106 Fleet Landing Blvd 2012 shower/porch conversion r S f •= CIT OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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tit
Application Number . . . . . 12-00000731 Date 6/20/12
Property Address . . . . . . 106FLEETLANDING BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . 5600
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Application desc
shower porch repair donversion
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Owner Contractor
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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/ PORCH REPAIRS
Occupancy Type . . . . . . RESID , NTIAL
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Permit RESIDENTIAL A T/OTHER
Additional desc .
Permit Fee . . . . 80 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 5600
Expiration Date 12/17/12
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Other Fees STA E DCA SURCHARGE 2 . 00
STA E DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
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Permit Fee Total 80 . 00 80 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 84 . 00 84 . 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, Atlantis Beach, FL 32233
Office (904) 247-5826 F 4'x (904) 247-5845
Job Address: 106. F( Permit Number:
Legal Description Parcel #
P
oor ea o q. t. q• t
Valuation of Work$ S(ono Proposed Work h6ated I Vcooled non-heated/cooled
Class of Work(circle one): New Addition <Alteratt n Rep air Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercialesident'
If an existing structure,is a fire sprinkler system installed? (Circle one): es o N /A
Florida Product Approval#
For multiple products use product approval orm
Describe in detail the type of work to be performed: Cz, 2 p ,,
Ga�.lest o v �j �Ocark'lf 4e
`
Property Owner Information:
Name: NCCRF Address: _Qni 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/Contact Number 904-838-9 79 Fax# 904-838-9179
State Certification/Registration# CGC 1518918
Architect Name &Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as inalicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be per formed to meet the standards of all l ws 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. 1 understand that separate permits must be secured for Elect ical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Tanks andAir Conditioners, etc.
WARNING TO OWNER: YOUR FAILt RE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR I AYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFO RECORDING YOUR NOTICE OF
COMMENCE ENT.
1 p reby certify that 1 have read and examined this-plication and know the same to e true and correct. All provisions of laws and ordinances governing this
tv e o work will be complied with whether s ect sed herein or not. The granting of a permit does not presume to gave authority to violate or cancel the
provisions of any other federal,14,
low regulating construction or the per rmance of construction.
Signature of Owne �ignature of Contractor
Print Name Joshua Hatfield rint Name Joshua ogan
.............................................................................................. ............... ..... ....... .................................... . .............
Sworn t and subscribed before me worn to and subscribed before me
this , P Day of N- 20 t its �Day of n e 20
' ELIZABETH TESKE
Notary Pub iiAv"••, ELIZABETH TESKE ota 'o* Notary Public•State of Florida
Notary Public-State of Florida
•« My Comm.Expires 4mi 1.26.10
_• •_ My Comm.Expires Apr 5,2013
k .� Commission #DD 867829
Commission#DD 867829 ''••°F,��•`' Bo.aur Through National Notary Asan.
Bonded TArough National Nogry MM.
Doc#2012126902,OR SK 15970 Page 2054,
Number Pages: 1
NOTICE OF COMMENCEMENT Recorded 061'0,2012 at 11:11 AM.
!IM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
l RECORDING$10.00
Permit No.
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvements will be ma e to certain real property,and in accordance with Section
713.13 of the Florida Statutes,the following infonnation is provided in th s NOTICE OF COMMENCEMENT.
l.Description of property(legal description):
a)Street(job)Address: 1,?1,
2.General description of improvements:
r
3.Owner Information
a)Name and address:
b)Name and address of fee simple titleholder(if other than own r)
c)Interest in property
4.Contractor Information
a)Name and address: Ai
b)Telephone No.: Fax No. (Opt.) `10-Y t3 t;1,3-- 7'7 q 0
5.Surety Information
a)Name and address:
b)Amount of Bond:
c)Telephone No.: Fax No. (Opt.)
6.Lender
a)Name and address:
Phone No.
7.Identity of person within the State of Florida designated by owner uporl whom notices or other documents may be served:
a)Name and address:
b)Telephone No.: I Fax No. (Opt.)
8.In addition to himself,owner designates the following person to receiv a copy of the Lienor's Notice as provided in Section
713.13(1)(b),Florida Statutes:
a)Frame and address:
b)Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement(the expiration date is ol a year from the date of recording unless a different date
is specked):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OW 'ER 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,CON ULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OFC NIMENCEMENT.
STATE OF FLORIDA
COUNTY OF PINELLAS 10•
Signature )fOwner or Owner's Authorized Officer/Director'Parmer.'Manaser
Print Naz
The foregoing instrument was acknowledged before me this tj day f Jam. 20 i'Z by
as (type of authority,e.g.officer,trustee,
attorney in fact)for (nar ie of party on behalf of whom instrument was executed).
Personally Known ✓ OR Produced Identification Notary ignature
Type of Identification Produced Name k. rint) , t f}h �' � - Z` S A C__
OR
Verification pursuant to Section 92.525,Florida Statutes.Under penaltie of perjury,I declare that I have read the foregoing and that
the facts stated 'n' b d belief.
ELIZABETH TESKE
FORMS/NOC.rosd2010 ?,0.Y P„w`c w Notary Public•State of Florida
My Comm.Expires Apt 5,2013 Signatur of Natural Person Signing(m litre#10.)Above
`dam= Commission #DD 887829
Bonded Through Natrona!Notary Assn.
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