Permit Interior Demo 717 Triton Rd 2012 li
CITY OF ATLANTIC BEACH
, 800 SEMINOLE ROAD
'' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000598 Date 5/16/12
Property Address 717 TRITON RD
Application type description DEMOLITION (PARTIAL)
Property Zoning TO BE UPDATED
Application valuation . . . 700
Application desc
INTERIOR DEMOLITION ONLY
Owner Contractor
FORE, STUART ASHBY HOMEOWNER BLDG SVCS, INC (RC)
717 TRITON ROAD 739 BROOKMONT AVE E
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211
(904) 322 -1054
Permit DEMOLITION PERMIT
Additional desc . PARTIAL INTERIOR DEMO ONLY
Permit Fee . . . 100.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 11/12/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 100.00 100.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 104.00 104.00 .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: `71 �(Z, (TO� Permit Number: ( -SI I
Legal Description 31 t it 38- 2 Area 2 -�' e Parcel # •
Floor ea of Sq.Ft. Sq.Ft
Valuation of Work $ 2 O. 6u Proposed Work heated /cooled tC ° v non - heated /cooled .524-/
Class of Work (circle one): New Addition Alteration Repair M. - 1 •e olition pool /spa window /door
Use of existing/proposed structure(s) (circle one): Commercial ' : identi.
If an existing structure, is a fire sprinkler system installed? (Circle one): • es No N /A
eil-,,,,,,.
Florida Product Approval # . - b.. e
For multiple products use product approva form
Describe in detail the type of work / t w o be performed: Tice)/MA.... OF cAg (ice- AFt --`z S TGe.
Property Owner Infformation: ,
Name: A (LT _ Address: 719 7- 24 — 6-
City A WEE M E ∎Mt State Zip3Z233 Phone gel — Q5JV
E -Mail or Fax # (Optional) ,- -- 1
Contractor Information:
Company Name: o✓l u fZ e_0 ta=d SfaZWCFs � Agent: (.� . ./,%y Own //A 4::-ce,.
Address: i 'c/ij , Iitvz . k . City `T„4 ,;c , State i"- • Zip 3 ?- l,2
Office Phone Wiley.. 32> -- 403 Y Job Site/ Contact Number gay 3az • /a S y Fax # q* L/ • 7Z - 644,
State Certification/Registration #
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and ddress 1 //-1
Bonding Company Name and Address i V 4
Mortgage Lender Name and Address ��
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced 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 pernzit 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 six (6) months at cnty time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo Healers.
Tanks and Air Conditioners, etc
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.
/ herebv certify that I have read and examined this a plication and know the sane to be true and correct. All provisions of laws and ordinances governing this
type of work will be conzplied with whether specified herein or not. The granting of a permit does not presume to • - - • uthority to violate or cancel the
provisions of any other federal. state, or local law regulating construction or the performance of construction.
F
✓ S i gnature of Owner
1 1 1 ,i .�i1 � .... Signature of Contracto -
Print Name 5-raoehkr MK Print Name 6 fee ✓1 t2 14 iexa r
Swor L s, .nd subsc ,d before me Sworn to and subscribed before me
this _1• of Y Y 1 P,IL'A , 201 this (C Day of MtA41 , 20 a
Notary Pu iiiii No • .lip�t '4: •••
""ta CINDIE HERNANDEZ ; =o;� i JASON DRACH
MY COMMISSION # EE148600 r * _ • _ Notary Public } t4g08imipa2 , .10
EXPIRFS:Noverrba27,zots N ill My Comm. Expires Aug 9, 2014
-'rte o ,.
t y ,� t � y Fl . Notary Discount Assoc. Co. � .'iFOF c o rA Commission # EE 14543
■
t
A. U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT B. TYPE OF LOAN
SETTLEMENT STATEMENT
The Law Offices of Rod Schloth, P.A. I. FHA 2. Li FMNA 3. CONV.UNINS.
2187 South Third Street
Jacksonville Beach, Florida 32250 a. IvA s. ncUNV INS,
904 372 - 9351 fax: 904 - 372 - 9230 6 Fik Number 7 Loan Number - "T
R S 12 -631 _
B. Mongage Ins, Case No
NOTE: This form is furnished to give you a statement ofactual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked
(poc) were paid outside the closing. They are shown here for informational purposes and are not included in the totals.
Stuart Ashby Fore
D. Buyer: 717 Triton Road
Atlantic Beach, Florida 32233
Ella Mae Dillard, an unremarried widow
E. Seller: 2304 Alderman Oaks Drive
Jacksonville, Florida 32224
F. Lender: - - -- - - -------
G. Pro e 717 Triton Road
p Atlantic Beach, Duval County, Florida 32233
H. Settlement Agent: The Law Offices of Rod Schloth, P.A.
Place of Settlement: 2187 South Third Street, Jacksonville Beach, Florida 32250 Duval County
I. Settlement Date: Ma/ 10, 2012 -
J. Summary of Buyer's Transaction K. Summary of Seller's Transaction
100. Gross Amount Due From Buyer: 400. Gross Amount Due To Seller:
-
101. Contract Sales Price - - - 401. Contract Sales Price
102. Personal Pro_perty _ 402. Personal Property Settlement Charges to Buyer (line 1400) 243.50 403.
Adjustments for Items Paid by Seller in Advance: Adjustments for Items Paid by Seller in Advance:
106. _City / Town Taxes � _ 406. City / Town Taxes _ _T
107. County / Parish Taxes 407. County / Parish Taxes
108. Assessments 408. Assessments �^
120. Gross Amount Due from Buyer: 420. Gross Amount Due to Seller: ^ •
200. Amounts Paid by or in Behalf of Buyer: 500. Reductions in Amount Due to Seller:
201. Deposit / Earnest Money 10,000.00 501. Excess Deposit (see instructions)
202 Principal Amount of New Loan 502. Settlement Charges to Seller (Line 1400) 10,122.09
203. Existing Loan(s) 503. Existing Loan(s)
204• - - .. 504. Payoff of First Mortgage
205. 505. Payoff of Second Mortgage
506. Purchase Money Mortgage _ _
Adjustments for Items Unpaid by Seller: Adjustments for Items Unpaid by Seller:
210. City / Town Taxes 510. City / Town Taxes
211 County / Parish Taxes Jan 1, 2012 thru Ma 9 , 812.66 511, County / Parish Taxes Jan 1, 2012 thru May 9,
2012 2012 812.66
212. Assessments 512. Assessments
220. Total Paid by / for Buyer: 10,812.66 520. Total Reductions in Amount Due Seller: 10,934.75
300. Cash at Settlement from / to Buyer: 600. Cash at Settlement to / from Seller :
301. Gross Amount due from Buyer (line 120) / % ; i 601. Gross Amount due to Seller line 420 ) AMEN
302. Less Amount Paid by /for Buyer (line 220) 10,812.66 602. Less Reductions Amount due Seller (line 10,934.75
520)
303. Cash From Buyer: 603. Cash To Seller: IMENIO