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Permit ResAlt 5121 Polaris Ct 2012 CITY OF ATLANTIC BEACH .• 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 V "tit Application Number . . . . . 12-00001788 Date 12/07/12 Property Address . . . . . . 5121 POLARIS CT Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 8500 ---------------------------------------------------------------------------- Application desc retile 2 baths/wdo in 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 RETILE 2 BATHS WDO REPAIR IN SUNROOM Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee . . . . 95 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 8500 Expiration Date . . 6/05/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 95 . 00 95 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 99 . 00 99 . 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, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 517-1 Permit Number: Legal Description Parcel# Floor Area of Sq. t. Sq.Ft Valuation of Work$ 'Soo Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Itarati - 'ZiMab Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial <Z=a If an existing structure,is a fire sprinkler system installed?(Circle one): Yes <� N/A Florida Product Approval# For multiple products use product approval form p Describe in detail the type of work to be performed: PM Property Owner Information: Name: NCCRF Address: One 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 Builder Qualifying Agent: Joshua M Hogan Address: 6771'Shindler Drive City Jacksonville State FL Zip 32222 Office Phone: 904-838-9179 Job Site/Contact Number: 904-838-9179 Fax#904-838-9179 Stat6 Certification/Registration# CGC151891 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 indicated. 1 cert' that no work orihas conznzenced prior to the issuance of a ermtand hat all work will be performed to meet the standards oall 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. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, Furnaces, Boilers, Heaters, Tanks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not resume to give authority to violate or cancel the provisions of any other federal, state, or local law regulating construction or the performance of construction. Signature of Owner Signature of Contractoc*� Print Name Joshua Hatfield.................... ...... ... .................................. Print Name Joshua man Sworn to and subscribeq before me Sworn to and subscribed before me this_P Day of h:1 c— 20 i2 this _ o Day of ` r 20 12 Notaryt Notary Publib ELIZABETH TESKE Notary Public-State of Florida 've 0 26.10 .�� My Comm. Expires Apr 5.2013 ,?O`,aYPUB(,,, ELIZABETH TESKE �•' Commission#DD 867829 Notary Public-State of Florida �� "`°�••• My Comm.Expires Apr 5,2013 Bonded Through National Notary Assn. ' j"; Commission#i DD 867829 Bonded Through National Notary Assn Doc#201 2122 9336.Ot?BK 16.72 Page 1993, NUrrlber Pages i NOTICE OF COMMENCEMENT Recordce i3 l 06-2 2012 at 03:54 PSA, JINI PULLER t.__RK CiR(v +;;CCL1RT DU'VAL COUNTY Permit No. RECORDING x1000 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. 1.Description of property(legal description): :51 Z i b'tc'13, t ,avf+ a)Street(job)Address: 2.General description of inlprovements se. -};1e f�Z) b�-�ro.�,�ns >�� w+ ��5 �� c.• �a 3.OwneIl Information a)Name and address: 41 _ �i��'�' (�,1�r rsl �va . - ��✓-�n�c {�_j��;'2�� b)Name and address of fee simple titleholder(if other than owner) c)Interest in property 4.Contractor Information ; a)Name and address: fV o: '�.^+ �� i n. c�, _� .-r Lis_ •;^._�r• �r - r = 'a7J, �} b)Telephone No.: Fax No. (Opt.) 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 upon whom notices or other documents may be served: a)Name and address: b)Telephone No.: Fax No.(Opt.) 8.In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes: a)Name and address: b)Telephone No.: Fax No.(Opt.) 9.Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a different date is specified): WARNING TO OWNER: AN'Y PAYMENTS MADE BY THE OWNER 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,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA COUNTY OF PINELLAS 10. Signature of Owner or Owner's Authorized Officer/Director;Partner;Manager Print Name The foregoing instrument was acknowledged before me this- —day of Jt - ,201,by I-i as 4hxa rk:LC t (type of authority,e.g.officer,trustee, attorney in fact)for )IN CC h1: (name of party on behalf of,"•hom instrument Nvas executed). Personally Known_?�OR Produced Identification Notary Signature `, � Q•f�c-' - - / \ 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 tILe besLof_my1I elief. ELIZABETH TESKE Y FORMSNOC.r,sd2010 ;,;g`+ �� Notary Public-State of Florida My Comm.Expires Apr 5,2013 Signature of Natural Person Signing(m line#]0.)Above P:= Commission#DD 867829 Bonded Through National Notary Assn.