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Permit Bath Remodel 124 Fleet Landing 2012 AV SS CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 jilt Application Number . . . . . 12-00000728 Property Address . . . . . . 124 FLEET LANDING BLVD Date 6/14/12 Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4650 ----------- ---- Application desc------------------------------------------------------- shower conversion/sunroom ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 6771 SHINDLER DR 1 FLEET LANDING BLVD JACKSONVILLE FL 32222 ATLANTIC BEACH FL 322334599 (904) 838-9179 --- Structure Information 000 000 SHOWER/SUNROOM CONVERSIONS Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee . . . . 75 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 4650 Expiration Date . . 12/11/12 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 75 . 00 75 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 79 . 00 79 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Doc#201212'2/97, OR BK 15968 Page 1606, NOTICE OF CO qMEyCEMENT NUmber Pages: I Recorded 06/14,12012 at 11:13 AM, 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(legaldes tion): a)Street(job)Address: 2-General description of improvements: e,_ 1100,1::: '41y -)-Owner Information a)Name and address: AIC 1Z< k4- b)Name and address of fee"�rimple titleholder(if other than owner) U c)Interest in property 4-Contractor Information a)Name and address: -1W b)Telephone No.: Fax No.(Opt,) 5.Surety Information a)Name and address: b)Amount of Bond: 61ender c)Telephone No.: Fax No.(Opt.) a)Name and address: of person within the State of Florid.�deignat_dby 7. ldentitT Phone No. a)Name and address: owner upon whom notices or other documents may be served: b)Telephone No.: 8.1n addition to himself,ow Fax No.(Opt.) ner designaies the following person to receive a copy of the Lienor's Notice as provided in Section 711 13(l)(b),Florida Statutes: a)Name and address: b)Telephone No.: Fax No.(Opt.) 9.Expiration date of Notice of Commencement(,he 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 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMEN7CENT. STATEOFFLORIDA COUNTY OFPWLL4,A� (/,-4 1.— 10. Signature of Owner or Own ,ed r1Dn-,.r/P.,t.�r/M.n.ger th ized 6171�ice JP544 Print Name The foregoing instrurrient was acknowledged before me this H day of 20_L.?��by as (type of authority,e.g.officer,trustee, attorney in fact)for (name of party on behalf of whom instrument was executed). Personally Known OR Produced Identification Notary Signature I, Type of Identification Produced Name(print) 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. — — — — — — — — — — — — FORNISNOCs ELIZABETH TESKE Notary Public-State of Florida My Comm.Expires Apr 5,2013 Commission#DO 867829 Bonded Through National Notary Assn. CITY OF ATLANTIC BEACH U 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00000728 Date 6/14/12 Property Address . . . . . 124 FLEET LANDING BLVD Application type description' RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4650 ----------- ---- Application desc------------------------------------------------------- shower conversion/sunroom ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 6771 SHINDLER DR 1 FLEET LANDING BLVD JACKSONVILLE FL 32222 ATLANTIC BEACH FL 322334599 (904) 838-9179 --- Structure Information 000 0oo SHOWER/SUNROOM CONVERSIONS Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 76 . 00 Plan Check Fee Issue Date . 00 . . . . Valuation . . . . 0 Expiration Date . . 12/11/12 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 76 . 00 76 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 80 . 00 80 . 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 JOB ADDRESS: Ph (904) 247-5826 Fax (904) 247-5845 PERMIT#_e� —�72_ 9 NEW OR REPLACEMENT INSTALLATION: TYPE OF FixTURE QTY Project Value Bathtub TYPE OF FIXTURE QTY Clothes Washer Septic Tank&Pit Dishwasher Shower Drinking Fountain Shower Pan Floor Drain Slop Sink Floor Sink Th�ee Compartment Sink Hose Bibs Toilet Kitchen Sink Urinal Laundry Tray Vacuum Breakers Lavatory Water Connected Appliances Other Fixtures Water Heater RE-PIPE: Water Treating System TYPE OF FixTURE QTY Bathtub TYPE OF FixTURE Clothes Washer Septic Tank&Pit QTY Dishwasher Shower Drinking Fountain Shower Pan Floor Drain ink Floor Sink TSh'orpeeS Compartment Sink Hose Bibs Toilet Kitchen Sink Urinal Laundry Tray Vacuum Breakers Lavatory Water Connected Appliances Other Fixtures Water Heater Water Treating System qISCELLANEOUS: I Sewer Replacement 11 Back Flow Preventer 11 Grease Interceptor (Trap) gallons(Requires 3 sets of plans) Lawn Sprinkler System-Number of Heads El Well SJRWD Well Completion Form. COmpleted—form to be submitted to tKe-—Building Department for final inspection." Other d-P-W-E_ ,rmit becomes void W 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 is 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 ori t V101 e the provisions of any other state or local law regulation construction or the pe ormance of construction. -not. The permit does not give auth * rf roperty Ovmers Name �Is & — Phone Number lumbing Company A (.�e, Office Phone� Fax 7 X%7 city State F( Zip _12-2-t MdTegs' le State Certification/Registration ice"Se H.1der(Print): otairi d-signature of Eicense Holder SHIRLEY L laRk" 0M and subscribed befo m QX 2Q) COMMISSION 9 DD 957760 EXPIRES:February 14 2014 lic Boridedl Thru Notary public Un�,rwriters gnature of Notary