1809 Tierra Verde Drive BEAM (DOORWAY) 2015 CITY OF ATLANTIC 13EACH
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: 15-RAAR-26
Job Type: RESIDENTIAL ALTERATION
Description: beam/doorway
Estimated Value: $12,000.00
Issue Date: 1/14/2015
Expiration Date: 7/13/2015
PROPERTY ADDRESS:
Address: 1809 TIERRA VERDE DR
RE Number: 169542-5094
PROPERTY OWNER:
Name: LAURINAITIS, MARIUS
Address: 1809 TIERRA VERDE DR
GENERAL CONTRACTOR INFORMATION:
Name: CHISMARK HOMES & CONSTRUCTION
Address: 8370 WALDEN RD TIMOTHY JAMES CHISMARK
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $55.00
BUILDING PERMIT FEE $110.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $169.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
................
31 BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
4(""
PerinitNumber:/v X
gal Description :3 —Z5—zV -1e1(1(4_r16y"4 Parcel# &q S 412, 5-6 q 6/
ILloor Area of' _ Sq.Ft. _0
Valuation of Work Proposed Work heated/cooled_ non-heated/cooled 16
/Z 0099
Class of Work(circle one):/ New Addition (9� Repair Move Demolition pool/spa window/door
Use of e.�ijtingVpro osed.structure(s) circle one): Commercial
If an existing strucrure,is a fire spriWer system installed9(Circle one N/A
Florida Product Approval# ep 8:,g -2--
For multiple products use pro uct approval form
U1411 IqWeil
I Describe in detail the type of work to be performed:
C=
C.M3 Property Owner Information:
LJ6J Name/44,-/e,5- 7 Address-
C i ty 441,;A j-Ic/?�A A Sta F*�Z:::Z_ipR�? Phone
E-Mail or Fax#(Optional)
Contractor Information:
LL. nt:
J Company Name:CA 15-A Ile,*if 5 Z Co A 5-4 -7
Qualifying Age z
Address:2-? ?v WA I�j e/I je e4 -city_Z4 C&<�_4,t!�//, State Zip
Office Phonel'of -700 Job Site/Contact _2,? -S-ffz
NumbepqjeY,? Fax#
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby inade to obtain a pennit to do the work and installations as amficated. I cert��that no work or installation has conintencedprior to/he
thruance ofapertnil and that all work will bepe ortnedto ineet the standards-ofall laws regulalingconstruclion in thisjurisifiction. 7hispermil becomes nuil
rf
an void 11 wi'rk is not connnenced wilhinsix(6j months.or ifconsiniction or i,ork is suslvided or abandoned lbr a4
,-k"c nenced. /understand thalseparate permits mial be ,riod ofsix t6)nionihs at anv t e ter
i) ew B)i i*.v (,
Tanks and Air Conditioners,etc. secured.for Electrical Work,Plumbing,sijus, ells,pli is,l-k—c , ( le 'Ve er.,,
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.
Iherebv,c-erlifi,thailliaverea4lanie-ra ' ddis pplic-aiit)iiaiklkite)m,ilie.%-aitieiobeiriieaiklcorrec-i. Allprovi.vioti.%-of'la*-sairdtirditiaticc�vgr)v,eriiiiiglhi,%
/Y/W of work will be complied with whether.- let herein or not. 7he granting of a permit�oev not pr.isitine to g&e anthorftv to violate or cancel
Xylisi.ons qfaqv otherfiederal,state..or loca., dating construction or ihepe�fninyahce(?fc n. niction
-�4W
It"Signature of Owner Signature of Contract
Print Name P.....( Print Name
............... .................................................................................................................................. M Cl)z
X =7 R
Sworn to an�,�ubcrile me Swor subscribed efore me - W
I M 0 �F
th,
is
this_LQDavof 20 1-1 of 20 3
3
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Notary Public
-n
E'.-n
Revis Q0�16.10 3
0
ANGELA M JONES
MY COMMISSION#EEI 15744
EXPIRES July 26,2015
FloridsNotaryService.com
NOTICE OF COMMENCEMENT$
(PREPARE IN DUPLICATE)
, ,, FILE Copy ;
Permit No. Tax Folio No.
State of— PL 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: 3?-
0 2�6
Address of property being improved:
General description of improvements:
Owner -,4qr 11,4 e Al.
Address
10
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor
Address—P2;74-9 Ulal4AJ
Phone No. 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.
--------------
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Q;'-i City of Atlantic Beach
APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 2—
Phone(904) 247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
Cityweb-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: '1JJrfa_ Vgi'�00 ,6 _pApartment review required Yes,,'OoNo I
( Building D tell
Applicant: /*S-yV"7 I -PtaTM-1h—g &Zoning
Tree Administrator
Project: d'-77) .4 je A)A'- Public Works
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: MA-pproved. FIDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:-- Date:
TREE ADMIN.
Second Review: DApproved as revised. OlDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. FIDenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
00
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