Permit Siding 1969 Beach Ave 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001502 Date 10/15/12
Property Address . . . . . . 1969 BEACH AVE
Application type description SIDING PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 29480
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Application desc
Replace exterior stucco with Hardie lap siding
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Owner Contractor
------------------------ ------------------------
GREIDER, JACK L JR REEVES INSULATION, INC.
1969 BEACH AVENUE 7028 DAVIS CREEK ROAD
ATLANTIC BEACH FL 322335936 JACKSONVILLE FL 32256
(904) 288-9913
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Permit SIDING PERMIT
Additional desc . .
Permit Fee . . . . 200 . 00 Plan Check Fee 100 . 00
Issue Date . . . . Valuation . . . . 29480
Expiration Date . . 4/13/13
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAl ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 3 . 00
STATE DBPR SURCHARGE 3 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 200 . 00 200 . 00 . 00 . 00
Plan Check Total 100 . 00 100 . 00 . 00 . 00
Other Fee Total 6 . 00 6 . 00 . 00 . 00
Grand Total 306 . 00 306 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
.st City of Atlantic Beach
APPLICATION NUM�BER
Building Department a d
(To be assigned by to Building Department)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 17? - 16 0 2-
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept(Mcoab-us I EDaterotftd: �12_
City web-site: http:/twww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Fl-u-9astment review required Yes4-No
J Build V
Applicant: Pranning&Zoning
Tree Administrator
Public Works
Project: &Jw_�
Public Utilities
Public Safety
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
I of Permit
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:
APPLICATION STATUS
Reviewing Department First Review: Explop-roved. ODenied.
(CI Comments:
: BUILDIN
;;G
PLANNING&ZONING Reviewed by: )�V' Date: /Cy- 2- 7-
TREE ADMIN. 4
Second Review: E]Approved as revised. DDer gid.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SER\ACES Third Review: FlApproved as revised. [--]Denied.
Comments:
Reviewed by: Date:
Revised 07127110
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-�: 845
WW0M0WWMNN�
Job Addres;s: t%'I F)W 13A;:Vk, iii- ?Z233
Permit Number:
Legal Description 15 4>5-7 e� --ZS'- 2'3 �:' � Xo�0,'L
'K'r�el#
Floor ea of Sq.Ft
Valuation of Work$ Z%Ve,0 , L'O ProposedWork heate*dVcooled non-heated/cooled
Class of Work(circle one): New Addition (:�� Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial t al
0
If an existing structure,is a fire sprUer system installed?(Circle one).�Yes N/A
Florida Product proval# r-L 13 191-
For multiple prosucts use product approval Form
Describe in detail the type of work to be performed: 12 0,pia
UA12iZ1u7 _<j0i0%1
Pr2ggrtv Owner Information:
Name: J C le L 0,-iii-j of,-L A
�igi�_L ddress:—14;�l 8-2om,in .(-)V4,
City 6116f-W, IC&1�ch State KZit) 3 2- 3
_I-Phone
E-Mail or Fak!#(0 ional)
Contractorj
0,formation:
CompanyName: Qualifying Agent:
Address: -7CZZ L>0qk)& cj?_ff
�jc City oi-A I iz- State zip .. 3 Z 2-5-(-
Office Phone 2 a# 2 -29)1 Job Site/Contact er 0 _117ax# 90Li - 25b- 9 15-
State Certificaiion/Registmtion# 61 C- o9 5 s"Z-7
Architect Name&Phone#
fq/N
Engineer's Name&Phone# tq
Fee Simple Tiile Holder Name and Address, 7
1 14 1A
Bonding Company Name and Address
ti/A
Mortgage Lender Name and Address
NIA
A �eb de bana e d wor and aa a nd'c d cer y tha�no work or installation has commencedprior to the
f
cons ctio in thisjurisdiction. Thispermit becomes null
s r aba� ond or a penod of sixJ6.)months at any time after
um g St s W 11 Pools, urnaces,Bolleis,Heaters,
k ns s Og,
�o w 11 aw e atn
t i
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vo m 'a e ix�t to 0�"e to mZt t t'�r 0 k I de
" ' ' pi be e ed h an a
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and 'd r 0 c w
e I u r t th I s Pa i smu t cur e
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d nd and a e rate pe be se edfor E e k b gn
I I
wo'k is n
Ir
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an and A Con tioners,ec.
WARNING TO OWNER: YOUR FAILURE TO RE ORD A NOTICE OF
COMME NCEMENT MAY RESULT IN YOUR PAYING TM ICE FOR IMPROVEMENTS
TO YOU R PROPERTY. IF YOU INTEND TO OBTAIN FUN ANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOITli NOTICE OF
COMMENCEMENT.
1here certify th at I have read and examined this a plication and know the same to be true and correct. A 11provisions of laws and ordinances governi.ng this
IlVwork will&coTplied with whether s ecif J d herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any#therfederal,state,or I Ta ting construction or the pe�brmance of constructibn.
�7
Signature of Owner Signature of Cont�acto
Print Name
..................... ....... Print Name
...............................................................................................................
Sworn to and subscribed before me Sworr�� N;cribed before me
�o
,,and su
V,
this DaW_49—,,j j5'&&2'71 J�
20 /Z this Day of
120 /
Notary Public Not Pub
ary
------�R_j sed 01.26.10
-PH D,STE
JUUL ARMAN
JOSEPH D.STEARMAN
Co"sSiOP,#DO 999790 Comroission#
Expires DD 998790
June 18,2014
sor*a na
troy Fwn kwarm.Afvvu,�.. �kgf- Exoros June 18,2MO14
NOTICE OF COMMENCEMENT
State of FL Tax Folio No.
county of
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 of property being improved: 7 2�5 - 2"
7
Address of property being improved:
General description of improvements: J?L)I C 1---) 5
Owner: L z Address: i I
IL
Owner's interest in site of the improvement: '3 Z 33
Fee Simple Titleholder(if other than owner):
Name:
Contractor:
Address: 1? —75
Telephone No.: "I O�i- Z Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: 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:
Address:
Telephone No: Fax No:
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 Statues. (Fill in at Owner's option)
Name:
Address:
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):
Al"W� JOSEPH D.S7AR7N
THIS SPACE FOR RECORDER'S USE ONLY OWNER J.-Ommi, Sion#DO 995790
E X 4
piresJune 18,201
17019
Signed:
Doc#2012224411,OR BK 16102 Page 2052, Before me this..... day of in the County/of D -'al, State
Number Pages: 1 Of Florida"has personally appeared
Recorded 10/12/2012 at 09:55 AM, Notary Public at Large,State of Florida,County of Duval.
JIM FULLER CLERK CIRCUIT COURT DUVAL My commission expires: �-x��
COUNTY Personally Known: or
RECORDING$10.00 Produced Identification:
(2�1