Permits 123 Fleet Landing kitchen/bath 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 11-00001561 Date 1/18/11
Property Address . . . . . . 123 FLEET LANDING BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 7800
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Application desc
remodel kitchen bath
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Owner Contractor
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NAVAL CONTINUING CARE NORTH RIVER BUILDERS AND PROPE
FLEET LANDING PROPERTY MANAGERS
1 FLEET LANDING BOULEVARD 6771 SHINDLER DR
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32222
(904) 838-9179
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Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee 45 . 00
Issue Date . . . . Valuation . . . . 7800
Expiration Date . . 7/17/11
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total 45 . 00 45 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 139 . 00 139. 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
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Date,routed:
E-mail: building-dept@coab.us
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /9 -3 fli ment review re Yes No
_DAprt_ i
7- Building
ng &Zoning
t review required
n i ng
Applicant: 0ZS 0 t
Tree Administrator
I
's
Project: Public Works
Public Utilities
Public Safety
Fire Services
0610-
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: ff�(Approved. FIDenied.
(Circle one.) Comments:
(E5
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: DApproved as revised. OlDenled.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F�Approved as revised. OlDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: la3 E64 Laak_- Permit Number:
Legal Description_11� f�leef tMA Parcel
Valuation of Work$
Class of Work(circle one): New Addition P<6� R air M Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): _CommerciieP 1��esienlji
es
If an existing structure,is a fire sprin2r system installed? (Circle one): es No N/A
Florida Product Approval#
For multiple products use product approval I-orm
Describe in detail the type of work to be performed: k0a,10 AAA
(kj
I U
Property Owner Information:
Name: rlep_+ LanklnA Address:
City A, laf%Vic ?)�Ch State r-L-Zip 3 zL33 hone q04- ki 7A-1331
E-Mail or Fax# (Optional)
Contractor Information:
CompanyName: kjarA Alva Rjrlees t &per& Mg&yo Qualifying Agent: L Jo u4 140odA
Address: WIT SkAkec'by. -'-City Stat8' -L- Zip 3ztZZ-
Office Phone -cw2lact Number 838-1(-7,1 Fax (pS 3- i-7qo
State Ceitification/Registration# r _QL51
Architect Name&Phone# If vmwED FOR c,()nlg v
Engineer's Name&Phone# cin or, ATI A ILTrInw—
S i r-rr n NJ ty
Fee Simple Title Holder Name and Add*ss — RE.EEPER"TTSPORA DMONAL 11 1 Li Ll E I
Bonding Company Name and Address QUIREMENT -A N.rn p
Mortgage Lender Name and Address
J,11,-VMD BY:
';�'nce_ rior to the
4pplication is hereby made to obtain a,permit ti(� te installation has com, d7
issuance oJ�aaopermit and that all work will beperformed to meet the stitLizir o isjurisdiction. Thispermitbecomes null
and void f rk is not commenced within six(6)mo,,,,-, dud or aban one eriod ofsix months at any time after
Ma,",*,Plu,,bing, e Is, Pools, -urnaces,Boilers,Heaters,
work is commenced. I understand that separate permits must be securedfor Electrica s
Tanks andAir Conditioners,eta
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.
I herelb cerofy that I have read and examined this application and know the same to be true and correct. Allprovisions of laws and ordinances governing this
work will be co�nplied with whether speci r not. The granting of a permit does not presume to give authority to violate or cancel the
f1ed herein o
provisions of any otherfederal,state, or local law r gu ting construction or the peTformance of construction.
-__1 �
Signature of Owner 01 L" Signature of Contractor
Print Name
Print Narne -:::Tc_WytA t".
..............I......................................... ..................................................
Sworn�o and subscribed before me Sworn to and subscribed before nZe
L) �j e
YL Z e
this Day of 20 �6 this �� Dayof 0 &
a
Notary PulAc
ELIZABETHTESKE Re -sed0l.26.10
ELIZABETH:TESKE
c S of]
State of Florida
Notary Public
Notary Public-State of Florida
My Comm.Expires Apr 5,2013
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My Comm,ExPirls AV 5,20113
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Commission#DID 867829 11
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Bonded Through National Notary Assn..
:=Lftary Asma
NOTICE OF COMMENCEMENT
(PREPARE IN DUPWCATE)
Parrrdt No. I sin Tax Follo No.
State C :�-IcyffL County of
To whom It may concern:
The undersigned hereby Informs you that Improvements will be made to certain real propertA and In
accordance with Section T1 3 of the Florida Statute*,the following Information Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being Improved; LIA J2&1 IA"'Ag ANA
Address of.property being Improved: tu nwj iAj.�A
General description of Improvements: tywi)ltk� V hA16A C04- 5k4-1� 111.11 S-
-4y,rr,,�t J�dt�au iq
Owner t&r-RF
Address o,,e Meet+ LA^Air-. 11,jal - A41A,,Hc, ieal PL s zz-1
V
Ownees Interest In site of the Improvement
Fee Simple*1710eholder Of other than owner)
Name
Address
�Contractor mo(U- 9,i\ser -PrWeJ4 M- -'f4i: U-C
Address— D( - 6L .3":7s
PhoneNc. Fax N�. b, 3-R2q 6
SuratyOfany)—
Address -Amount of bond
Phone No. Fax No.
Name and address of any person m"g a loan for the construction at the Improvements.
Name
Address
Phone No. Fax No.
Name of person 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 addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided In
Section 713.08(2)(b),Florida Statutes.(Fill In at Ownses option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date Is one(1)year from the date of recording unless a
different date Is specified):
THIS SPACE FOR RECORDER'S USE ONLY Signed:-:jC�44'. i4AmI
Belbrain-6-t-hisdayof- AQUAW-2p-8--
County of Duval,state of Fbide,has alkappeared
uoc,g Aj i u,:.�-�--!D,Ul� t3K ina6o- �age ot3u himselfY herself and affiffne tat all statern anq4a tlOn-"Grolu-
NUmoer Pages: am true and accurate 7YELIZABET14 TESKE
pub Sjj�
a of
Recorded,31 13 2-011 at C 1 30 PM 40lary Public-Still of Florida
Mm Piroll W 5 201
j W F U!�L E R C L E R K C'I R 1,L 41-C C J R'7 DI-VA L my Comm.EX 13
EXPInst AI)f 5.2013
COUNTY Commission 0 7008g1829
RECORMNG SIC CC
-Noterf%tiff tLaM#Staloof NVOral Notary Assn,
My com ag
n
expires:
Perronally Knom _or
Produced IdentIfloation
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