Permit RAAR 372 5th St 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
±� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000404 Date 12/11/12
Property Address . . . . . . 372 5TH ST
Application type description RESIDENTIAL ADDITION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1000
----------------------------------------------------------------------------
Application desc
SUMMER KITCHEN
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
SCOTT BRIAN AND KAY CROSS TIMBERS CONSTRUCTION
2078 BEACH AVE 2770 EAGLE HAVEN DR
ATLANTIC BEACH FL 32233 GREEN COVE SPRINGS FL 32043
(904) 838-8154
--- Structure Information 000 000 SUMMER KITCHEN
Construction Type . . . . . TYPE 5-B
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
----------------------------------------------------------------------------
Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 10000
Expiration Date . . 6/09/13
----------------------------------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BD PLAN REV. 2ND SUBMITAL 50 . 00
STATE DCA SURCHARGE 4 . 00
STATE DBPR SURCHARGE 4 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 100 . 00 100 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 58 . 00 58 . 00 . 00 . 00
Grand Total 158 . 00 158 . 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: 3772 S-NN S1_1 Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 10, 94545 Proposed Work heated/cooled 4 non-heated/cooled l2-4
Class of Work(circle one): <�p Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s)(circle one):installed?
ide
If an existing structure,is a fire sprinkler system nstalled? (Circle one): Yes a N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Ck_i-rS i oe Sj t--1Kt R kt Tche-�j Avs n
Wool) 17 c.
Property Owner Information:
Name:S-_&-rr 3P4ptA A"D kFti- Address: ZO-70 AgAer! / ilE.
City C MACH" tate 0Zip _Phone 96y (AXGY1lo
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:jjps iM6EAS4Qualifying Agent: ,4LAti _S. /v
tF ,ES J,;2
Address: 7 T4&U Ci A 'al-E a0-4q State,L Zip O(OA
Office Phone 2!/Sw 'Rist' _ �–Job Site/Contact Numberc/OSl83® g/5 Fax#?6q 410& QMp
State Certification/Registration#
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. ce oAllatk ion has commenced prior to the
ancefa permit and that al!work will be performed to meetthestandards of alawsctn isdiction. 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 aperiod of six 6)months at any time after
work is commenced. I 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 hereb certify that 1 have read and examined this a plication same be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specs here' or grantin f a permit does not presume to give thority to violate or cancel the
provisions of any other federa s , or local law r on or p ormance of construction.
Signature of Owner Signature of Contracto
Print Name2vlorr.t, F Print Name ..
........ .... ........................ ........................................
Sworn t d s bs 'bed before me Sworn Wpnd subscrib d before me
this t Day f ,2 this of e 20 42
Of
No ublic ,° _ t.°�-COMMISS1 'N N DD 957760 No r► c otary Public,State of Ftgrid
t EXPIRES:February 14,2014
Bonded Tnru Notary Public Undervrr tors t ommissionp EE 497p� jd0 1.26.10
My comm.expires Deci
DEC-11-2012 11:58 FROM:CLERK OF COURTS 904 270 1512 TO:92475845 P:1/1
No"CE OF CQMWN
C'EIVCENT
Stage of—19� PzI D/�
Tax Folio No.
County
To Whom ft May Concern: —
Thc undcrvigncd hereby inform.you that improvements will be rnade to cxrtairt real ry
Statutes,the following information is stated in this NOTICi OF('O A Aerty, and in accordance With Section 7l3 of the Florida
i,C$;t1, sC►5iption of property tieing improved: MTv1F NCEMEN-1
--
Addrcss of property being improved;
Gmerat dcseriptlon of improvements
f3w,ncr•, Cp�
Address; A4Y ,
Ownnr's intct+est in site of the irt2ptoyerucnt:
F'Ce Simple Titleholder(if other than ownca):
None
Co tror:..e55�•. i l~' �7f�S �— _
'Po1cpon h
a
Surer it — Fax No:
Amount of Bond$—
'fcicphnno No: _ —
Name anal address of any
person Making a loan for the construction of the impronxnenls
Name:- /N
A.ddrms:
Phone No:
Now
.. Fax No:
Naof person within the State ofFlorida, other than himsclE designated by owner upon whom notices or other documents
Name: may he verve d:
Address:
Telephone No:—yT Fax No:— y
- _
In a6dition to himscil owner designates the.following person to receive a copy of the I,ianor's Notice As provided in Section 713.06(2)(b),Florida
Statues. (Fill infit Owncr' option)
Name: f>•
Addrass: --
Tc1cphone No:
Fax No.-
Expiration
o:Expiration date of Notice of C:omnlenocment(the cxpiration dateis one(I) year from the d of
_-... �.._.. .. ass a ditTerent date is speci.(i.ed}:
THIS SPACE FOR RECORDER'$US]E ONLY OWNER
Coe p 201226216N.OR 9K 16177 Page 1566, Sigac
Number Paged: t Before me this - A � -
Recorded:2111;2012 at 11!27 AM, —dri T f c County of oval,State
dIM FULI.ER CLERK CIRCUIT COURT DUVAL Of Florida,has terse fly a arcd
i
COUNTY Notary Public tit Llg/g Stec Iorida,County o Val.
RECOPIMO$1 O.W MY evmmission ,Piro
Personally ICno -
PrOduced Idcntifi or
I
r -
N.
?�; :,r_ MY COl1gt45810N�PD 957764
�' - �YAES:February 14,2014
r'�'¢,};,. 1 BOndeR'm�NotaN R�buc lhxfervrr;tny
�7 59 4
ELITE HOMES INC .
357 12TH STREET ATLANTIC BEACH FL 32233
904-349-2803
To Whom It May Concern:
This letter is to serve as a release of permit 12-00000404 on property located at 372 5th street
Atlantic Beach,Fl. 32233. Owner Brian and Kay Scott
r O Ll
1
hris Lambe
Elite Homes,Inc
P
BP820U01 CITY OF ATLANTIC BEACH 12/11/12
Payment Due Selection 10:21:00
Application nbr : 12 00000404
Property . . . . . : 372 5TH ST
Select fees due, press Enter .
1=Select entire amount
Amount Fee
Opt to apply Type Trans amt ount due St /Seq Permit Inspection
PF 69.00 58.65 0 000 RAAR 00
Total .00
F3=Exit FS=Select all fees F10=View 2 F12=Cancel F21=User defaults
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
/ 5 INSPECTION PHONE LINE 247-5814
�r �� SCMNED 30
Application Number . . . . . 12-00000404 Date 4/23/12
Property Address . . . . . . 372 5TH ST
Application type description RESIDENTIAL ADDITION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1000
----------------------------------------------------------------------------
Application desc
SUMMER KITCHEN
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
SCOTT BRIAN AND KAY ELITE HOMES INC.
2078 BEACH AVE 357 12TH ST
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 349-2803
--- Structure Information 000 000 SUMMER KITCHEN
Construction Type . . . . . TYPE 5-B
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
------------------- ---------------------------------------------------------
Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . . SUMMER KITCHEN NEW
Permit Fee . . . . 69 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 1000
Expiration Date . . 10/20/12
----------------------------------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BD PLAN REV. 2ND SUBMITAL 50 . 00
STATE DCA SURCHARGE 2 . 00
STATE 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 54 . 00 54 . 00 . 00 . 00
Grand Total 123 . 00 123 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
r Atlantic Beach, Florida 32233-5445 7 G
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: — �Z- � 7-71r Department review required Yes No
i '
Applicant: ` �' 5 j tanning &Zoni
- "- ministrator
Project: t rC/' Public Work—
u Tic Utilities
Public Safety
Fire Services
0-m-W1_ MM*29=���
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
P �&ZONIN
Reviewed by: Date:_ �
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATIONV4,5�
CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233Office (904) 247-5826 Fax (904) 247-5845
G v
Job Address: 2 15� /' Permit Num5r>s-
>—
Legal Description Parcel#
Floor Area o q. t. Sq.Ft LL.
t�
Valuation of Work$ olarN,,� oetm,t- Proposed Work heated/cooled non-heated/cooled Zoo
,(-3vro
Class of Work(circle one): ew) Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial 6LZ ial
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No
Florida Product Approval # 14A4
For
4A 4-
For multiple products use product approva orm
Describe in detail the type of work to be performed: , �„ z
Property Owner Information: ,� n
Name:,e,- Address: 6bn &4t4
City. ✓ i State R-Zip 322r 3 Phone tL&q- M�ewc?
E-Mail or Fax# (Optional)
Contractor Information: / //
Company Name: 1!51,-& A,,_e5 1 v� Qualifying Agent: ai�is ZI.., ✓�
Address: '?57 2 City �¢t/°�f�r'c r3e-y-A State ISL- zip 32-X33
Office Phone 3 -Z Job Site/Contact Number 3gf '- ZSv3 Fax# L'f/- 97Y,'j
State Certification/Registration# b 5 00
Architect Name& Phone# 2-go I
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. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes Mull
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. I understand that separate permits must be secured for EleetriearWork, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heaiers,
Tanks and Air Conditioners,eta
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 an examined t s a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
ope of work will be complied wit ther s eco led herein or not. The granting of a permit does not presume to give authority to violate or caIXel the
provisions of any otherfederal,st ocal aw regulating construction or the performance ofconstruction.
r /
Signature of Owner Signature of Contractor
Print Name .R � !V.........�J.CQ.��............................................................ Print Name
Sworn an subscrib ore me Swoi> tgAd�stlbscrib f r�
this Da L 20/2, this !! Day of z 20
ZRAHAM
SHIR
No ry b 1c Notary Tiz
EXPIRES:February 14,2014 ;,P'?v'' � 0FEoi�9
Bonded Thru Notary Public Ur4orw IterssY COMA
, ExpjREs:May 21 1.26.10
TsV City of Atlantic Beach APPLICATION NUMBER
J� Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
-'` Phone(904)247-5826 • Fax(904)247-5845
? E-mail: building-dept@coab.us L Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �Z '77t7- D9partmept review required Yes No
Applicant: Planning &Zoni
J� ministrator
Project: � /7I/� �,� �/rCf7� 71 Public Wor
u is Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: ®Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by.-y Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date.-
FIRE
ate:FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
r
r CITY OF ATLANTIC BEACH '
800 Seminole Road,
Atlantic Beach FL 32233 6
Office (904) 247-5826 Fax (904) 247-5845 j gz
G� y
Job Address: 2 f /' Permit Number. %
Legal Description Parcel# \"
rf�a Floor Area o q. t. q• t t�
Valuation of Work$ orgaa,sC P,2fm,t- Proposed Work heated/cooled 4� non-heated/cooled
(r- lata
Class of Work(circle one): New ` Addition Alteration Repair �Mo-'v'e�Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial lie ial
If an existing structure,is a fire sprinkler,system installed? (Circle one): Yes No (�N� '
Florida Product Approval #
For multiple products use product approval orm
Describe in detail the type of work to be performed:
Property Owner Information:
Name: t`i Address:
City
✓ i StateF!-Zip ZZ, 3 Phoner�bt
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: c_ Qualifying Agent: LF►�3 G.4+�� ��
Address: Z City State /'�•t- Zip 32-Z-33
Office Phone -Z . Job Site/Contact Number 31f1` Zo-,<,3 Fax# 4�e t- 97Y j
State Certification/Registration# b 5 t C)
Architect Name&Phone# - 2 c,
Engineer's Name& Phone#
Fee Simple Title Holder Name and Address r,,g(o
Bonding Company Name and Address �v
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work isnot commenced within six(6)months, or if construction or work is suspended or abandoned for apertod of six(6)months at any time after
work is commenced. I 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 an examined thisa plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied wit r ther speci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,st ' ti ocal law regulating construction or the performance of construction.
Signature of Owner Signature of Contracto
Print Name 2� Qs Print Name .f.
........... ...... -- ........................................................... .::..... ... ..................................
Sworn ant subscrib ore me Swott6t %d- ubse t me
this Da 20/'Z- this _/'Dia/y of 20
SHIRLEY L GRAHAM
Not 1 b tc ` ' Notary P" ' pEgt)RAH
y �'. UPiRES:February 14,2014 ?v #EE057349
.1� `g 1-)gdad Thru Notary Public U1Nd0rWfters r?' MY
' EXPIRES:May z 1.26.10
}i% Notary