Permit Siding 1933 Seminole 2011 0 1j. lel
,A CITY OF ATLANTIC BEACH
� „ s 800 SEMINOLE ROAD
I ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
C).3
Application Number . . . . . 11- 00001726 Date 2/28/11
Property Address 1933 SEMINOLE RD
Application type description SIDING PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 5000
Application desc
REPLACE WOOD SIDING WITH LAP HARDI BOARD SIDING
Owner Contractor
HOLLEY GALAXY BUILDERS INC
1933 SEMINOLE ROAD 5544 DOVER CREST LN
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32258
(904) 616 -8938
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee 37.50
Issue Date Valuation . . . . 5000
Expiration Date . . 8/27/11
Special Notes and Comments
*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 75.00 75.00 .00 .00
Plan Check Total 37.50 37.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 116.50 116.50 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
so,
' BUILDING PERMIT APPLICATION
1 , CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 19 '`'INAL 'RA Af Wit Q, 322.33 Permit Number: //— / 70{.6
Legal Description Parcel #
Valuation of Work $ S 06° Proposed Work heated /cooled S lit
Sq. cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing/proposed structure(s) circle one): Commercial Residential
If an existing structure, is a fire sprinjler system inst� (Circle n ): Yes No N /A
Florida Product Approval # ' /. (' ( i1 ar g oev r
For multiple products use product approvafTorm
Describe in detail the type of work to be performed: � i\ Al r fezt tt yJaS I 71 MQ af2 S, aylt,
„...)6,(-.. ski i l k . Si ck; I u.ii-e _ o,,ri l bwrik , 61k- QQi -p__---
Property Owner Information:
Name: Ott' PA. (v) 14t\t'\ Address: ftrgivO.P /.3 ')JI B l - It
City Sa• ..srwi \lt, State -Zip 32.1 -" Phone 7 bqIB- 4-D• -CD...
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: C (q i �/l rd, (, , Qualifyin Agent: A C'` ?Gf 'PC 4-5,,` hC��
Address: 5c it Av f L- - City orce�' �� l
Office Phone Q'0 Lf - ca. I4 3 J r=-..:2--,--z--: - -.._..._.-_...._ --- �P _ - F-71-- G ip 1 `,�
Mate Certification/Re stration # j -45.1 - rriq _ k '�`: / 1 �' n - .. � Z
4rchitect Name & Phone # 1 n : It V r4 ff
Engineer's Name & Phone # 1 _ _ _ !. "
Fee Simple Title Holder Name and Addres
3onding Company Name and Address , ' ' ' - � -I" � - - - - � � � - ' � � ���
Vlortgage Lender Name and Address !
,; �.�--��—����
application is hereby made to obtain a permit to do t e wor and installations as indicated 1 certify that no work or installation has commence, prior to the
ssuance 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
znd void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for apperzod of six (6) months at any time after
vork is commenced I understand that separate permits must be secured for Electricar Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo Heaters,
ranks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMIVIENCEMENT 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.
'hereb certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
ype of hereby will be complied with whether specij ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
?rovisions of any other federal, state, or local law regulating construction or the performance of construction.
signature of Owner n
//J1 J �� / i ahu e of Contractor
'riot Name data ( i //� r /� / 1 i'
/ " /O (/ w .... �+. Name r re--ta(4
;wo $ d subscr' fore me ' vto and subscribed before me
his his t-- Da of d , 20 (/ d C ur rn 2 Day of 2_ • Totary Public e� ',��, MY COM # D 634126 i r .1„�� "'i ot. • ,a∎ • : .
ese
' MY COMMISSION # EE0335 9
°" i « E XPIRES: May 2 2611 mime t+ .
� � b�' Bonded Thru Notary Public Underwrdere ? � � . ' 1
'g o � Y�, ,1 Limp � g 4 p» ` XPIRES October 1.26.10
¢ r -) y ( Florida NotaryService.com
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,
NOTICE OF COMMENCEMENT
Permit No. (H� 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 with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of property flegal description of property and address if available):
19 3 3 Swm;..k t 1 1 . F. 3 2313
2. General Description of improvemen s:
f`tplo �� Q t row , a 06 4, Si ti usf kVA to
3. Owner Information: ii ''
a) Name and Address: .Ci �- ( $ j 1- 11l1t'
b) Interest in property: OvJ r.xr
c) Name and address of simple titleholder (if other than owner):
Contractor Information: � I F
a) Name and Address: 6 q [Gl 0 lase /sr / c
y b) Phone Number: ' t.tt 6/.6-pig
5. Surety Information: Al
a) Name and Address:
b) Phone Number:
c) Amount of Bond: $
6. Lender Information: 1
a) Name and Address: N
b) Phone Number:
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: /316
b) Phone Nuinbers of Designated Person:
8. In addition to himself/herself, Owner designates °1l of to receive
a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
a) Name and Address:
b) Phone Number of person or entity designated by owner:
9 Expiration date of Notice of Commencement (The expiration date is one (1) year from the date of Recording unless a
different date is specified:
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
I, 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 FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
The foregoing instrument was acknowled ed before me this day //
yof � / ,20
/l /r
/
Doc # 2011044750, OR BK 15526 Page 1145,
Number Pages: 1 NOTARY PUBLIC, STATE OF FLORIDA
Recorded 02/25/2011 at 03:24 PM, r 7 • . 'w 'r _i1 f
±.A4 City of Atlantic Beach APPLICATION NUMBER
Building Department g p (To be assigned by the Building Department.)
' 800 Seminole Road 7Z 6
Atlantic Beach, Florida 32233 -5445
Phone (904) 247 -5826 • Fax (904) 247 -5845
(0-6/1 r tt E -mail: building - dept @coab.us Date routed: Z-
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 " -,3 w � ..�, (4) Del nt review required Yes, No
:uildin•
Applicant: �J 0.X ?7a-r5 Planning & Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire Services
p z Y ri !�$ � ��(r� �i ��k 1 �wN a ilii *� S ✓ a i �
F evi w fe f I � �� ..; ilia @� �a aD p i
ig ture �� `rj, c 1 6 i � 1 4 0400
Other Agency Review or Permit Required Review or Receipt Date g 1
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 hl#44#‘6
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: FlApproved. ❑Denied. -
(Circle one.) Comments:
(BUILDING
PLANNING &ZONING Reviewed by: Date:0 /1
TREE ADMIN. Second Review: ['Approved as revised. ❑ enied.
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