Permit Siding 781 Cavalla 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5814
INSPECTION PHONE LINE 247
Application Number . . . . . 11-00002941 Date 11/30/11
Property Address . . . . . . 781 CAVALLA RD
Application type description SIDING PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3800 ---------------
-------------------------------------------------------------
Application desc
SIDING REPLACED ON CHIMNEY WITH HARDI PANELS
----------------------------------------------------------------------------
Owner Contractor
------------------------
------------------------
HERITAGE BANK NO FL LOVEJOY & SON MAINTENANCE
794 BLANDING BLVD 6130 FIRESTONE RD
ORANGE PARK FL 32065 JACKSONVILLE FL 32244
(904) 219-5660
----------------------------------------------------------------------------
Permit . . . . . . SIDING PERMIT
Additional desc . . REPAIR CHIMNEY WITH SIDING 35 . 00
Permit Fee . . . . 70 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 3800
Expiration Date . . 5/28/12
----------------------------------------------------------------------------
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONAl ELECTRIC 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.
APPLICATION NUMBER
City of Atlantic Beach
(To be assigned by the Building Department.)
Building Department
800 Seminole Road
-5445
Atlantic Beach, Florida 32233 f
Phone(904)247-5826 - Fax(904)247-5845 Date=muted: 2,!f- f
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPL=-n-0N-REVM-W
ent review required Ye No
Property Address: Build*
Applicant: S"' Planning &Zoning
Tree Administrator
Project: /0 6— Public Works
Public Utilities
Public Safetv
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Flori 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: [2A" pproved. ODenied.
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date:_/L2E—_//_
TREE ADMIN. Second Review: FlApproved as revised. Re�n7ied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05114109
BUILDING PERMIT APPLICATION
CITY OF JxticsoNvrm BEACH
*Pursuant to F.S. 553.721 & F.S. 468.631, a surchargefee will be collected on any permit regulated under the FBC
D f Permit Number:
Job Address: 5 k C-itc h V �^
Legal Description '5-, NGkc-- t2ZT?9:!s4 kA�S-3-
Project Valuation $ <�S-uov
Class of Work(circle one): New Addition Alteration 4 Z
Use of existing/proposed structure(s) (circle one): Commercial
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes N /A
Roofing Materials: Main Material FL Approval # 4 ��4��2 - Underlayment FL Appr6val#
-V :E: ----I C:A1%J k tA-
Describe in detail the type of work to be performed: IJ(O. C-k
NOV 28 201,
Property owner Information: NOV 2,6 20
Name: REcLk-.VrtC6eC 91b�\4- _Registered Agent (If Applicable): /�i, 11
Elt-v
Addre
State
Contractor Information:
Company Name: L- 0 v t '5 cA-j (vxr-4,.,j i - Name of License Holder: Ce/Iv /_0 C',
Address: Co(S ici'�-%a,,,�-:Srcx�-:5- -�z--(> city7x.-tc �e State /::� Zip
Office Phone 'LO4 Q:�kck S-66o Office E-Mail or Fax # 9 qV 177 - Qclil 5�
State Certffication/Registrat�m# C-0 C�Q-6-941 T%"3 Job Site-f,onYvit/Number q&H -91.7
Architect Name & Phone # I a
Engineer's Name & Phone
A a h b de b , re do he- k nd ,o�sindi,-ated e tha n oon h's commenced prior to the
,!,n insto""'t
c n a t 0 t t, 0 w or'or d, h permit becomes null and
Y on in th u-'s_'ti 0.Ot
(6� h,at any time after work is
st O�,a es B
x o p
E a er,
to 0 t- it to I or a h 't da",'d a in
0
v I P I
ppli- flon d h k I be per 0,_,d t�meet� e t
Per n 'on iit,� 0,'or "!,
n s�),nd,d a adon I
P Si
0'in n, d th, 6 h a ri rk g S, 00 s e Heaters,Tanks andAir
of el F,
"s.' a"
aid, k t t must ca 0 Um I
c",,,c,d. I nd",tnd th, ep"'atepe, ii s b ed le b ng,
Conditioners,etc.
Owner's Affidavir I hereby certify that I have read and examined this application and know the same to be true and correct. Allprovisions oflaws and ordinances
ertung this�f e 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
gov prov's, 4 f'construction.
the ons o any otherfederal,state, or local law regulating construction or the performance 6
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY 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 LENDE R AN
Z
ATTORNEY BEFORE RECORDIN�-,' YOUR NOTICE OF COMMEN��7 T.
Signature of Owner?� Signature of Contractor
f .........................
e Print Nam . .....
Print Nam ............................. .............I............IN................................. e .................................. ......... .... ... ................ .....................
STATE OF FLORIDA, COUNTY OF oJO04 STATE OF FLORIDA, COUNTY OF -l"
Swo (or ffirmed n efore me Swo o (or aff�rmed) and subsc7rib d before me
'ilp
this ' 0 y of ' 20 it this JD ,,6 f 2011
OF
�rV'taMry,Pqffic SiTanature Print 7or Type commissioned Name Below) Nrotary iknature (Print or T pe Commissioned Name Below)
P.
"F
y.PubliZ 9'
N N
Eotary Public State of Floridli�' -,t0f P?,6, Notary Public State a,Fl 31- ..........................................................................
Ei,zabeth C Reed 50-ally Known/OR Elizabeth C Reed LJk<sonal ly Known/OR
Identification Type ?a Identificationfrype
my commission DD862954 49, n my Commission DD8b2954
4
OF f% Expires 02/19/201 a
10, ,,� Expires 02/1912013
DO NOT WRITE BELOW THIS LINE: OFFICE USE ONLY
A—71-"1. CI�A�v- ')A07 Onrill" Riiihlinu Cntlp w/7009 TZevisions
f I /- NOTICE OF COMMENCEMENT
Permit No. Ir 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.
I. Description of property(legal description of property and address if available):
\A-0 u--LE 'or I C-A VV14, I k C4 A1-117-1-Tl en—tt 75 Z-Z-3,�
2. General Description of improvements:
-6 ', \)L (YC(E ivA
3. Owner Information: f7
a)Name and Address:
b) Interest in property:
c)Name and address of simple titleholder(if other than owner):
4. Contractor Information:
a)Name and Address:
b) PhoneNumber: Ctoik
5. Surety Information:
a)Name and Address:
b) Phone Number:
c)Amount of Bond: $
6. Lender Information:
a)Name and Address:
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:
b) Phone Numbers of Designated Person:
8. In addition to hims6lf/herself, Owner designates 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 may not be before the completion of construction
and final payment to the contractor, but will be 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 1,
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.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true to the best of m knowledge and belief.
Signature of Owner or Ov(ner's Aut�orizea Officer/Director/Partner/Manager Signatory's Printed Name&Titfe/Office