1675 Selva Marina Dr 2013 Demo CITY OF ATLANTIC BEACH ,
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003558 Date 10/24/13
Property Address . . . . . . 1675 SELVA MARINA DR
Application type description DEMOLITION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
DEMO SINGLE FAMILY HOUSE
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Owner Contractor
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GIBBON, THOMAS L BOSCO BUILDING CONTRACTORS
1675 SELVA MARINA DR 2158 MAYPORT RD.
ATLANTIC BEACH FL 322335615 ATLANTIC BEACH FL 32233
(904) 241-0320
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Permit . . . . . . DEMOLITION PERMIT
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/22/14
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Special Notes and Comments
Full erosion control measures must be installed and
approved prior to beginning any earth disturbing
activities . Contact Public Works (247-5834) for Erosion
and Sediment Control Inspection prior to start of
construction.
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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 . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 104 . 00 104 . 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
4� 11ding Departnerit.)
Building Department (ro be assigned by the Bui
800 Seminole Road
Atlantic Beach,Fbdda 3V3M445 S.
Phone(904)247-W26 -- Fox(904)247--r" Date routed:
E-mait buikring-dept@coab.us
City web-site: http:/ANww.coab.us
APPLICATION REVIEW AND T CKING FORM
Property Address: 1&7YSdVA -11)jarjAl Department review required Yes No
Building
Applicant zmsco Planning&Zoning
Tme Admiribb-afor
Project: bfiqnE��
Public Safety
Fire Services
Dept Signature
Review fee
Review or Receipt
7 Other Agency Review or Permit Required of Permit Ve~Ift Date
Florida Dept of EnvironmentEil Protection
F 0
n
Llorfda Dept of Transportattion
St.J
St.Johns River Water Management Disirict
A y Cc
rmy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other
APPLICATION STATUS
Reviewing Department First Review: *pproved. E]Denied.
(Circle one.) Comments:
BUILDING I
PLANNING&ZONING Revkwied Date:–/—O)�),?
TREE ADMIN. Second Review: []Approved as revised. E]Denfed.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by. Date:
FIRE SERVICES Third Review: ElApproved as revised. []Denied.
Comments:
Reviewed by. Date:
Revised MUM
BUILDING FERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1�75 .(�Wgd JI" VF- ��23':3 Permit Number:
Legal Description M1,2q O-Z-A15 c'�Pja 5Parcel 9
v loor Area ot *qk�tCU Sq.Ft
Valuation of Work $ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demoliti pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial esidenti
T.,
If an existing structure,is a fire sprinkler system installed? (Circle one N /A
Florida Product Approval #
For multiple products use product approvall form
Describe in detail the type of work to be performed: Ar�� le-fz�
Property Owner Information:
Name:I I jot>LeY-F0LReV-T- Lr�M&Al. /,,,J,-- Address: 4-5 60jaff
City 87-4-11W711 6122nt��- Staltel i-7j'[p Phone -TI 4�0
--4
E-Mai I or Fax#(Optional
. ..................
Contractor Information:
A /.-2 (1—le-A J�C .
Company Namej?69 C-- Qualifving Ap-ent:
Address: city L -State r-L Zip 31-7-33
Office Phone .710 ILf-UAZII-05,2DJ ob S ite/Contact Number 1,04/-,,?-q9-/*fi3O V Fax#
State Certification/Registration# 1!�fw
Architect Name&Phone#
Engineer's Name&Phone# A
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
A 'ca he eb ade b an a ermit to do the work and installations as indicated. I certify that no work or installation has commencedprior to the
11 be performed to meet the standards ofall laws regulating construction in thisjurisdiction. This permit becomes null
p
"9 is r Y ml h to 0 'rk-i
issp-nce o a ermit an i at a 1 0
, , p k d,_1h six(6)months, or if construction or work is suspended or abandonedfor aWeriod ofsix�6,)months at any time after
,d v id f'or is_01 commence ' in
work is co" c . I" r, , I t s s ters,
e ed de ta d ha eparate permits must be securedfor Electrical Work, Plutnbing,Signs, �rlls, Pools, urnaces, Boilei , Hea
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 herelb certify that I ha rea nd examined this application and know the same to be true and correct. All provisions oflaws and ordinances governing this
th ecij
o work will be co lie w I Ted herein or n1t. The granting of a permit does not presume to give authority to violate or cancel the
w
),rovisions efrany other era,st I , o o I Paw i ulating construction or the pe�fo�mance ofconstruction.
iignature of Owner Signature of ContractclL
.... ..........................
3rint Name Print Name
....... .................................................... ........................... ..........
;worn to and subscribe fore nie Swo t and scri b ore me
0
his a . 20 13 this A M-13
.1 IF --...,.IA PIMIENTA
qota i N6-Ta-ryWu6l -.F*,* 48 ,
Notary Public-State of Florida
........... ...........
f Notary Public-State of Florida
My Comm. Expires Jan 26,2015 MY==Jan 26,2015
Commission#EE 59080 Fisc EE 59080
NOTICE OP (A)ININIENCEMENT Doc#20132679-12,OR BK 16566 Page 1070,
Number Pages: 1
Recorded 102:1&2013 at 12:52 PM.
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
Permit N. o. COUNTY
'I,tx Folio 1�1`1_1 RECORDING$10,00
'I I If-, I'NI)FIRSIGNIA)hcrch,, gives notice that improverriclits
ill be made to certain real propcirty,and in a(cordance --ith Section
71 11 (if the I-lorida ls'tattltes� the folh-ini-, information is provided in this NO'1'1('E OF(,OMMVN('+Mi,1N'j.
1.Illescription of pi opertN (IrRal descrilition).- jLj
a)Street(joh)Addres,�
ta nq�uiyuqt t4�ra,4.,, ej,
2.General description of improvements:
3.0wner Information
a)Name and address q6 BEKC-H
b)Name and addre."offcc simple titleholder(if other than owner)
c) Interest in propertN
4.('ontractor Infinniation
a)Name and address
b)lelephone No.: -10L( Fax Nk(opt.)
5.Stiretv Information
a)Name and address:
h)Amount of Bond- ok)
6.1.en(fer 01elephone No.: Fax No.(Opt.)
a)Name and address:
7. Identify of person within the Statc of Florida dcs Phone No.
a)Name and address: iqated by W upon whom notices or other documcnt.�, ma� be served:
b)I'cicphone No.: - Fax No.(Opt.)
8.In addition tZT himself.own—Wr ng person to receike a copy (if the Lienor'-s NN-iilice as,provi iled in Sectio—n
713.13(i)(b),Florida StatUtCS:
a)Name and address:
b)'Velephone No.: Fax.No.(Opt.)
9.Expiratiori date of Notice
of )mmencement(the pirat' n is one year from the date of recording unless a different (isle
is swifled):
WARNING 1'0 OWNFR: ANY PAYMENI'S MAM.,BY 110'OM'NtR AF-111"R I'llit' EX111RA1*1ON OF1fHE NO1'10E OF
COMMENCEWNT A11F CONSIT)CRIE.11) IMPROPFR PAYMENTS VNII)ER CHAP`1-VR 713,PAR1-1.St',"'11ON 713.13.
FL,ORIDA STAIAII'FS,AND CAN RESILIL-1-IN VOILIR PAYING mict, FOR IMPROVEWNTS TO YOUR PROMR-11'.
A N01'WE OF COMMFNCFMFN1'M1 IS'U HE RFCOR1)V1) ANII) POS'I'VII)ON'V1IFjOH Si'll'ife, Hr
VORV,j,jIV pIkS,I,
INSPEC110N. 11'YOU MUFNWFO 0111'J'AIN FiNANCING,CON�SILJII�Vj 01111 XN f-. ( AN A1-VORNVV FIFFORE
"N(A'
("(WIVIIII, I NO[; WORN OR RE11"01141I)ING V011114 NO`11'11(1�of.'(' N(
SO NO 1,01, F I AM I DA
COUN I 1 01, 10.
Sigildlurk:0 -11I)11kX-(011Pkk1 Died lagel
Print N
I'lic foregoing instrimiciii,%kas acknowledged b0lorc me this das of
06�Le,4 ' 2013.1" L1Ajt_-�LEZ7-`
as (type of atilhorkii.c.p. office,.,11 uslcc,
Oki�j EW-
1-11c,i in (140) (or <
jl�W—A �--T-
3ittt Va (118"le of piOrty 01 bell 14) 1104-41114ent %as cxlll�
Personally Known V--,()R Pr(Kiticed ldcmiri"lion NotarY "ir"ittir
I'vpc of ldcntific�t(ioll Pri.xitict,-d Name(print) j
0"
Verificalion porsoatil to 1,(cijoll(2 Irlo(j(I;j !�fjI1)I(,
111HICI I)VIIHIliC!,(IFIKAJ01), I dtvlalk, I hh,kc wad Ilic
ihe f�iot, suttcd ill i( ,ij( Irk, I,Ili( t,(.kl f .N kilovludy,V and k-licV
MARIA PIMIENTA
10
Notary Public-State of Florida]
015
MY Comm. Expires Jan 26,2015
Commission#EE 59080