1021 Atlantic Blvd #953 2013 column repair r l„�
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003237 Date 8/14/13
Property Address . . . . . . 1021 ATLANTIC BLVD
Tenant nbr, name . . . . . . UNIT 953
Application type description COMMERCIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5800
----------------------------------------------------------------------------
Application desc
REPAIR COLUMN & STUCCO DAMAGED BY CAR
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
EQUITY ONE ATLANTIC VILLAGE, THE SHROUT COMPANIES INC
16 NE MIAMI GARDENS DR 3811 UNIVERSITY BLVD WEST
ATTN: TREASURY DEPT STE 13
MIAMI BEACH FL 33179 JACKSONVILLE FL 32217
(904) 509-8539
--------------------- Structure Information 000 000 ----------------------
Occupancy Type . . . . . . BUSINESS
----------------------------------------------------------------------------
Permit . . . . . . COMMERCIAL ALTERATION/OTHER
Additional desc . .
Permit Fee . . . . 80 . 00 Plan Check Fee 40 . 00
Issue Date . . . . Valuation . . . . 5800
Expiration Date . . 2/10/14
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 80 . 00 80 . 00 . 00 . 00
Plan Check Total 40 . 00 40 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 124 . 00 124 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
\ rsy�;lr City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
r 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 S
E-mail: building-dept@coab.us L__Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �53 / l �A��G �V Q' . De artment review required Yes No
Buildin
Applicant: I I lE �ShYOu CKMa(AVl I fS Planning &Zoning
Tree Administrator
Project: , C( 1 ( CiIO) ury)� d" Public Works
S�k' L&O d G�mc��C �d C&r- Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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:
APP (CATION STATUS
Reviewing Department First Review: R6Approved. ❑Denied.
(Circle one.) Comments:
BUILDING d
PLANNING &ZONING / �j-�Z-Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [-]Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Aug 1413 03:16p Tom Shrout (904)731-2574 p.2
Doc # 201321_284, OR BK 16492 Pa! e 2017, Number Pages: -IRecorded
08/14/2013 at 02:29 PM, Ronnie Fusell CLER3 CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
t.A NOTIC E OFCOMMENCFMENT
Slate of Ra A 1+ Tax Folio Vc. 111
1.0Z-col,
County or
To Whom It May Concern:
The uMersigned hereby informs you that imptoverr nis will be made to certain real property,and in accordance with Section 713 o
the Florida Statates,the following inrormation is sta d In this NOTICE OF COMMENCEMENT,
Legal Cescription cfproperty being i roved:
Address ofprapertybeing improved:
1 t
General description of improvemerts: �.f
Owner rql. 0 IN J114t 4-'Address: 40�t Ar/ix►bA�8 7I tGK I• A'd 14/t_
Owners interes�isi.of the improvement:_Jr�i - Siete -
Fee Simple Titleholder 4iffoyther than a(�t`�ner):
Nama: all l itR qtl Contractor
= Z,
Address:
Telephone No.:_ 09-8 Fax No
Surety(i rany) —
Address: Amount of riond 5
Tdcphcne No: _,_., Fzx No'.
Name:atd a4cims of any person making loan to-I ie construction or the improvements
Name: —
AddrCSs: —---
PEa:z-No. __--- _ Fax No-
Name orperson with n th tztc DI-Flori4a,other t an himself,designated by owrer upon whom notices or other documents may be
served: Nanie'jVlJ-PA
Aadress:_�Ipo1 Jo _ d.�—SLA 32
TelephoncNo:- iz. ZZ F..NO: �Z.•�� _
le addition tc. hirr.self,owner dcsignales tte folli'ming person to receive a copy of d'.e l.icnor's Notice as provided in Section
,I3.06(2)(b).Florida Statucs. (Fill,in at Owner's o;
'on)
Nwne
Address: ------- —._---
Trcphone Ns: Fax No'.
Erpira6cn dal:of Notize of Commcnoemem(:he c 4pirdLion dat:is one yca V the date of recording,untess a dlfrcrent dare is
spenikd): Y,ttrtptant r� _
THIS SPACE FOR RECORDER'S} i }G � 'fR
More 1ZrCthe f�Ir�I?uval.�
Df Flpfida`.has sang: appeared
YubhC of Urge,State ofJ;,lur'Wt�,- wss v tT Ihrva{
'37).•..'. 41 :I ea:dniisviul�ex`iro ^ .1 r�
! --
`•.-4u_..:.i,,xrauciA Idcntiflcatitm: `
i
23
pC� C� C� OdC� j
BUILDING PERMIT APPLICATION AUG 12 2013
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 BY=4�� i
Office (904) 247-5826 Fax (904) 247-5845
,lob Address: ls•3 � N r r�- • Permit Number:
Legal Description3g'11S•Z, E_ j 1.0 arcel#
oor Area ot Ycql. 't. q t
Value ion of Work$ •.*ooProposed Work heated/cooled, 4 _ non-heated/cooled
(loll Wt-I-1,
Class of Work(circle one); New Addition Alteration Move Demolition pool/spa window/door
i
Use of existing/pro osed structures) circle one): crena Residential
If an existing structure,is a fire sprin r system installed? lrc c one); Yes No /A
Florida Product Approval #
For multiple products use proTil—et-approval form t
Desc 'bei detail the type of work to be performed:
Propertv owner Information:
Name: 1r V�l� Address:l&c 't
City Sta e /_ip Phone o
E-Mail or Fax (Optional)
Contractor Information:
Company mcl N A, _. Quali in gent: A0i
Address; City State zip I
O
b Site/Contact Number
Office Phone Fax# �—
State Certification/Registration# O I
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address ► tQ-' �-�'
Bonding Company Name and Address ("
Mortgage Lender Name and AddressIk
Application is hereby made to obtain a permit to do the work and installations as indicated. I certljy that no work or installation has eammenecd prior to the i
issuance ofa permit and that all work will be erArmed to meet the standards of all laws regulating construction in thpisejurisdiction.. This permit becomes null
and void ix(6)months at any time cJ?cr
wok is commenced,ot I understand within sLr
separate months, or
be secured or
Electricalwork is pWorkaPlumbing Sgns;�aWc/1t�Pools ,maces,Bollem ficnterR
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 LENDS R AN ATTORNEY EY BEFO E ff'
RECORDING YOUR NOTICE O
I here b certify that I have reo d ex a n this plication and know the some to be true and correct, All provisions of laws and ordinances governing this
type oJywork will be complt th wh s ec herein or not, The granting of permit does not presu a to give authority to violate ar cancel the
provisions of any other al, t re.o a! egulating construction or the performance ojconstruction.
iNitE4 I Snature of C tract
Signature of Owner F �a
a
�� `� q
Print Name e >y Print Name .g.,.� ._.,._..._.._._.....W.-........_.._.........
.,
h� �•...�
4,?JY d o _-ofly A&4 JOEL E.O'NM
Befo e e
Before e 44 * MY COMMISSION t EE 34B'ta 20
'�
4 Day
this ay of � �• •�=this ,
ash.. tai t
Y •• � E151 •
«t're Bonded NuMo Warp Sc,,,
./ M10, k
Notary P is �/ ,}6.; i�•F6�•, �ti= otat'y u s
Revised 10.24.12
£/L d t252 L£L y06 << Sti85 14Z 'ida0 BuLp) lne 92:60 60-90-£ 02
PAUL S. LI, P.E. #18305
DESIGN & CONSULTING ENGINEER
9218 CYPRESS GREEN DRIVE, SUITE 10
JACKSONVILLE, FL 32256
Ph/Fax: (904) 737-6876/737-2385
q6�;-LArZAXITIC /,,�\/V - AFj4&Iff-C A� .' FL
d xC t 4elz = P�
un x
o ,
4 3 — 3 cJ= D► Z
t Ly
OXl
Joe
� u
THE 19ArA AAC-4o
t �
Cp lof
Til
a �j v
z
4,
Ali awl -SIA K q �
4 t a .tom!
41101. W
PAUL S. LI, P.E. #18305
I DESIGN & CONSULTING ENGINEER
9218 CYPRESS GREEN DRIVE, SUITE 10
JACKSONVILLE, FL 32256
Ph/Fax: (904) 737-6876/737-2385
T- Com_ I T
c('6 % .j(
-�
it
+ ' = b x = �?
3
o
- - LAW
-
2-
4')
4')
r.
jMelkA 11:
Ly^�
I Z!,
q ^ I
vj
TH V AtA AC4C4a
Oli
_ Zn - 2
r
t�
A Z
�- �,.,
a Z(l 4 T
r
s
2
_