Permit Awning Poe's 363 Atl #1 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00002867 Date 11/18/11
Property Address . . . . . . 363 ATLANTIC BLVD UNIT 01
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3620
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Application desc
decorative shutters
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Owner Contractor
------------------------ ------------------------
POE ' S ADVANCED AWNING & DESIGN
POIS RESTAURANT 2155 CORPORATE SQUARE BLVD
ATLANTIC BEACH FL 32233 BLDG 100
JACKSONVILLE FL 32216
(904) 724-5567
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee 35 . 00
Issue Date . . . . Valuation . . . . 3620
Expiration Date . . 5/16/12
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
FLORIDA FIRE PREVENTION CODE
NATIONAL ELECTRIC CODE
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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 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.
Doc#20!1250932,OR BK 157/713 Page 11364,
NUmber Pages� 1
NOTICE OF COMMENCEMENT Recorded 11,1&2011 at 11�09 AM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
Permit No. RECORDING$10.00
Tax Folio No.
TBE 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 descriptio : -( )] -I - 2-- P-7 1 -�ot 4W1r4;C- Feclo_�\
a)Street(job)Address: sto!K� P'V1CAf\jt0 "�'L� 4k i
2.General*scription of i in rk-C%Q(CzhW GMArnmkiry\ Lf"�bt..k44ers- I)tq *1 e
WQ'b� 4 CA('I n 6 U �C�om U S
3.0,A,ner Infbnnatioj�
a)Nameari Id-,
b)Name and address of fee siniple titleholder(if other than owner)
c)Interest in property
4.Contractor Information tilou
'31,L-a V 17L S22 1 L-0
a)Nameand address: Acy'noer' Qwn'teiQ 4-�be�kQn U Q- L
b)Telephone No.: ULA -72-H '55LD-1 Fax No.(Opt.) CH 2A I rz-:�;-
5.Surety Information
a)Name and address:
b)Amount of Bond:
c)Telephone No.: Fax No.(Opt.)
61ender
a)Name and address:
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:
b)Telephone No.: 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):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFI'ER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IA11PROPER 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 YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COt7T*,W OF PINELLAS 10.
siarture ofo, 'q Authorized OiTicer/Director/Pm-tner,'Manage-
CL79Z�-' -
Print Name
The foregoing instrument was acknowledged before me this 6V XA day Of hLl, ,6,e2- 20 // by
as (��rj (type of authority,e.g.officer,trustee,
attorney in fact)for (name of party on behalf of whom instrument was executed).
Personally Known OR Produced Identification Notary Signature a,11,4:-)
Type of Identification Produced Name(print)- leo,-,) hi G J-)�S
OR
Verification pursuant to Section 92.525,Florida Statutes.Under penalties of peijury,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.
FORMSNOC�'W2010 Signature of Natural Pemnrson fir&n line#10.)Alaftry PuEblic
Kathleen Marks
vommonweWth of MassaOusetts
setts
ja
Sky Corninissiori Expires on Jan.16,D2O1 8
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC 13EACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845
LIU Iyu V V 17 U
Job Address: 3�'3 J3141 5--+1 Permit Num L'er: '7
e
C'r,olc By
Legal Description 1-U':D- th Parcel
OL) Floor Area of Sq.Ft. SqTt
Valuation of Work S &o207 ProposedWork heakilf—led non-heated/cooled
Class of Work(circle one): New (25�� Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one):. cCo-m4merc* Residential
-a '
If an existing structure,is a fire sprin=system insta ircl'e tone): Yes No
Florida Product Approval#
For multiple products use product apliroval form
Describe in detail the type of work to be performed: 5k4efr
V-/9-4+ tlu of CL u e S�cl A Akr S
Property Owner Information: 12-f.-,4 M 44"1 cwte-vv
Name: L-M Address: t3vy. 13'30.+197
City. f3c*�'A State F-Zip-17-!:33 Phone lvl(, T11, (15-1
E-Mail or Fax#(Optional
Contractor Information:
Company Name: LLC —Qualifying Agent:
Address: 'L�S'5 6—IL-4- a,— W-14 -11t foo City �&e- ZiD *3 2 7-1(0
OfficePhone It, Job Site/Contact Number 90LIS 609 4-7 Fax# q pq 1 ZJ4 13 2'-,&
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone# LeLYXWck—jT,41L-A 6(o I L4 1<6 L 4'-:: r i i r- r%v
Fee Simple Title Holder Name and Address' r ii r i a tj r i
Bonding Company Name and Address
Mortgage Lender Name and Address
�pplication is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commencedprior to the
issuance ofa permit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
and void If work is not commenced within six(6j months, or if construction or work is suspended or abandonedfor a period of sixj6"months at any time after
i , 1 6 1 u, Bo is at rs
work is commenced. I understand that separate permits must be securedfor Electrical Work,Plumbing,Si ns We Is,P a s, rnaces, He ,He e
Tanks and Air 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 YOUi NOTICE OF
COMMENCEMENT.
Ihere certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances gov this
work will be complied with whether specified herein or not. T ranting of a permit does not presume to give authority to violate or the
typ e o7l, I
provisions ofany otherfederal,state,or local law regulating on Pne7the peTfomance of construction.
Signature of Owner. Signature of Contractor_
Print Name 6�e* 1411;A- Print Name Sfy 'j..t
. .1 .
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Swo) to and subsq$be�bef9re me Swom-lo and sub c 'bed fore n�e,
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thia Day of4f4i!2,MZ4rgr 20// this Iq Day of V -20
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Notrry�uby Nbtar)�-Pubfic
NA9NCY E.C EY
N :q .10
otary Public ALANNA LAW"u 1 0
MONWEALTH OF MASSACHUSETTS Notary Pubk-State of FWWA
My Commission Exlpires My Comm.Expires Oct 30,2015
er
U$ COM December 274,�2015 Commission#EE 13MOOM96
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izs% 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: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
No
Property Address e ZIVJ Dep t review required Ye
ffuil ing��
Applicant: Alriro c4 id Planning &Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
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: E]-Approved. OlDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: DApproved as revised. RlDerlWid.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F�Approved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05114109
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