Permit Bath Remodel 2045 Selva Madera 2012 r.z, 6s . t , CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
1 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000435 Date 4/18/12
Property Address 2045 SELVA MADERA CT
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 20000
Application desc
bath remodel
Owner Contractor
POTTER STEVEN A TRUST REDSTONE BUILDERS
2045 SELVA MADERA CT. 2105 EVENTIDE RD
ATLANTIC BEACH FL 322334531 ST JOHNS FL 32259
(904) 591 -0332
- -- Structure Information 000 000 BATH REMODEL
Occupancy Type RESIDENTIAL
Permit RESIDENTIAL ALT /OTHER
Additional desc .
Permit Fee 150.00 Plan Check Fee . . 75.00
Issue Date . . . . Valuation . . . . 20000
Expiration Date . . 10/15/12
Special Notes and Comments
NEED NOC
2010 FLORIDA BUILDING CODE, 2008 NATIONA1 ELECTRIC CODE
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE DCA SURCHARGE 2.25
STATE DBPR SURCHARGE 2.25
Fee summary Charged Paid Credited Due
Permit Fee Total 150.00 150.00 .00 .00
Plan Check Total 75.00 75.00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 229.50 229.50 .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: 20'1s Sklv` c/i-x 0,-r Permit Number: r;^ t am
Legal Description Parcel #
Floor Area of Sq.Ft. non-heated/cooled t 1 7 �
Valuation of Work $29 Proposed Work heated /cooled n
Class of Work (circle one): New Additis Alteration Repair Move Demolition pool /spa window /door
Use of existing /pro osed structure(s) (circle one): ommercial Residentia
If an existing structure, is a fire sprinkler system installed? (Circle o s No N /A
Florida Product Approval #
For multiple products use product approval form ,. ;trtf + hir" *^,^- .. .4" ^ �` k ".' n,
Describe in detail the type of work to be performed: remc e '° 11111141
1 1 SI Property Owner Information: -i » �•
Name: LAvetrAi E. Address: on SS 's&•L V/9 -, b� C
City , 7ZA- Arf C- Arge4C –H State fl Zip 7.../.7. ? Phone 9 Y• ZV 9. '6 D 6
E -Mail or Fax # (Optional) i 77
Contractor Information: '9 / - O 3 3 2-
Company ?
Name: Pct S)T 13` ' 1 ex s Qualifying Agent: J - k; k r B c . r
Address: $3 v' Co 1 e e Cc,-- ffct Ci . .A4 1 State FL Zip 32c 5 Z
Office Phone r --- -- _
� 1 , –U 3 '3 2 Job Site/ Contact N �� +er g..-. g..-. State Certifica ion/Registration # 2 1 a'J 1 * '4 M O I i 1 , - - ! ` -
Architect Name & Phone # f " 1�0i ii ktis1 vr.b a„• .. _ a _
Engineer's Name & Phone # '
Fee Simple Title Holder Name and Address 4111.1.1
RE. ,, -.r _ _ . I. L
Bonding Company Name and Address i , , ,�
Mortgage Lender Name and Address ( ► f ' ' D BY: r :. r
k i i
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or insta a ion . . >♦, ced prior to the
issuance 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
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of siz 6) months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, Bo Heaters,
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 YOUR NOTICE OF
. COMMENCEMENT.
1 hereby certify that I have read and examined this a placation and know the sane to be true and correct. All provisions of laws an. <,rdinance •.veining this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give auth, to vi. to or cancel the
provisions of any other federal. state, or local law regulating construction or the performance of construction.
Owner �%G /� Si . /
Signature of O � a Signature of Contractor
P rint Name 3 . .5�'I 78c) ha K YNC. ^ Print Name LfI IJR�j✓ L / !J �� �
Swo' to • nd subscr,}bed before me Swore ,, and s bscribea before me
,►is I,. T n., of tt PC f t— . 20 1c _this 1 Day % A._ • ,�I; , A 20
\ 30 1 OPPIA1411111r Am,
otary Public I .' . ' : : . - bligy co , - sION4 s so
,.�O , % ,,� ;,,: ALBERT MORENO ° *;
�� " P XP
Notary Public - State of Florida + � d� gunded EIRES: ihru Notary ' ebrua Pub�i _ 14, 20
vised 0 1.26.10
% ,e My Comm. Expires May 26, 2015 r '
, ,
Commission EE 97846
r # ,° , , Bonded Through National Notary Assn. raters ,
�,i ;�. City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
o A 800 Seminole Road t 3
Atlantic Beach, Florida 32233 -5445 /�
7 f/P r
r
Phone (904) 247 -5826 - Fax (904) 247 -5845 � J�
--r 1 E -mail: building- dept @coab.us Date routed: f
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: C 75 JE/V,??267/fP&_ D ent review required Yes No
ui lding
Applicant: 3 7f f . ,t / d - -3 ng & Zoning
Tree Administrator
Project: / ` ito d e L Public Works
Public Utilities
Public Safety
Fire Services
4 - 21t t sk. v . f a { �r,.L r { rte '^ !P "n ! k ' ' � .. f .. .. •
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: ['Approved. ['Denied.
(Circle one. Comments:
/l/ e s Ai 0 C_
BUILDING
PLANNING & ZONING Reviewed by: ‘. Date: 4 / -1 6 -/
TREE ADMIN. Second Review: ['Approved as revised. EDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
NOTICE OF COMMENCEMENT
/
State of �' C. _-
Tax Folio No.
,
County of LI ct i
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: 7
Address of property being improved: C L�' , x 1 t `= r CC
General description of improvements. (' > < =� 71,'6 -gym 1 Os:- A-
, r:'x' ,•
`<: - ,-, r ipc 1 (-- i Address- -
' Doc # 201208459, OR BK 15916 Page 872,
Owner's interest in site of the improvement: Number Pages: 1
Fee Simple Titleholder (if other than owner): Recorded 04i18i2012 at 01.42 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL -
COUNTY –
Name: ( c r RECORDING $10.00
Contractor: c-- p S titc� 15 --r , 1 ed S
� f� e Sr. r Li�
bh, Address: ;.t' 3c 5 c"`- l cc � z ,(- 6 A d rC" r
� ' - r! 5 �' _ Fax No: = 1 /6 2
Telephone No.: i �' � ->
Surety (if any)
Amount of Bond $
Address:
Telephone No: Fax No:
Name and address of any person making a loan for the construction of 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:
Telephone 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
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone 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 OWNER y / ��
:4 /
Signed: deta,--e--k--;' E " C✓
' Date: {/
Before me this / /+ day of Ariz i'- do 10- in the County of val, State
Of Florida, has personally appeared L A re<r f , O TF Y.
Notary Public at Large, State of Fliorida,,Cpunty of Duval.
My commission expires: r) A l JE, I a 6 i s
or
p ,.*ryY p /// ALBERT MORENO Personally Known: _ � rNs F
. — Notary Public - State of Florida Pri i ' / } r d t' tcation: Ft_C' 2 , nA 17 Z i ✓ >
• : r : • c My Comm. Expires May 26, 2015
=;; �.�� .s Commission # EE 97846 '1 i r t3rR r m o ��,,
c
/ ' � R � Bonded Through National Notary Assn. �,
J � ,
(4
' � i CITY OF ATLANTIC BEACH _
800 SEMINOLE ROAD
~� < '� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000435 Date 4/19/12
Property Address 2045 SELVA MADERA CT
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 20000
Application desc
bath remodel
Owner Contractor
POTTER STEVEN A TRUST REDSTONE BUILDERS
2045 SELVA MADERA CT. 2105 EVENTIDE RD
ATLANTIC BEACH FL 322334531 ST JOHNS FL 32259
(904) 591 -0332
- -- Structure Information 000 000 BATH REMODEL
Occupancy Type RESIDENTIAL
Permit PLUMBING PERMIT
Additional desc .
Sub Contractor . NELSON PLUMBING CO. INC.
Permit Fee . . . 83.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/16/12
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONA1 ELECTRIC CODE
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 83.00 83.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 87.00 87.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 � 7 -5826 Fax (904) / a- 247 -5845 �f y �
JOB ADDRESS: aog6 Set Da- [' l ad a C4 PERMIT # � /4151
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub ' i Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 1
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE -PIPE: ll.' 1 i 't 7T- teAJ�e6
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System - Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
❑ Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name �6-tf e.1Z _ Phone Number 600
Plumbing Company Ne 5D` -,71c n bi, Cd l n c Off e Phone aka - Ogg Fax 223-873(0
lC �ls Ct e <. ? Zi
Co. Address: I � (in Z � ( t° r' � i t� State F( p 32.200
License Holder (Print): COTT Net 306 l to e ertification/Registration # CF
„ , ,.-, _ . • Ier � �
I'
,•.�µ` r P U S P. BASS I 20 2-
'. ,* � ` t, °. Notary Public - State of Florida , worn and subseh ed before me this 8 day of
7 My Comm. Expires Nov It 2015
137475 . ignature of Notary Public b0
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
—Olt so
Application Number 12- 00000435 Date 5/10/12
Property Address 2045 SELVA MADERA CT
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 20000
Application desc
bath remodel
Owner Contractor
POTTER STEVEN A TRUST REDSTONE BUILDERS
2045 SELVA MADERA CT. 2105 EVENTIDE RD
ATLANTIC BEACH FL 322334531 ST JOHNS FL 32259
(904) 591 -0332
- -- Structure Information 000 000 BATH REMODEL
Occupancy Type RESIDENTIAL
Permit ELECTRICAL PERMIT
Additional desc .
Sub Contractor . M V ELECTRIC
Permit Fee . . . 61.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 11/06/12
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONA1 ELECTRIC CODE
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
*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 61.00 61.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 65.00 65.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
_ c' Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: 2 9 5 S e f v a m e - 4 -
��. PERMIT # / z ^ e y3 S
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK $ / 060
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential (Main) Service
❑0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
❑0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑ Multi- Family (Main) Service
❑ 0 - 100 amps ❑ 101 150amps ❑ 151 200amps ❑ amps # of Unit Meters
❑ Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps ❑200amps ❑ amps ❑CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 0. 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: y
OTHER ELECTRICAL PROJECTS
❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty ❑ Transformers KVA ❑ Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts /amps VALUE OF WORK $
REPAIRS/MISCELLANEOUS
❑ Replace Burnt/Damaged Meter Can ❑ Safety Inspection ❑ Panel Change ❑ OH to UG
❑ Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name 27 y Phone Number
Electrical Company /)9 , ae_c.f i-- 1 h c , Office Phone C - 2 76 y F SA 271 9
Co. Address: /f 3 7 S - J a Sr City CL '37-22
rv�" Y 1 �7� Stat Z
License Holder (Print): EAA-t .-i / I � , e /'S o ri 5 State Certification/Registration # £ CVO oo s
Notarized Signature of License Holder _� ?- p _. 14-- -7e
Sworn and subscribed before me this day of 20
Signature of Notary Public