175 15th St 2013 siding CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
U ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003225 Date 8/16/13
Property Address . . . . . . 175 1STH ST
Application type description SIDING PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 10000
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Application desc
siding
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Owner Contractor
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JOHNSON R MARK & TERESE M COWART & ASSOCIATES CONSTRUCTN
175 15TH STREET 912 BENTWOOD LN
ATLANTIC BEACH FL 32233 DAX@COWARTCONSTRUCTION.COM
PONTE VEDRA BEACH FL 32082
(904) 392-1998
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Permit . . . . . . SIDING PERMIT
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee SO . 00
Issue Date . . . . Valuation . . . . 10000
Expiration Date . . 2/12/14
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAl ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
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other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 100 . 00 100 . 00 . 00 . 00
Plan Check Total 50 . 00 50 . 00 . 00 . 00
other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 154 . 00 154 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. TaxFolioNo. 171869-0000
State of County of Duval
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: 10-11 16-2S-29E Mandalay Lot 3 Block 63
Address of property being improved: 175 15th Street, Atlantic Beach, FL 32233
General description of improvements: Window and sliding glass door replacement.
Mark ay. Johnson
Owner
Address 175 15th Street, Atlantic Beach, FL 32233
Owner's interest in site of the improvement Residence
Fee Simple Titleholder(if other than owner) N/A
Name
Address
Contractor Cowart & Assoc. Construction
89 S. Roscoe Blvd. Ponte Vedra, FL 32082
Address
PhoneNo. 904-392-1998 Fax No.
Surety(if any)
Address Amount of bond$
Phone 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 himself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax 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 Statutes.(Fill in at Owner's option).
Name
Address
Phone 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): OWNER
THIS SPACE FOR RECOIRDER'�USE ONLY DATE
Signed:
Before me this—A--da Of 10 in the
u of Du State of lorida,h personally peared.-
Doc#2013206520,OR BK 16486 Page 1349, �51= he.rein by
difirins that all statements an de ein
Number Pages: 1 imsell herself and SUSAN D.LUDLAM
Recorded 08.108/2013 at 03:33 PM, are true and accurate Notary Public-State of Florida
Ronnie Fussell CLERK CIRCUIT COURT DUVAL F My Comm.Expires Apr 2.2014
COUNTY I'r FIZZ Commission#DD 962036
RECORDING$10-00 1-" 1
notary Public at Large,State f
My commission exppires: or
Personally Known
Produced Identification
City of Atlantic Beach APPLICATION NUMBER
(To be assigned by the Building Department.)
Building Department
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Date routed:
E-mail: building-dept@coab.us
City web-site: http://Www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Dpliarlment review required Yes No
B idin
Property Address:
Applicant: Planning &Zoning
Tree
Administrator
Project: f Public Works
4 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:
APPLICATION STATUS
Reviewing Department First Review: RApproved. OlDenied.
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: -Date:
TREE ADMIN. Second Review: nApproved as revised. E]Denie
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIR SERVICES Third Review: [-]Approved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05/14109
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
2013
800 Seminole Road, Atlantic Beach, FL 32233 :1
FAUG 08 2013
Office (904) 247-5826 Fax (904) 247-5845 Z
/I -
By
Job Address: 175 15th Street �it_t�Lber�:
Legal Description 10-11 16-2S-29E Mandalqy Lot 3 Block 63 Parcel#
t,'Ioor Area ot Sq.Ft. Sq*t,'t
Valuation of Work 40;000- Proposed Work heated/cooled non-heated/cooled
,ol fee
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa
Use of existing/proposed structure(s) (circle one): Commercial i�;si den]t
s
If an existing structure,is a fire sprinkler Sys in installed? (Circle one): es No N/A
e _ � ill�1,0q
Florida Product Approval # SLJ�i C4 k,4 1Lf3d6 WTA)D,)W-S
For multiple products use product approval form ' S_TAJC1t6 �AVA FL-A-7-
Describe in detail the type of work to be performed: ?_rCT4" WPPt)0W F�, 1;2 Replace
existing cedar lap siding on east upper gable.
Property Owner Information:
Name: Mark Johson Address: 175 15'hStreet
City Atlantic Beach State FL Zip 32233 Phone 904-242-8081
E-Mail or Fax#(Optional) 61 3 E() 5 a 0 S.-A 1"�W YI e r r n r
L. UU1 I
Contractor Information:
Company Name: Cowart&Assoc. Construction Qualifying Agent: Dax Cowa State FL Zip 32082
Address: 89 S. Roscoe Blvd. City Ponte Vedra
Office Phone 904-392-1998 Job Site/Contact Number 904-392-1998 Fax none
State Certification/Registration# CGC 1506405 R - FORCODEeom
Architect Name&Phone# C4TV OF ATLIM77 C HEACH
Engineer's Name&Phone o__PERMITS Ful<ADDITIONAL
Fee Simple Title Holder Name and Address RPQUIREMEWS A"CONDI'IjONS.
Bonding Company Name and Address
Mortgage Lender Name and Address REVIEWED Hy� /_71 (1 41
—E)ff..E. Sr
I ul
commenced prior to the
4pplication is hereby made to obtain a permit to do the work and installations J�i 'i 11 7 � 11
issuanceo a permit and that all work will be performed to meet the standards of all laws regulatin��construction in this jurisdiction. This permit becomes nu
f
and void 1�ork is not commenced within six(6)months, or if construction or work is suspended or abandonedfor aWeriod of six(6)months at an time after
i gr�
work is commenced. I understand that separate permits must be securedfor Electrical Work, Plumbing,Signs, ells,Pools, Furnaces,Bo v, Heaters,
Tanks andAir ConaUtioners,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 here certify that I have read and examined this application and know the same to be true and correct. Allprovisions of laws and ordinances governing this
7Mrk will be coTplied with whether specified herein or not. The granting of a permit does not presume to thority to violate or cancel the
provi.si.ons of any otherfederal,state, or local law eglating construction or the peifi��mance of construction.
Signature of Owner Signature of Contractor
Print Name Print Name DAK—
.................................................. ......................... ...........................................
..................................................................
Sworn to and subs9pbed b ore me SX�Oypho and subscri d be re e
t=Day of Mouc 2017, t y of 7— . 20R
bSCr* d be' re e
Notary Public evised 0 1.26.10
SUSAN D.LUDLAM
SHIRLEY L G
L"j% I
Notary Public-state oi Florida L
Ay COMMISSION#D 57W
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Uary 1'2 1�eM
IRES:February 14,2014
my Comm.Expires Apr 2.2014 EXP tM P,
..... Bonded Thru NotM Public Undereers
commission#DD 962038
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