Permit Remodel 107 Fleet Landing 2011 `$ i �' 1'Jf •i ce'
' CITY OF ATLANTIC BEACH
=+ r) 800 SEMINOLE ROAD
`) " " ATLANTIC BEACH, FL 32233
f J INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000017 Date 1/09/12
Property Address 107 FLEET LANDING BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 10900
Application desc
REMODEL BATH AND SUNROOM
Owner Contractor
NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS
RETIREMENT FOUNDATION, INC
1 FLEET LANDING BLVD 6771 SHINDLER DR
ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222
(904) 838 -9179
Permit RESIDENTIAL ALT /OTHER
Additional desc .
Permit Fee . . . 105.00 Plan Check Fee . . 52.50
Issue Date Valuation . . 10900
Expiration Date . . 7/07/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 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 105.00 105.00 .00 .00
Plan Check Total 52.50 52.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 161.50 161.50 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 101 +'leek L Aki, gIvA , Permit Number: `o — 0077
Legal Description Parcel #
Valuation of Work $ to , 90o Floor Area of Sq.Ft. S Ft
Proposed Work heated /cooled non- heated /cooled
Class of Work (circle one): New Addition teratt 1 Repair Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial Residential
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: 0 . e ,,,, $ L $c rci, ' sad i ,knar ..it e b &c
♦ &-(A • 2- ..vv r v- 1• `
IJIr( .00C . + v. I..n
Property Owner Information:
Name: NCCRF Address: One Fleet Landing Blvd.
City Atlantic Beach State FL Zip 32233 Phone 904 - 246 -9900 xt.150
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: North River Builders Qualifying Agent: Joshua M. Hogan
Address: 6771 Shindler Drive City Jacksonville State FL Zip 32222
Office Phone 904 - 838 -9179 Job Site/ Contat ,- ii 1 = a ii;r;;zwz - _ _ _ __ _
State Certification /Registration # CGC1518918 I ; x / IIKA/ I il l A 9, 4
Architect Name & Phone # - - - -
Engineer's Name & Phone # im`i o =• • • ___ i r_ ____1; �ll '
Fee Simple Title Holder Name and Address "' • ' '�
Bonding Company Name and Address " - - "" `--
Mortgage Lender Name and Address { 1.4- t r ► +,y�s>t_y�l - �'
.,.,
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certi t at no wor or ins a a m.n has comp ed pprioito',
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This p ,711COPOs , . l
w void
is commenced. of 1 understand within
hat separate permits. t months, if be construction
ecured for Electrical Plumbing, Signs, a Wells,Pools, :' „il��, at
Tanks and Air Conditioners, etc. i
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE O1
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 sseci med herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or loco aw regulating construction or the performance of construction.
■
Signature of Owner JOL. ■- lif a Signature of Contractor
Print Name Joshua Hatfield Print Name Joshua M. o gan
Sworn to and subscribed before me Sworn to and subscribed before me
this to Day of OC1660.- , 20 / this 5 Day of S 20 i2
, — i AY” , . • ♦. d ELIZABETH TESKE •. .4 .i../ _ _ /0•11M4,,,, ,; , ELIZABETH TESKE
otary' ublic `e'•
i I ota P I n s
, ` r ° ` c' =
, .� Notary Public • State of Florida 1 -• •e My Comm. Expires Apr 5, 2013
My Comm. Expires Apr S, 2013 t 1 0 „ r yQ �
%N 111 1' L0 1�
'1/44,,--....-- • Commission # 00 887829 I ^.,� o��• � vi s�!t 1gMS DD 867829
I ° ' " °i•1 Bonded Threuph National Notary Assn, l _ '” " _ mo Bonded 'rough National Notary Assn.
teleamemeneeeeeememeimeeemeek
r -rte.+
- -- ----* City of Atlantic Beach APPLICATION NUMBER
�\ Building Department f be assi ned b
800 Seminole Road R 9 y the Building Department.)
\ 7:', " ` '`' 2 /// Atlantic Beach, Florida 32233 -5445 Q / 7 Phone (904 247 -5826 • Fax (904) 247 -5845
A D1119r E -mail: building- dept @coab.us Date routed: 2 -
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: / e 7 � �/ //24) 4A/.• ■ - :. nt revi review required Yes No
BdcillitEr
Applicant: �� - eV ie / C� - - arming & Zoning v
eig „/ Tree Administrator
Project: -�) t 0 ( 4Z - D & hi Public Works
_ , itkOdf 1 Public Utilities
YY 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: . ❑Denied.
(Circle one.) Comments: f
BUILDING ' ”
PLANNING & ZONING
Reviewed by: Date: /— 5"---
ADMIN. Second Review:
Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Doc # 2012004743, OR BK 15817 Page 1774,
Number NOTICE OF COMMENCEMENT Recorded 0 09 2012 at 02:50 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
Permit No. RECORDING $10.00
Tax Folio No.
THE 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 description): ( (may' r :; , } ( ..0,r�;is t" j /vc^►.
a) Street (job) Address: 0
2.General description of improvements: -, , ..
ti , .
3.Owner Informat
a) Name and address: ' • Y n _
b) Name and address of fee simple titleholder (if other than • ner) a
c) Interest in property
4.Contractor Information
(', a) Name and address: 't,
.> V' a; -y 7,(,r1 ;., i(r.c- ,�.1?C qt ��'
y
b) Telephone No.: 1,:ii.{ g -;:; ,'31 } 0 Fax No (Opt.) z.
5.Surety Information `'('. L v .� 7 y8
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6.Lender
a) Nanie 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.)
8.111 addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(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 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 YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEM NT.
COUNTY OF FLORIDA
E G / (04 (:
coon Pm e ry of t t,1. `s 10.
Signature of Own or Owner's Au ized Officer /Director /Panner'Manager
—)0S1-1 (4A A-'ll%t ��
Print Name
The foregoing instrument was acknowledged before me th ' � day of ,. c ,, t u ;, t va , 20 J 2.-, by
i 1 n
>.� as ' r ' <; .
'. (type e
of authority, e.g. officer, trustee,
r
attorney in fact) for (name of party on behalf of whom instrument was executed).
Personally Known OR Produced Identification Notary Signature ` �' , -
Type of Identification Produced Name (print) /t e /9- e 5 �...
OR
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, 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. '
_ JV "• l ( V " I
1 n sd?U I (1 ' 16
iit "S "�Y P''• ELIZABETH TESKE
,, z ° • Signature of Natural Person Signi , n line # 10 ) Above
Notary Public - State of Florida s' � ' • a My Comm. Expires Apr 5, 2013
.,... — a Commission ill DD 887829
' °� " �� Bonded Through National Notary Assn.
' ': y `S s CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
,v,,,,,„, '" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000017 Date 1/20/12
Property Address 107 FLEET LANDING BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 10900
Application desc
REMODEL BATH AND SUNROOM
Owner Contractor
NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS
RETIREMENT FOUNDATION, INC
1 FLEET LANDING BLVD 6771 SHINDLER DR
ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222
(904) 838 -9179
Permit ELECTRICAL PERMIT
Additional desc .
Sub Contractor . BARKOSKIE ELECTRICAL SERVICE,
Permit Fee . . . 58.60 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 7/18/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 58.60 58.60 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 62.60 62.60 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
EL.CMCAL PERMIT APPLICATION
CITY of ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845 • • -
JOB ADDRESS: 1047 f 1 -eea 1,64. vv ( . Putpar # / z - 5
NEW SERVICE DOverkead ❑ Underground ❑ Underground up Pole
❑Residential (Main) Service
00 -100 amps ❑ 101- 150amps 0151- 200amps 0 amps # of Meters
OCommercial (Main) Service
00-100 amps 0101- 150amps 0151-200amps ❑ amps OCT Service amp
Conductor Type Size
[Multi-Family (Main) Service
00-100 amps ❑ 101- 150amps 0151- 200amps 0 amps # of Unit Meters
❑Temporary Pole 0 amps
SERVICE UPGRADE D amps 0 CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTUR +'S, ETC.)
0100 amps ❑ 150amps O200amps 0 amps OCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets/Switches: 2 0- 30amps 31- 100amps 101- 200amps
Appliances: 0- 30amps 31- 100amps 101- 200amps
A/C Circuits: 0- 60amps 61- 100amps
Heat Circuits: # circuits ® kw
Number of Lighting Outlets, Including Fixtures: -
OTHER ELECTRICAL PROJECTS •
❑Swhnming Pool 0 Sign OSmoke Detectors Qty OTransformers KVA ❑Motors
FIRE ALARM SYSTEM (Requires 3 sets of plans & Dire Alarm Cheekli st)
Qty volts/amps VALUE OP WORK $
REP US
OReplace Bumt/Damaged Meter Can ❑Safety Inspection OPanel Change OOH to UG
OOther: SA-Fc= F VIN LA5 el> C iZ e .1 .-r —y emu N
Permit becomes void if work does not dace within a six malt period or work is sum or abandoned fix six months. I hereby certify that I hay(
reacithis application and know the same to be true and correct All provisices of laws and million= gowning this work will be complied with whether
specified or not The permit does not give Ito violate the provisions ofany other state or local kw regulation construction or the perforce of
construction.
Property Owners Name V7.--e L A 1 eJC� Phone Number Z 4 16 - ` �I �' c:
Electrical Company -�`-. A1?- X514-► C Office Phone Z 4 3/ F ®o ! 7
Co. Address: St -1 _ City - ` 15 State R Zip zzm
LicanstBalder (Print): I f,�,' r�.•�►_ State Certification//Registratiion #lam /30
Notarized Signature of License Holder I 1 " €
° Notary Public State
? Florida Sworn - 14 subscribed before me this t 0 day of �'( 20
4 ` Trf[any August 149 0
i tiny commission DD601 Signature of Notary Public -4�� -AA/
ip� Exorres 06/26/2012