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1878 Seminole Rd (vault) FOR OFFICE USE ONLY 19 .Z7 Date..... 2) Permit #...........:.......... _0... Fee$ CITY OF ATLANTIC BEACH Valuation '3 - zE . ............ ..... ....... FLORIDA I--- - ------------- --- ......... --- ----JXouse ----- 4 P ---------------------- APPLICATION FOR BUILDING PERMIT Y- -----------------A----K­ ... PROVED ...... --------------C+-V-OF...ATLAf+Tf--ftE-AC4--------------- — R 111 91? Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity wi the9B 1111VOrdinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordil[6 oTt. ityy.of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shajL-b com]Vied with,;Viether herein specified or not. By The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain th T all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can be verified. Date-------------------------_---- -------------------------------­---1 19-------•---- kel ........­­-------------- Owner.#//f­*"';� ------ a t�j- - ,I I ?z Z ---------------------Address.... -- -------- elephone No_e�// Architect.......................................... ----------------­- --------_-Address------ _--------------------- Telephone No--------------------------- ru.n --­--------------- --- ------ ---------------- --—-------------............. ephone Contractor Builder........�##�...... -Address...... TakAs No--------------------------------------------------Block No---------/-------------- -----Sub Division_.'!5,'_e-/to- A,4-9,_ -----I f---------•---•---------------Zone----•---•-------- Lot --------Street- ---.Side Between-- --------------------------------------------------and------------------------------------------------------Stiq- -------------- ----------------------- -,q -zoo Valuation $----------._)_.................For what purpose will building be used-- - - - -- ..--..-_--..------Type of construction-------------------------------------- Dimensions of Building--------------------------------------Dimensions of Lot-- -----------------------------------------------------Size of Footings-------------------------------------- Size of Piers---------------------------------Size of Sills-----.--- -------Greatest Sill Span in ft--------------------------Type Roof.....-------------------------------- How will Building be Heated?.-_-__C_ eated?--. 1.14-") cz_ld_4---- - ­ ------ --- ....... Will Building be on Solid or Filled Ground?-....................................... Size of Ceiling Joists---------------------------- - -----I Distance on Centers--- -------................................, Greatest Span............................................ Size of Floor Joists------------------------------------ .........Distance on Centers_. .----- ................................ Greatest Span............................................ Size of Rafters.---------------------_-- ---------------------- Distance on Centers ................................. Greatest Span-------------------------------------------- -:5 This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. Inspections required. 1. When steel is in place and ready to pour footing. 2. When steel is in place and ready to pour columns and/or lintel. Z Z 3. When steel is in place and ready to pour beam. 04 1 A E-4 4. When framing is completed. % 5. When rough plumbing is completed,and ready to cover up. 6. When septic tank drain field or sewer is laid but before it is covered. 7. Electrical inspection by City of Jacksonville. 8. Final inspection. Note: In case of any rejection,re-inspection MUST be called for after corrections are made. FRONT OF LOT In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in accordance with the attached Tans and specifications, which are a part hereof, and in accordance with the building regulations of the City of AtlaAtic e e�ol -4--7,-_,^ Z_ ---------- ---------------- ----- Signature . ......... Address-_ ...... -C Signature of Builder------ ---- ---------,7��!4 . ....... Signatureof Owner. ---------- ---- ..-- ........ Address---------------------------------............................................................... �• DEPARTMENT OF BUILDING 3453 � € CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date 7/28 1977 Valuation$ '' `t Fee $ This permit not valid until above fee has been paid to City Treasurer, and is subject to revocation for violation of applicable provisions of LeH.�] This is to certify that +°�an(�9� s illi i 4�!!lg gpyp� " fii 60•, - E I has permission to buil' a7< residential Classification SIF Dwe I I i ng 7.nne Owned by Manders 131 dg. Co., I nC. r Lot 11 Block i S/DW9 House No. 1878 Seminole Road According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS G AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIR MONTHS AFTER DATE OF ISSUE 1 x_10 ► O Building material, rubbish and debris from this work must not be placed in public space, and must be cleared up and hauled away by either contractor or owner. R. C. Vogci 1 Building Official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING r ELECTRICAL SEWER WATER a. ��I CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT D�ATE : '7-027' 2? L(:T :N;". BLOCK NO . SID MA ",R PLUMBER- BLDG . D(;I .,l1ER OR CONTRACTOR— � ^� PERMIT NO. TYPE +J L101 DING � QINKS_—, Z LAVATORY__/ BATH TUBS URINALS CLOSETS FLOOR DRAINS SHOWERS WATER HEATERS DISHWASHERS DISPOSALS �.__. OTHER_ T10"I'AL r:T.KTURE'S @1 .00 NO '.^ICR'K MUST HE DONE UNITL A PERMIT HAS BEEN PROCURED PLANS 2AND SPECIFICATIONS must show a plan and description of the { rite and location of all the soil and vent pipes , and the number anal location of all fixtures , (In accordance with or-ftinanc e No . 188 of the City of Atlantic Beach, Florida) muss: be sbown on back of application and be approved by the Inspector . DRAW PLAND SPECIFICATION OF ABOVE PLUMBING ON BACK Approved by Plumbing Inspector Date (FOR OFFICE USE ONLY) , <o-ugh..-Zn In_-pected­ REMARKS Finall Insp:,�cted _CERTIFICATE ISSUED: 1 DEPARTMENT OF BUILDING 3449 CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date 7-27-77 19 Valuation$– P 1 UMb 1 ng Fee $ 9.W This permit not valid until above fee has been paid to City Treasurer, and is i subject to revocation for violation of applicable provisions of law. This is to certify that Ivslarcus Pri agi a of Able Plumbing Co. has permission to build to tf install I sink, 2 1avatibri es, 1 bath tub, 2 closets, I shower, i water heater, and I cashing machine. Classification residential 7nne Owned by Wanders iBu i 1 ders i Lot ( Block I S/D House No. 1878 Semi nol a '' d According to approved plans which are part of this permit i NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE ♦ -10 ► O Building material, rubbish and debris 1 from this work must not be placed in public space, and must be cleared up and hauled away by either contractor or owner. R. C. Vogel Building official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER t PLUMBING {6 t ELECTRICAL I SEWER WATER CITY OF ATLAunc BEACN LATER CM** 0 ON CHARGE DATE LWATIt PLUMBDNG; Fl a%sim 'a+ ML— l BI1O -cot TYIE OF 9UI LDO Wv fie) —Lawram m tN)OIp CONS 9 STB)a Of JSNOM STALL. DOMESTIC C2 UNITS) WAM CLOSET, LAVATORY a @ATH UE3 OR �tIMM STALL (6 umrrs) S (im) M NMD (3 UNITI BArdW MOTH Oft xI Tit 0w:. SDw 0 UNITS) WA ) (2 UNITS) —MAISHONG RIR SINK BA MY$) UNI FS P SERV I CSE SI NK-TMP STAND (3 IMI TS _ ,00MI MTB ON SINK a ymy e3 U'14175) L.�.'ss Y I CE S B NK-P THIP Q2 1UI TS) 6 NATI ON SINK *MY WATOOD DI SPOSAI. —Wit (4 UNITS) __�-__�T, SCULLERY-ST* {# UNITS) != .DE)f�111. Uil T OR CALSPI DOR SII T) URINAL, PEDSTAL, SYPHON .!ET, BLOPW to UNITS) 08ftX LAVATORY (I w"T)" _._—M NAL, MALL LOP B4 UNITS) ._.,.�!).�i0t16 POtE'ITAIM d+� tAN�TS� _ _ M NAL STALL, MMM (4 UNITS) �,,,,�,;l98�1�IIASIER (2 „__ tRi1T51`.; „_,�ti IwL 1'k0l�W B EACH 2-�T. SECTO ON FL W41 NS C9 twit)' B2 UMTS) 1*0 4I1K BZ tJINtTS)` WHIM NO (RES,) 0 UNITS) K� SINc MIPooD wkSiriE' ---JM SIN IL MM SET IF (FAUCETS B UNTS) (2 UNITS) ',,,,.J„JtrINTUIY (I UNIT) /wu U. , TANK-OPERM 3 --u"--.MMKTM, 109M, BEWTY PAkOlt (4 IM TS) (2 UNITS) WATOt CLOMP, VALVE-- tATED (a UNI TS) ._,_..+,LAVA1TMY, SUIMEONS (K2 UMI TS) JAMW TRAY (2 UMOTS) `2 �, 796 OMM BU-411JINPIRD ATMM.0 KfCA, R-MCOM. 1878 Seminole Road:,__–__ 2. Tho SiIvv#',e4 ph14-M aWlm bull I-d"'YA-9 1u s 'p ed subjmt j6tj;fiat jn9 ;f tv cardi caftereft wader er"rerbw well 6,; rvi0cf4rad W�Iti Iwo Vel do rets ufamiegg rvft for Orm-Stcwy a& wv- twy 9 dI aos,)d Tt;rao 54"'0' def&MW rGI FftWCI eV i fob" t S s� zttoH, be pRamd �� *.mlowaar crv-."-fWR4 at the, footr, " gs, p,-vpwvIy pllawod and fastened an SeW i%WIOS with VIM- FOO t'050 ZhOU be S;x 4 wftw Wder or, each Swdo "mn ,eft %wo Obwe, SWO be ar'r beast 4;100t �wtes -a-A4* W.-'d stmul v vst or, '�i m S0.1 0' e" 11.663+ t wall,"ve 5#wIwS be r"Ow UVAU Stv'r*V4 0 wAt ca QCs shoo 6 be reinforogm UM ,vt ';eastane No. 5 bw eq, a 11,0 tornemv, pwu'usS4 m1d wIft c szxh MOOM—Im St"W be propw1v tled "44V fte fo*. Ing end SpW&VI bemp i1 fi X411 t be setwvfly fastwed to uns covhw1or "w(; iWit, -ov/vd &vnIcane amc4=3 'ar 40fP,- d' Omelan Ov, mar :i Ev "p,P rcq%S wrpf.iki'l Or's dlvf Icates *r intamty liarlity Comiders, fte mchwmfi 0060,106 ion r.d Cam e., I! awtWfati s. 4Aadow sl ze *ad dest 9a' ft 6MV of qtrk~05.� in G"C'Wd Wilk +be tOr4VJ", ,* vieU..'ar, *r duph Imtre N,MM SW f 1W bO CcWtisiIfIftift COMS prml"+Y. a� gods c,*tw,, and Wto t t be irt"o*as& 500 f"t,ipw-t am &;Oq 9 log rS A Sf We I�rvw am O'HIM—W alas per *w#Vlr'.Wj Se mw w0im comoc'Mcam mo be prGb4W WIN'4 'pw fliall *=eCtlep ba-h-.0" "e hcu*4 PlI&OWIm"a wd tto Sww swvlce by It* CAY "#We beg i% covaed. TW %mdws!qiwd hwvbV CSI'MIGS WS f?"d ft"'�W-z 4WA wtdgIrS1wft "a% ' ';q 0646n*" low .'C.A I'me Oww ;wIf C'mim-if &Isil 1�a fa 1� pe.8;m &to zpcc'.: 77 e • e MY 011 �����wi�!� BEACH F hy AMPU CAT3X44 k S MME M FOR __..k. 314"w Tap 11 w w Cj.rr,--?4f COME CF 85.00 + 4.00 ponst. water a?n�"3' NO, ._ 1.878 Semi nol a Road Wanders BI dq. Co. , Inc. 962 St. Johns Bluff Rd. , Jax FL PARUNG MOSS AccvJMT NO. DYE 7/28/77 LWATI ON 1878 Seminole Road LOT NO. � ...___ 11 1: BLOCK NO. I StWI VI SI ON -.AW—.L O _ Wanders Bu I di nq Co„ I nc. .w. TM OF FUUI US � Residential PLUMM DA'I PSR-3844 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ----- PERMIT INFORMATION ------ LOCATION INFORMATION ------ Permit Number: 10716 Address : 1878 SEMINOLE ROAD Permit Type: RE-ROOF ATLANTIC BEACH . FLORIDA 32213---1 Class of Work : ALTERATION ---------- LEGAL DESCRIPTION --------- Constr . Type: WOOD FRAME Lot : I.I. Block 1 Section: Proposed Use: SINGLE FAMILY Township- RNG: 0 Dwellinas : I Code, 0 Subdivision: SELVR MARINA Estimated Value : $2449 .00 Improv . Cost :- $0 .00 Tot:� ! $22 . 50 Amou 5 2 2 50 _____._ ___ _ OWNER 0- OWNER INFORMATION APPLICATION FEES Namt , FRINKLEV PERMIT $22 . 50 Address : 'L178 SEMINOLE ROAD WATER !MFA:'T FEE -TLA TIC BEACH, FLnPTr - SEWER IMPACT FEE Phone - 13114)397-4934 WATER METER/TAP S0 .00 RADON GAS-H. R. S. $0 .00 CONTRACTOR INFORMAT1QN RADON CAB 5% $0 . 00 Name . STUDARD ROOFING, TT- " I CAPITAL IMPROVE . $0 . 00 i r e s 4438 IRVINGTON AVEI- SEWER TAP $0 . 00 jo-'KSONVILLE, FLORIDA 3221' CROSS CONNECTION License ' CCCO27462 Type, 0 SEC H IMPACT FEE CONST-SURCHARGE NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. OV.....wweeew --.56 t4 Date: 9/01/95 01 Rept: 0079092 ATLANTIC BEACH BUILDING DEPARTMENT CHECKS 1159 00100003221000 By: CITY OF ALANTIC BEACH ROOFING PERMIT APPLICATION owner(s) : Address: l g 7 8' tylde Phone: Lot #��, Block or Unit # Subdivision;SCIVG-Ao-y- VCS Contractor• Address : La City, State and Zip FL- Phone State License # C &LZ ql�L J j�` Describe work to be performed: rie Tl� r 00*t, j Al or Valuation of Proposed Construction: q`rZ Materials to be used: YP -'Le S c Signature of Owner; Signature of Contractor: Liability Insurance Supplied Workers Compensation Insurance Supplied License Information rpt r J%jrJ�� J ;°= `S� CITY OF ATLANTIC BEACH y 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028301 Date 5/17/04 Property Address . . . . . . 1878 SEMINOLE RD Tenant nbr, name . . . . . . REPLACE EXISTING HVAC Application description . . . MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------ ------------ -- ---------------------- HAYES OCEAN STATE HEAT & AIR 1878 SEMINOLE ROAD 1476 ATLANTIC BLVD. ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 249-8251 - --------------------- -------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 79 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ---------- ------- ---------- ----- ---- - ---------- ---------- Permit Fee Total 79 . 00 79 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 79 . 00 79 . 00 . 00 . 00 BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. c , BUILD OF CIAL s, CITY OF ATLANTIC BEACH MECHANICAL PERMIT APPLICATION / Date: � v Property Address: kA-Y)K�QU89S 1)�4 rr� Owner: ­ R" Telephone #f2'`"1& l 8qj Contractor: Qt Aan IC 04 C Telephone #:E11P p � Contractor Address: 141(p CN, �C&rH rp) Fax #: In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of good practice listed therein. Type of Heating Fuel: If other construction is being done on this building or site,list the building permit number: Electric— — Gas: LP _Natural Central Utility U-6 ❑ Oil ElOther–Specify MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK Heat —Space _Recess ed-A Central —Floor Residential Air Conditioning: _Room Central ❑ Duct System: Material Thickness O Commercial Maximum capacity cfin ❑ Refrigeration ❑ New Building ❑ Cooling Tower:Capacity gpm Existing Building ❑ Fire Sprinklers:Number of Heads ❑ Elevator: Manlift Escalator (Number) Replacement of Existing System Z) Gasoline Pumps__ (Number) ❑ Tanks (Number) ❑ New Installation ❑ LPG Containers (Number) (No system previously installed) ❑ Unfired Pressure Vessel ❑ Extension or Add-on to Existing System ❑ Boilers ❑ Gas Piping ❑ Other-Specify ❑ Other–Specify LIST ALL EQUIPMENT AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving Number Units Model# Manufacturer Ton's Agency ,Description 3 HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving Number Units Description Model# Manufacturer BTU's Agency TANKS Nominal Capacity Type Liquid Serial Approving How Manv &Dimensions Contained Manufacturer No. Agency 800 Seminole Road • Atlantic Beach, Florida 32233-5445 Phone: (904)247-5800 • Fax: (904)247-5845 • http://www.ei.atlantic-beach.fl.us 5626 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH J­EiYiiij' !NrURMATION LOCATION INFORMATION Permit Number,: 5626 %ddress: 1878 SEMINOLE ROAD Permit TypL_: RE-ROOF ATLANTIC BEACH, FLORIDA 3223:.1 Class of Work : NEW ----------- LEGAL DESCRIPTION Constr. Type: WOOD FRAME Lot : Block: Section: Proposed Use: SINGLE FAMILY Township: RNG: 0 Dwellings: I Code: 0 lubdivision : Estimated Value: $0. 00 Improv. Cost : $0. 00 Total ees : $22. 50 Amount id ; 522. 50 8/92 hL K FLAT ROOF' ONLY OWNER INFORMATION -------- - ---- APPLICATION FEES ----- Name: PROPERTY OWNER PERMIT $22. 50 Arid-,-ess - 1878 SEMINOLE ROAD WATER IMPACT FEE $0. 00 ATLANTIC PEACH, FLORIDA 322-. 3 SEWEP IMPACT FEE SO. OU Phone: WATER METER *U. 00 RADON UAS-H. R. S. $0. 00 ------ - CONTRACTOR INFORMATION RADON GAS - 5% $0. 00 Name: ROMANO BROTHERS ROOFING WATER TAP $0. 00 Address: 1601 MAIN STREET SEWER TAP $0. 00 ATLANTIC BEACH, FLORIDA 32, HYDRAULIC SHARE $0. 00 License: RC0039983 Type: 7 RE-INSPECT FEE $0. 00 SEC- H IMPACT FEE $0. 00 OT14ER SO. 00 NOTES: NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.59'32 ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. CNiGt ATLANTIC BEACH BUILDING DEPARTMENT By: CITY OF ATLANTIC BEACH PERMIT APPLICATION ROOFING Owner(s) : Address: 0 C� Q 2 Phone: Lot # Block or Unit #$ Subdivision Contractor:—&- C)Gr.--� Address: 116 / ��„, �- f j Phone State License No. �' Cj G 3 1�3 <� } - -7 Describe work to be done:_ /Vcz- �� PGS Materials to be used:__ �J�-� �L J--) Signature OWNER: ' Date: Signature CONTRACTOR: c. PS , *844 15464 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT INFORMATION LOCATION INFORMATION Permit Number : 15464 Address : 1878 SEMINOLE ROAD Permit Type ; SIDINI-", ATLANTIC BEACH , FLORIDA 3223--, Class of Work :NEW --------- LEGAL DESCRIPTION ---------- Constr . Type:WOOD FRAME Block: Lot : 11 Twp: Proposed Use: Section: 0 Subd:O Rng * Dwellinas : 1 Subdivision: SELVA MARINA Est . Value: 0 .00 Improv . Cost : 2 , 900 . 00 Total Fees : 37 . 50 Amount Paid: 37 . 501 7i� J* 10/27 /1997 Work '('%'-EPLACE 29 SHEETS SIDING, ROTTEN WOOD AND ONE EXT . FLUSH PA­ OWNER INFORMATION APPLICATION FEES ---------- Name , BRINKLEY PERMIT 37 . 50 Arl,- 17 - !??8 SEMI HOLE ROAD ATLANTIC BEACH , FLORIDA 32233 r-iic-ne: ( 904 ) 387- 49'4 CONTRACTOR INFORMATION Name: BLASSINOAME BUILDING SERVICES Addr : 611 NORTH FOURTH STREET JACKSONVILLE BEACH . FL 32250 Lic : CGC049923 Exp : NOTES: NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS." ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. 137 5@ 14 Date: 10/28/97 01 Receipt:_8887019 CHECKS 1266 ATLANTIC-BEACH BUILDING DIPARTMENTI CiT=r OF dTI�_.NTTC �� p T A-=FZ__C-A ON R-HIMCDEL, ADDI.TSONS, CR AZ= —ONS MCVLVG, D�CLiT20NS Cwner s ACC,ess: Zen lcz Cr tate C G C_ ..or.? l4c: -7az= j l Com. e� f _-.Sen c.^.=t==cc_or. , 9 cru "d ._ CCsea .:Se: =-e :=ace: =cc'et New _._Cmase' New _New __zeclacal New -ea_, T"'U (�Ey--Z-1L) C^..MPI.cZ - 7TS CS ?La S, ===7-VG CCL:E FCRms, NCM-- CF 3Nr CTTMM IS CCN=uC-_CR. . CCN':?.A.C'"CR.: Swc=. zc ar.0 sa scr_ et ce=cre me ::.._s �F p� CAROL R.BLASINGAME °9 My Comm Exp.8/10,2001 N Pueuc ; Bonded By Service Ins No.CC670412 I Personauy Kr.own I 1 Other I.D. FLA. 1947 LAWS t■r FS 713.17 PAMCO IORM 409 �rtt�c�e of Ciainmracemrnt 'Eli fvliom it uux� "Utast: The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE /OFF',COMMENCEMENT. / Description of property....... . S 1/11 " c e_ 01-401-4 /0 Q -) U e Jo N � ................................................................ no �.- ............................................. .......................... .............................................................................._................................................ ......................................................................................................_......._..._...............:........................... General description of improvements......,�....d�' lA 51�• �t ...... ...................................�.... 1...............S C...............:.; . ............................................................................................................................................................ /� / ....................................................................................................................................................... Owner.......L. �:r1�a-.��.4..........,f :c.�!. . ............................................................................................................................................... Address.....���:' ......°� Owners interest in site of the improvement .•................... ............................................................................................................................ fee Simple Title holder (if other than owner) Name.................../��.......... Address..................................................................................................................................................................».............................................. .......... Contractor.............%..l>/i c G. �-%�� S o ,,� lJE- ��o�_�l�S +ti o-,,«�G J 5 ............f.......... ......................................j. ........._................ ......: ..., y .2 Address......!!��......11.T.. ....... Surety (if any)................ .. ... .. ........................................ Address.............................. ....................................... ..............................................................................Ar wxW of band $................................ Name of person within 16 State of Florida designated by owner upon whom notices or other doosmeres may be served: Name ............ ......... ..�.,./}........................................................................................................................................................................................... Address......................%........................... ...................................................................................................................................... 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) (F), Florida Statutes. (Fill In at Owner's option). 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