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469 Atlantic Blvd Unit 8 2012 build out CITY' OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-CO001009 Date 8/08/12 Property Address . . . . . . 469 ATLANTIC BLVD Application type description COMNERCIAL INTERIOR BUILD-OUT Property Zoning . . . . . . . TO EE UPDATED Application valuation . . . . 23000 ---------------------------------------- ------------------------------------ Application desc build out for dr office ---------------------------------------- ------------------------------------ Owner Contractor ------------------------ ------------------------ DIAMOND REAL ESTATE PROPERTIES MACK BROTHERS GENERAL CTRS. 6517 LOU DRIVE SOUTH 5521 BARKER STREET JACKSONVILLE FL 32216 JACKSONVILLE FL 32207 (904) 237-0868 --- Structure Information 000 000 INTERIOR BUILD OUT Construction Type . . . . . TYPE E -A Occupancy Type . . . . . . BUSINESS ---------------------------------------- ------------------------------------ Permit . . . . . . COMMERCIAL ALIERATION/OTHER Additional desc . . Permit Fee . . . . 165 . 00 Plan Check Fee 82 . 50 Issue Date . . . . Valuation . . . . 23000 Expiration Date . . 2/04/13 ---------------------------------------- ------------------------------------ Special Notes and Comments per m griffin no fire review 2010 FLORIDA BUILDING CODE, FLORIDA FIRE PREVENTION CODE 2008 NATIONAL ELECTRIC CODE ---------------------------------------- ------------------------------------ Other Fees . . . . . . . . . STA9E DCA SURCHARGE 2 .48 STAIE DBPR SURCHARGE 2 .48 ---------------------------------------- ------------------------------------ Fee summary Charged laid Credited Due ----------------- ---------- ---- ------ ---------- ---------- Permit Fee Total 165 . 00 165 . 00 . 00 . 00 Plan Check Total 82 . 50 82 . 50 . 00 . 00 Other Fee Total 4 . 96 4 . 96 . 00 . 00 Grand Total 252 .46 252 .46 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF i TLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT MPLICATION CITY OF ATLANTIC BEACH FILE C 0 Y i 800 Seminole Road,Atlantic 3each,FL 32233 '7� Office(904)247-5826 Fax (904)247-5845 Job Address: 469 Atlantic Blvd. Ste 8 Permit Number:-Li _/0 0 Legal Description 10 - 16 21-2S-29E Saltair Sec 3 Parcel# Floor Area ot Sq.Ft. Sq.Ft Valuation of Work -Proposed Work heatedkooled 919 non-heated/cooled Jf Class of Work(circle one): New Addition Alteration Repaj r Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed?(Circle o le): Yes No N/A Florida Product Approval# For multiple products use product approval form D e in detail the type of work to be performed: 61K 'WA-- "4& �01 Property Owner Information: Namc:Diamond R.E. Properties IV, LLCAddress: 6517 Lou Dr. S. City Jacksonville -State FIZip 32216 P hone- E-Mail or Fax#(Optional) Contractor Information: Company Name:Mack Brothers Bldg Cont. , Inc�Qualif ing Agent: Frederick W. Mack _T272�5 Address:1546 Girvin Rd. Unit 1 Citv Jacksonville State FL Zip OfficePhone 220-2500 Job Site/Contact Num�er 0 8 6 8 Fax# 220-0520 State Certit-ication/RegistratiTn-#-C--B-CT-1 2 5 8 0 6 2 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 herebv,made to obtain a permit to do the ivork and installations as indic ted. I certili-that no ii,ork or installation has comniencedprior to the issuance of a permit and that all ivoi-A-it-it/hepertbrined to ineet thestandards of till fait regulating construction in thisjyrisdiction. This permit becomes nuff and void if work is not commenced ii,ithin six(6)months,or if construction or work,iss ended at-abandoned lot-a period of'six(6)months at anv time after work is commenced. /understand that separate perinits must he secured - 1 ,lot Electri Work,Plumbing,Signs, Wells,Pools,Furmiees,Hoileis,Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PA YING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO 01�TAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFOR K RECORDING YOUR NOTICE OF COMMENCEIV ENT. I hereliv certitv that I have read and examined this qpplication and know the saine to he rue and correci. All provisions of I an ordi nces verni.ng,this go npe of worA ttvfl be complied with whether specified herein or not. Ae qranting at a permit does not presume to gi%, nth olat at' tic th 'action. provi.sions ofatit,otherfederal,state,ot-locallaii,i-egiilatitkgcon.�t;,uctiott tn�thepe�jfbrqance ofconsti,14clion. S4 nature of Co t r v— Signature ofOwner nT:mw F90M' 116 Print Name i2_1_C.±4/A R b F�A I A-T A Pri it Narne Aw. .4 ........................................................................................................................ .. . .......................4.............00*_ -./......................... Sworn to and subscribed before me SA-,)m to and subscribVd before me thi '- D f --J—, 20 thi! 3C3 Day of- _T u it 20/c� Notary PubliV Wi ary Public Revised 0 1.26.10 PAM HRYNCEINICZ COMMISSION#DO 961797 EXPIRES:March 2,2014 PAMELA HAYNCEWICZ Bonded Thru NOWY PUbk Underwrit9m W COMMISSION#DD 961797 EXPIRES:March 2,2014 kn4ed IMN Notary PuMc Undowlters Block Wall 00 T& a,"j B R 0 S. 41811 BUILDING T CONTRACTORS -_j Dr. Baiato __j 0 Dark Rm 114 Scale FM '12 (D X Q ;bC) 3 -< (D ;0 co 0 0 3 Elec Panel 51011 ;0 Cn 3 (D 81211 (D Q (D --+ --j to 3 CD Q :3 51011 131711 0 Cn Cn Q 3 (D + CD 3 (D Oil tz bun n � to 0 - 0 zv 0 dal �seC] J7� !Z do4 talunoo..4-9.1 -- 928 SQ.Ft. Q Nkl 191011 r Q > (D 6' Doors w C C= Wnl- 45k: City of Atlantic Eleach APPLICATION NUMBER 13ullding Deparbnent Cro be assigned by the BL"V Depeftot) $00 Serninole Road 12 - 1, 0d 12 Atlantic Beach,Flonde 32233-5445 phone(904)247-SM - Fax(904)247-5845 te E-mil: buNdkQ-dept@coab.us Da routed: City ma"ife! ft-JhAAow.awb.ue APPLICATION REVIEW AN TRACKING FORM Property Address: A _QeMrtment mvkm required Yes No *Ruildina*l ( r — a:n1ni Zooft & C Applicant: T Tree Adminisbator Public Works _7 Project: Public Utilities 7- fi4 -77 A-) Public Safety Fire Services Other Agency Review or Permit Required R or Recelpt Date Of ft ve~By Florida Dept.of Envirmnented Protection Florkla Dq*of Transportation St.Johns Rhw Water Management District Affny Corps of Engineers Division of Hotels and Restaurants Nvision of Alcoholic:Beverages and Tobacco Other APPLICATION STkTUS Reviewing D"wrtment Flmt Review: E�A'pproved. E]Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: Date: TREE ADMIN. Second Review: [34proved as revised. F]Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed I py: Date:— FIRE SERVICES Third Review.- E]Approved as revis Bd. ElDenied. Comawnts: Reviewed I y: Date: Revisol 07WIM0 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assoied by the Sullang Depaftwt.) 800 Serninole Road Afimnk Seex;h,Flondai 32233-5445 12 1 Phone(904)247-5826 - Fax(904)247-5845 E-mil: buildng-dept@coab.us Date routed: AZA&z- City vmb-446! ft!JA~.W0b.u* APPLICATION REVIEW AN TRACKING FORM Property Address: 4N nt review required Y No B Build Applicant anning A Zogld"S Tree AdminisMator Project: 4 4 C'rY;7 I"kg:;77 q Public Works Public Ublities dl� 7- Public Safety 4J 644 Fire Services Other Agency Review or Permit Required Re view or Receipt Date of P annit Verified By Fbrkla Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Ammy Corps of Engineers Division of Hotels and Restaurants Division of Ahu*wlic Beverages and Tobacco Other APPLICATION STATUS Revioming DepartmeW Firat Review: EXP-proved. E]Denied. (Circle one.) Comments: PLANNING&ZONING Reviewed b,f: Date: &�-6-/Z- TREE ADMIN. Second Review: [:]Approved as revised. F]Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed b1f: Date: FIRE SERVICES Third Review: E34proved as revise j. FIDenied. Comments: Reviewed b): Date: Revised 07)27110 NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Foli No. State of Florida County(of Duval To whom It may concern: The undersigned hereby Informs you that Improvemeni s 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, 10-16 21-2S-29E Saltair Sec 3 Address of property being improved: 469:,Atlantic Bl-7d. Ste 8, Atlantic Beach, FL 32233 10 General description of improvements: 611AII& Owner Diamond Real Estate Properties 117, LLC Address 6S17 Lou Dr. S . , Jacksonville, FL 32216 Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address Contractor, Mack Brothers Building Contract ors, Inc . Address 1S46 Girvin Rd. Unit 1, Jacksonville, FL 32225 PhoneNo. 904-220-2SOO Fax No. 904-220-0520 urety(if any) Address Amount of bond$ Phone No. Fax No. Name and address of any person making a loan for the constrL ction of the improvements. Name Address Phone No. Fax No. Name of person within the State of Florida,other than himself, esignated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax �o. 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 Statutes.(Fill in at Owner's optic n). Name Address Phone No. Fax No. Expiration date of Notice of Commencement(the expiration dat is one(1)year from the date of recording unless a different date is specified): ---f—HIS-615—ACE �Uk RECOR—DE-Ri 'S USE ONLY _:qWNER Signed: T=- DATE 2"�70 Before ir�W—this _670 day of -7-L.,/V �P- in the County of Duva 1,State of Florida.has persdnaI6 appeared herein t>y himself/herself and affirms that all statements and declarations herein are true and adurate Doc#2012164893, OR BK 16022 Page 1794, <-- Number Pages:1 Recorded 08/03/2012 at 11:41 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL Notary P­6611-ci'l StSte of Courft of Z7&-Z77;i--7- COUNTY My commission expires: 2 OV41 RECORDING$10.00 Personally — L---- or Produced Ide an P AMELA HRYNCEWICZ MY COMMISSION#DD 961797 EXPIRES:March 2,2014 Bonded Thru Notary Public Und-ebm JV CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12- )0001009 Date 8/16/12 Property Address . . . . . . 469 ATLANTIC BLVD Tenant nbr, name . . . . . . 469 -8 UNIT 8 ATLANTIC BLVD Application type description COMMERCIAL INTERIOR BUILD-OUT Property Zoning . . . . . . . TO 13E UPDATED Application valuation . . . . 23000 ----------------------------------------------------------------------------- Application desc build out for dr office --------------------------------------- ------------------------------------ Owner Contractor ------------------------ ------------------------ DIAMOND REAL ESTATE PROPERTIES MACK BROTHERS GENERAL CTRS . 6517 LOU DRIVE SOUTH 5521 BARKER STREET JACKSONVILLE FL 32216 JACKSONVILLE FL 32207 (904) 237-0868 --- Structure Information 000 000 INTERIOR BUILD OUT Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . BUSINESS ---------------------------------------- ------------------------------------ Permit . . . . . . PLUMBING PERMIT Additional desc INSTALL PLBG IOR COMM BUILDOUT Sub Contractor ST JOHNS PLUMBING Permit Fee . . . . 69 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/12/13 t ----------------------------------------41------------------------------------ Special Notes and Comments per m griffin no fire review 2010 FLORIDA BUILDING CODE, FLOR DA FIRE PREVENTION CODE 2008 NATIONAL ELECTRIC CODE --------------------------------------- ------------------------------------ Other Fees . . . . . . . . . STA E PLBG DCA SURCHARGE 2 . 00 STA E PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 69 . 00 69 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 73 . 00 73 . 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 �each, FL 32233 h(90�f2_47-5826 Fa (�'04) 247-5845 Aj X JoB ADDRESS: 1,--f U,— PERMIT# 42 NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FixTuRE QTY TYPE OF FixTURE QTY Bathtub S,-ptic Tank& Pit Clothes Washer S iower Dishwasher S iower Pan Drinking Fountain S op Sink Floor Drain T iree Compartment Sink Floor Sink T)ilet Hose Bibs U rinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory ater Heater RE-PIPE:Other Fixtures �ater Treating System TYPE OF FixTURE QTY T rPE OF FixTuRE QTY Bathtub Septic Tank&Pit Clothes Washer Sl lower Dishwasher Sl'ower Pan Drinking Fountain SI)p Sink Floor Drain TI iree Compartment Sink Floor Sink Toilet Hose Bibs U inal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: u Sewer Replacement o Back Flow Preventer E Grease Inte ceptor(Trap) gallons(Requires 3 sets of plans) -Number of Heads E I Well Fj Lawn Sprinkler System I **SJRWD Well Completion Form. Completeil—form to be submitt d to the Building Department for final inspection." 1-1 Other Permit becomes void if work does not commence within a six month period or work is s ispended or abandoned for six months.I hereby certify thTt I�haveread 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 Phone Number Plumbing Company S-ri D Office Phone /Lo(-/ ) Fax Co. Address: -LL G 0 IV)ArLe t I City JM State zip 1Z'7-\F? License Holder(Print): Aoberr W' �Plp I State Certification/Registration C ps Notarized Signature of License Holder (r– tA) DEBOW AMAWA Sworn and subscribed before�ptp this day of 101-2— My ComMWON 0 EE 349 2 W 1 067 15 J, J:7 EXPIRES:May 21,2D Bonded Thru N owipwilmmAn Signature of Notary Public