668 Selva Lakes Cir 2013 bath remodel CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
1 s) ATLANTIC BEACH,FL 32233
J
-_� INSPECTION PHONE LINE 247-5814
Application Number
13-00002594 Date 5/01/13
Property Address . . . . . . 668 SELVA LAKES CIR
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
--------------------------
Application desc
BATH REMODEL
-------------------------
Contractor
Owner -------------
------------------------
WILLIAMS ATLANTIC CO. , INC
FOX THOMAS FOX
1129 NECK ROAD
668 SELVA LAKES CIR
PONTE D
ATLANTIC BEACH FL 322334377 (904) 545� BEACH FL 32082
48g4
--- Structure Information 000 000 BATH REMODEL
Occupancy Type . . . . . . RESIDENTIAL
----- ----
Permit
• RESIDENTIAL ALT/OTHER
Additional desc • Plan Check Fee . 00
Permit Fee . . . . 80 . 00 6000
Valuation
Issue Date . • . • 10/28/13
-----Expiration Date ----------------------------------
------------
STATE DCA SURCHARGE 2 . 00
Other Fees • • • . . . . STATE DBPR SURCHARGE 2 . 00
-------------------------------------
----------
Paid Credited
----Due
Charged Pai
Fee summary g - -
_ ---------- ------- . 00
. 00
Permit Fee Total 80 . 00 80 . 00 . 00
. 00 . 00 . 00
Plan Check Total 4 . 00 . 00 . 00
Other Fee Total 4 . 00 00 . 00
Grand Total 84 . 00 84 . 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 Roa
d,
6anF (904) 247c Beach, FL 35845
2233
Office (904)
����� �z _ Permit Number:
Job Address: �v `�
Parcel# t
Legal Description oor Area of non-heated/cooled
Valuation of Work$ ®dam —Proposed Work heated/cooled
: New Addition teratio Repair Move Demolition pool/spa window/door
Class of Work(circle one) esiden
Use of existing/proposedstructure(s) (circle one): Commercial
If an existing structure, s a fire sprinkler system installed? (Circle one): es No N/A
i
Florida Product Approval#
For multiple products use product approva orm --�
Describe in detail,the typ
e m
of work to be p rfored:
tProgeOwner Information: m VZ- —
�— d'� Address: —
Name- < D '^ < < Phone
State p-Zip
City
E-Mail or Fax#(Optional)
Contractor Information: �— {
i L Qualifying
Company Name: g Agent:
tate _
'^` °`.� City V _
�L Fax ` 0 4.
Address: Job Site/Contact Number
Office Phone D 4 2istration# C -"_
State Certification/Reg
Architect Name&Phone# A
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address null
has
ndards of all laws regulating construction inahieriod of sixn6)months This attany time after
to obtain a permit to do the work and installations as indicated. I certify that no work orinstallation
n. commence prior becomes e
Application is hereby made Wells,Pools, Furnaces,Boil
months, or if construction or work is sus ended or abando f
issuance of a permit and that all work will be performed to meet the
and void if work is not commenced within six(6)
Si ns,
Plumbing, g
work is commenced.
found understand that separate permits must be secured for Electrica Work, TILE OF
Tanks and Air TO RECORD A NO
WARNING TO OWNER: YOUR FAILURE ING CONSULT WITH
COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICECFOR IMPROVEMENT
EY BEFORE RECORDING YOUR NOTICE OF
TO YOUR PROPERTY. IF YOUOIRN ND TO OBTAIN FI
YOUR LENDER OR AN ATT COMMENCEMENT.
granting of a permit does not presume to give authority to violate or cancel the
1 hereb certify that I have read and
examined this a plication 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 spect red herein or not. The g g
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Contrac r .
Signature of Owner Print Name ..-v- . ......... .........._ � �...�..hS
Print Name .........................................................................................................................................
.. fir,.
Befo,' e 20
Be f me thi of
t ay o �5H1 G
IS;ION#D4 95T160 2014
ru is 1 ES:FebTu hfcU am
o- n 'n+"NOM "� '�` Son n"N0 evised 10.24.12
No ary Pu 'c �4: Frei
Doc#2013113039,OR BK 16356 Page 2482,
2-44P7 �t r ,✓ Number Pages: 1
'/ '�_ Recorded 05/07/2013 at 08:43 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
NOTICE OF CJ].VIIVIENCEMENT CUNTYRECORDING$10.00
State of Tax Tax Folio No.
County of -77)a Va,
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:
l I
Address of property being improved:
f General description of improvements: —
/I 114A
Owner: 0 '�, D __. Adores: —
U� Q PF 5
;y
Owner's interest in site of the improvement: __--
s ,
Fee Simple Titleholder(if other than owner):
Name- CC
Contractor: � LA2
Address: _ /G-
Telephone No.: Fax 73
Surety(if any) ---
Address: Amount of Bond S
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 r imseif,Glesignatedby owner upon wqom notices or other docu-nerxts may be
served: Name:—__-----------------------_-._._.__.._.____.__-_____.__.__—____
Address:
Telephone No: _ _ _ lax 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): _. —_ —._. --.-------------- ___ _ ------- ---
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Date:
Signed. ---
IF
SHIRLEY L GRAHAM Before uh.is day of. in the County of Duval,State
W COWS310N#DD 957760 Of Florida,has personally appe
EXPIRFS-Fabnjary 14,2014 Notary Public at Large,St Flori a,County o6Tf� 30 4-10 rhru Notary Public Underwriters My coTnmi,ssion e pire .
or
Personally Knov m.:
t Produced Identification._