOTICE OF COMMENCEMENT
r� pacepRE IN DUPLICATE)
�_
Permit No. j ' c aO/7_3 ? Tax Folio No.
Stale of
To whom it may concern:
The undarsignod hereby to form! you that improvements veil bo malts to certain noel propotty, and In
accordance with Seam 713 of the Rands Statutes, tits following bttornietlon Is stated In this NOTICE OF
COMMENCIOFENT. p ��7/� ,
Legal dese rten of properly be Improved: 22 -lag 1 Z. D 21 . �-
1
oe
Ad s . of p lopeR y beteg im proved • l 9 � 2 ed..., . �C c
i L
Oesleral dtsalptloft of BnpeorsMtlerds: S
' /h F ,sue .h a t• r /
,� e2 r
Owner s. G . LA" e
Address _ Q -^
Owners Interest £r site of the improvement
Fee SIMpie TIIeholder Of Wet than owner) l
Name l
Address
k ))-1142 commit'',
Address 7 r - , - v /> 4) 3.7a.Z
Phone No. `� env „SS' 'c'' KC f? Fax No.
btit Sur ety
(It stip
/ Amo.jt albondS . laddnaia .
Phone No. , Fax No.
Name end of soy person making a loan for the oonaburdIon of the improvements.
Nine, /4--•
r
/Address
Phone No. , Fax No,
Name of person wQ $n the Stale of Florida. other than. himself. designated by owner upon rArom Micas or oCrer
documents may be served:
Name i .
Addle
ddlese /
Phone No. Fax No. .
In addition to Mend?. owner designates the lbllovAnp person 10 modes a copy of the Lienct'a No as prodded In
Section T13.OS as Flodds Statutes. (FN In at Owners option).
.
Name
/Address
Phone No , Fax No, •
t xplratlo» Onto of Notts of Commencement (the expiration data le one (1) yearthe» the date of teoesOhq unless a
efferent date is spetifed):
T14S SPACE POR RECORDER'S USE ONLY J - /� �v / / //��J,f1''
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P,ocorded 12/03/2010 at 03:40 PM, '' , +::� ;.,'"..-.-=a-_1---
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JIM t ; ULLER CLERK CIRCUIT COURT DUVAL N _ �.-=.1 �.'% ,,
COUNTY mycohisssedni • -, IC i.P enI et
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RECORDING 1i1U,OQ iv " 771!'tI I -.---