1652 BEACH AVE DECK CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-DECK-621
Job Type: DECK/PATIO
Description: DECK REPAIRS
Estimated Value: $15,000.00
Issue Date: 12/19/2014
Expiration Date: 6/17/2015
PROPERTY ADDRESS:
Address: 1652 BEACH AVE
RE Number: 169573-0000
PROPERTY OWNER:
Name: JOHNSON, GORDON J
Address: 1652 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: MATHIEU BUILDERS
Address: 1778 OCEAN GROVE DR QA DUSTIN MATHIEU BROWN
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $62.50
BU�LDING PERMIT FEE $125.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $191.50
PERP41T IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC 113EACH
- ILE P Y
800 Seminole Road, Atlantic Beach, FL 32233 LF F��i7
Office (904) 247-5826 Fax (904) 247-5845
Dr)F I
Job Address: Permit Nu
er:
Legal Description 4
Floor 4red of- S Parcel# i
Valuation of Work$ —Proposed Work q. t
non-heated/cooled
640 0 -
Class of Work(circle one): New Addition Alteration Move Demolition Pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial R idea"
pside
If an existing structure,is a fire spriler system installed? (Circle on Ve—s No N/A
Florida Product Approval #
For multiple products use product approval form
Describe n detail the type of work to be performed:
_A-m
Property Owner Info-rmition:
Name: Clwl JOk4l"I State fi A ddress: 1141)7_ Ave-
city A _Zip_M_13 Phone
E-Mai I or!�ax#(Optional M2_
I�144
Contractor Information:
Company Is ame:-. Im I ct) I 4t 6 IAL
�v �-hl[ '?rrA/A
Address: Qualifying Agent: DIVI, -
city State r
Office Pho e I ZiP.. -22-13 3
J1 -- 3j.t.i Job Site/Contact Number gj.113, 3L!6 I
1 q Fax
State Certif cation/Registration# &9C- 12-515-7 L
Architect Name&Phone#
Engineer's Name&Phone
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage L nder Name and Address
4pplication is �ereb atde to obtain a permit to do the work and installations as indicated I certify that no work or installation has commencedprior to the
f ym '
issuance o-a p and hat all work will be performed to me�t the standards ofall laws regulating construction in thisjurisdigtion. This permit becomes null
and void ifwoi k is not commenced within six(6)months, or y construction or work is suspended or abandonedfor a
work m6nced. I understand that separate permits must be secured _period oj six months at any time after
r Electrical'Work, Plumbing,Sijns, Wells,Pools, J urnaces,Boilers,Heajers,
is cnodmAir Con&doners,etc. t��
Tanks a fo
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 FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
f hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws and ordinances governing this
�vpe oj work wV1 be complied with whether specified herein or not. The granting of a permit does not presu e to give authority to violate or cancel the
)rovisions ofa),y otherifeaderCallte, or local law regulating construction or the pertbrmance ofconstruction. m
'ignature of wner Signature of Contractor- alt_�
)rint Name
hA
..................... V...............................
.. .... . ........... Print Name
................S
wo an sub tt"e Sworn
lis D ofs jo and subsciR*bed before me
20 4- this n Dayof_.....&khr '20
Iota u li KELLY LULLI A� F_ r
Notary Public,State of Florida Notary Public A U rK
Commission#FF 100524
My comm.expires May 17,201811[ MY COMMISSION#EES43706
i407v.im_nv;i C
pefrnl � ),I—Oeck- 62(
NOTICE OF COMMENCEMENT IR
State of—... Tax Folio No.
County of
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: 7-q 45
Address of property being improved:
Z-Z,
I �3
General,description of improvements: 1215-p—�-kf AAd I-
r iA�'j
Owner: -Pt11LVVj Address:
Owner'� interest in site of the improvement: SP-5-12(�,k r J'dgAg kA a-1,C4,-
Fee Simp le Titleholder(if other than owner): j
IName: >
:D
Contractlor:. MCL�
a
Address: �T'l j-1 0
<
'Telephone No.: 90 713 3 1�, Fax No: 8)
D
Surety(if any) W
Address:
C)
Amount of Bond$ (4
Telephone No: Fax No: 7 6
(\j
Name and address of any person making a loan for the construction of the improvements
:3>-n
a)LL
Name: -0 �-
-!4, -0 1)z
E D
0 '0W
Address: fn z rr 1?0 W
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:
Telephone 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 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
Signed:
Before me his d
KELLY LULU
5,M IR nty of Duval,State
.e i4s d I nty�iAt,
I Notary PublIc,State of Ndda Of Florida,has personally appeared
Commission#FF 100524 Notary Public at Large,State F ri a,C unty of Ll
My Comm-OXOSS May 17,2018 My commission expires: W IV
Personally Known:
Produced Identification: 2W 1 e or
City of Atlantic Beach APPLICATION NUMBER
Building Departlrnet-,i-'11- o be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
City web-site: http://www.�.i:)ab.us Date routed:
APPUCATION REVIEW AND TRACK�NG FORM
PropeNy Address: zk' Deparitment revieww required Yes No
Buildina
Applicant: Plannin�c., Zoning�
,_ I r 'o
1 r e e.AA,dw rit
Project Public VVo,ks
Public Utilities
Hre Servic�,as�
Review fee Dept Signature
EMAIL Ao.DDRESS
CONTRACTOR CONTAC-1-
APPLICATION STATUS
Raviewin� Departnhqerot First Review: [PA"pproved, IlDenie-1
mL s.
-n - _
(Circ e one.) Conaments:
C 'J
UII�D�11 ) -
PLANNING &ZONING
Reviewed by: Date: //4*1
TREE ADMIN.
Second Review: OAPproved as revised. DDenied,
PUBLIC WORKS Comments:
PUBLIC WTILITIES
PUBLIC SAFETY Reviewed by:
FIRE SERVICES
Third Revietcf:, []Approved as revised. UDeniec.
Conarrients:
Reviewed by:_
VISED 09252 U,