1647 W Park Ter (vault) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 09-00000644 Date 5/11/09
Property Address . . . . . . 1647 W PARK TER
Application type description RESIDENTIAL ADDITION/ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4500
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Application desc
SCREEN ENCLOSURE
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Owner Contractor
------------------------ ------------------------
MILLER, CAPT. DONALD M TROPICAL ENCLOSURES INC.
1647 PARK TERRACE WEST 2072 MAYPORT ROAD
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 241-2298
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
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Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50
Issue Date . . . . Valuation . . . . 4500
Expiration Date . . 11/07/09
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2007 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 55 . 00 55 . 00 . 00 . 00
Plan Check Total 27 . 50 27 . 50 . 00 . 00
Grand Total 82 . 50 82 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ei" CITY OF ATLANTIC BEACH
08-
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
OFFICE:(904)247-5826 0 FAX NO,:(904)247-5845
BUfLDfV,3-DEPT@COAB.US
BUILDING PERMIT APPLICATION DILIVALCOUNTY
1.JOB ADDRESS: 4 2.VALUATION OF WORK: ,�SQ.FT.UNDER ROOF
1(4n PAW-rf,,§/ Atlantic Beach, FL 32233 eje>
4.LEGAL DESCRIPTION:-:-
5.CLASS OF WORK. 6.USE OF STRUCTURE:
11 NEW BUILDING 0 DEMOLITION 11 RESIDENTIAL
LOT Z- BLOCK SUB DIVISION 6 L'4'q ci kxk U#4-17 0 ADDITION 0 CONVERTING USE 11 COMMERCIAL
:7.DESCRIPTION OF WORK::: , , �,: I I .
11 ALTERATION 11 ACCESSORY BLDG. 8.FIRE SPRINKLER:
0 REPAIR OPOOL/SPA 13 YES 0 N/A
11 MOVE 11 OTHER ONO
PROPERTYOWNER:. CONTRACTOR: : ARCHITECT I ENGINEER:
9.NAME: Id 15.COMPANY NAME: 23.COMPANY NAME:
"T;ZtP1 CA't- E'fJ e-LQGUA64�; ri,�e- , N/k
16.NAME: 24.LICENSEE NAME:
MEY1" W'. W-'4j6ZMr- I
10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LII:ENSE NO.:
1647 ;IqPK TVPMAQP- WETr U&C OS436!;
AV"3w- sW,&5 18.ADDRESS: 26.ADDRESS:
11.OFFICE PHONE: 0.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 128.FAX NO.:
z.j44-as z(, T7 Z-q) --Z:L-1 t I Z14'7--qz41
13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE:
14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30,EMAIL ADDRESS:
FEE SIMPLE.TITLE HOLDER-
BONDING COMPANY:: MORTGAPE LENDER.
(IF OTHER THAN OWNER)
31.NAME: 33.NAME: 35.NAME:
TW wwrilcs
32.ADDRESS: 34.ADDRESS: 36.ADDRESS:
444% 95*Asaue-swo G,-CT'6 (0j
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 permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
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
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER'or AGENT 4TRACTOW:,�::::::11:
f Agehf,Power ofAttomey or Agency Letter Required)
Y :,
Signed-X,�?�O�'. 144�- te: Si Date:
Beforemethis IS-1"d.yof j4AAj- 2001 in the county of Before' me this dayof 200fin the county of
' L6yappeared Duval,State of na
Duval,State of Florida,has person Florida,has perso F lly appeared
)euj" W "&W-qzx�
herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. true and accurate.
Notary Public at Large,State of );-L County of Z0 I(A L- Notary Public at Large,State of County of J"Nut'n L
EI Personally Known 6119, "I'M P4"
'0''��..Z", Roy RoCt M Personally Known
P
0 Produced Identification- M ROY ROC
my rnmul'qc
AwrInkilklinniz . 1:LPrnrfi,r.Pc1 Ident ion
Z) [DIU -.-WON#DD l6fl)
EXPIRES:Kay 27 10
Nota Signature. 7,2 �Otary Signature
REVJEWED FOR CODE COMPL1ANCE
'C
May7
116"
P CE
Crff OF ATLANTIC BEACH
q Wall SEE PERMITS FOR ADDITIONAL
COAB FORM BLDG01:REVISED:11/6/2007 it
REQUIREhffiNn AND CONDITIONS.
EF if L E COP J�.
jR=EVMWED BY:
DAM:
NOTICE OF C.OMMENCEMENT
State of F-LCO:kiCA Tax Folio No.
County of t>IVA L
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 ofproperty being improved:.sa&IL- Marian- uez-+ :�t-1- 136cka' L-6+ 11
Address of property being improved- 1614*7 �IjV-_4e
, 11GzQAcg
General description of improvements: &-VJ�q4a_
A-InAt-n� zr�- c-i4. FQ, &223 -
Owner- PP-j4C—MiU-J�Q- 0 n4 C
J_ Address:
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner): PJ
Name:
Contractor: Kc-vta \v , AiEw n-%iE� 71�-Co 1GAt 64(4�
Address: ky-%iq\jFC)M- rzj:>
Telephone No.:'�;%—Z.7-19 8 FaxNo: 'Zk4-7—qZql
surety(ifany)-r44-6 4rsLbnE<
Address: i4W-W 6o 57joj_�' '7zj-Vb -5u)-rf-- t0) Amount of Bond 560000
Telephone No: -- Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: N4
Address: MIA
Phone No- tJ�A 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- 01-A
Address: 141A
Telephone No: W/A Fax No:
In addition to himself, o d 1 atesaie �qllowing person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. 4 *76.
Name: 2072 MaVPOrt Rd.
Address: Atlantic Bch,., EL 3223.q
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
Signed: Date:
Before rn�lhis day of in the County of Duval,State
Of Florida,has personally appeared 7,7,-// —
Notary Public at Large, State Qf Florida,County of D V
Doc#2009108,179,0RI31<14866 Page1909, My commission expires-
NUmber Pages:1 ----- 7
Personally Y-nown-
ROY ROCKHM
Recorded 05/07/2009 at 02:23 PM, -W-C-Uhl—MIS SliNN-#D D 5116 10
JIM FULLER CLERK CIRCUIT COURT DUVAL Produced Identification:
COUNTY EXPIRES:May 27,2010
RECORDING$10.00 OF F�o Bonded Thru Budget Notary Services
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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
E-mail: building-dept@coab.us Date routed:
City web-site: hftp:[&vww.coab.us
11 . .-
APPLICATION REVIEW AND TRACKING FORM
00
,P!!partipent review required Ye,9 No
Property Address: 41LH�in
Planning &Zoning
Applicant: Tree Administrator
Public Works
Public Utilities
Project: /as-ka.
Public Safety
Fire Services
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:
APPL�ATION STATUS
rov
Reviewing Department First Review. Approved. FIDenied.
(Circle one.) Comments:
PLANNING&ZONING
TREE ADMIN. Reviewed by: Date: S/&_0
V
PUBLIC WORKS Second Review: [:]Approved as revised. FlDenied.
PUBLIC UTILITIES Comments:
PUBLIC SAFETY
FIRE SERVICES
Reviewed by: Date:
Third Review- DApproved as revised. F�Denied.
comments:
Dats:___
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