781 Camelia St 2015 screen room-window-roof CITY OF ATLANTIC BEACH
7 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
X INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-S814
JOB INFORMATION:
Job ID: 15-WIND-144
Job Type: WINDOW AND/OR DOOR
Description: REPLACE SLIDING DOOR
Estimated Value: $3,000-00
Issue Date: 2/12/2015
Expiration Date: 8/11/2015
PROPERTY ADDRESS:
Address: 781 CAMELIA ST
RE Number: 170937-0010
PROPERTY OWNER:
Name: SCHRADER, MATTHEW H
Address: 781 CAMELIA ST
GENERAL CONTRACTOR INFORMATION: INC
Name: WHYRICK BUILDERS NETH D WHYRICK
Address: 4242 LEXINGTON AVE QA KEN
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $32.50
BUILDING PERMIT FEE $65.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $101-50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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City of Atlantic Beach APPLICATION NUMBER
(To be assigned by the Building Department.)
Building Department
800 Semin le Road 115-WIND-14q
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Date routed:
E-mail: building-dept@coab.us
City web-site. hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
iew required Yes No
Property Address:-7(61 C&M CA 'Building� V
%n
Planning &Zoning
Applicant: tx-)c I ree Administrator
no door- Public Works
Project: Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or 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: [?/Approved. ElDenied.
(Circle one.) Comments:
PLANNING&ZONING Reviewed by: Date,.L-j i 5
TREEADMIN. Second Review: FlApproved as revised. ElDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 FILE COPY ' -.
Office (904) 247-5826 Fax (904) 247-584-, .7"Ui, ��14wllli
Job Address: 7S i m-elUo-, St. Permit Number: 5" 6(11 440
Legal Descriptionsez ft mia�fflG ftho PC*" r el# I 'X)9�!)P7- MIQ
Floor Area of ' Sq.Ft. ' Ig /1005- ,
Valuation of Wr, Proposed Work heated/cooled on!heated/cooled 0
Class of Work(circle one): New Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial entia�
If an existing structure,is a fire sDrinkler system installed? (Circle one N/A
Florida Product Approval#—
For multiple products use product ap_p`r5valToJrni--
Describe in detail the type of work to be n,�-formed:
Property Owner Information:
Name: MW�19 60 it -�tk(OAel-_ -Address: � Kl &Me,40,
City J�Zb(kj&Ak, J&1&UA StatdELZip �)�Phone 11Qq-E -S
1129 `7
E-Mail or Fax#(Optional) c!,nhra(Ae,,r(zc) zjno�e , ar 14 . okil
Contractor Information:
Company Name:WKvc�ck- F�xA TdCj6 Qualif c.,k
ying Agent: WK\4f I
Address: I State H_ C
A,-&�MvNaaon AAfe, -city 4, Zip
Office Phone Job Site/Contact Number ng Fax #
State Certification/Registration# OZ501 I !-;L
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
h b m d bana e i 0 d he work and insra"ati?ns as ind�,ca or installation has commencedprior to the
p a, �, ere a e t'f o' to_Z,'t stan a this jurisdiction. This permit becomes null
A Pic s y e 0 bm er d
' io ' 0 p r
Issuanc a p rmit and tha a w rk or-e s monZ atqX1i ea ter
k aW e r,,o d o�,s
0
n r
m t , or, c truct
a e 0 w.e t 0 w ill P(6
-d d, k is not co, en d_ h n on 0
e e t,par t p r it,_. t
e . !s sc.r f
or Ictnc '11, P0 s, 01
.or c c u r, e b ed E rs,
k n d f nde tand t a B
k 'wd C', .en,'I,
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 exa i ed th' ;plication and know the same to be true and correct. All provisions of laws and ordinances governing this
"'s _
type olll�work will be coMplied with wheth ec,71ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any otherfederal,state, lo I regulating construction or the performance of construction.
1.4 a\
Signature of Owner Signature of Contractor
Print Name f, Print Name
\\AoA_ k............................................................................................... .... .....................
'Swor4jo and subscribed before me Sworn to and subscribed before me
Day of "W�0(),.ry 20 this 1.�_Dayof )Ap-�_,Ao-t 20 t
J(I
Ao NZY�Public JEREMy C BONNER
Notary Pq
MY COMMISSON 0 E
a
EXPRES June 23,2016 Vf Florida
t407)31Q-"153 _ FW48N0hVJ69rV1C5A0T Commission#FF I,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NE)(T DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-146
Job Type: ROOF PERMIT
Description: ROOF REPLACEMENT. FL 1956.4
Estimated Value: $7,425.00
Issue Date: 2/12/2015
Expiration Date: 8/11/2015
PROPERTY ADDRESS:
Address: 781 CAMELIA ST
RE Number: 170937-0010
PROPERTY OWNER:
Name: SCHRADER, MATTHEW H
Address: 781 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: WHYRICK BUILDERS INC
Address: 4242 LEXINGTON AVE QA KENNETH D WHYRICK
Phone:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $87.13
Total Payments: $91.13
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 7S � OAlaQ0, St, Permit Number:
Legal Description �flr el 4 to
dG Lf
r7 L4 Floor Area ot Sq.Ft.
Valuation of Worlk Proposed Work heated/cooled eated/cooled
Class of Work(circle one): New Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial ��eentia�
If an existing structure,is a fire siDrinkler system installed? (Circle one . es N/A
Florida Product Approval#—
For multiple products use product approva orm
D,-Qrrihi-. in rit-ttsil thi-.i-vne. nf work to be performed:
0-,c f, V\,6& lzoclf
Property Owner Information:
N�me- mabbeo ,1�—� Address:
City A?H 0 4A�U� i�Sa U/1 Stat4�LziP Phone 6104 -?*Ci—
E-Mail or Fax# (Optional) 6&Pa:±U,-AA0 -h. e- . O-rrA LA . rAj I
Contractor Information:
Company Name: TdCJ6 Qualif Agent:
WKvr�cl--' ying n e�h W K f c.,k
Address: 4n4—k LPMYX n City7r/2 C State zip
OfficePhone Job Site/Contact Number Fax #
State Certification/Regi tion# E� I ,;L 5 1
Architect Name&Phone#
Engineer's Name&Phone#--fMVLA�6± ket4��
Fee Simple Title Holder Name and Address
Bonding Company Name and Address_
Mortgage Lender Name and Address
e
A I cat, Is hereb de bana e ,o do he work and instal ti?ns as i ndic or installation has commencedprior to thl,
all Ir this jurisdiction. This permit becomes nu
ork i s aWersiod of sixp,5)months at any time after
e y ma to 0 1 1 rmi orm t '�r r od
0 k p I b e ed to m�t thet,an
is P in r i d th 11 f �s n,rcl
p
c a p 't a, a a r
)mot , or, c
(6
is not c', t"c'0 w' ,ep
,d id if k d hin n
'c' f
0 ICmc
is c, "c I "ta, ' t it Ob red r E e Pools, urnaces,Boilers,Heaters,
w rk mm ed. de d tha eparate Per ," I
Tanks and Air Conifitioners,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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here d h' plication and know the same to he true and correct. Allprovisions of laws and ordinances governing this
,lb certify that I have read and examine t 11s. to
work will be co�nplied with wheth eci7ied herein or not. The granting of a permit does not presume to give authority violate or cancel the
late, lo I re lating const;
provisi.ons of any otherfederal,s=ruction or the performance of construction.
Signature of Owner A Signature of Contractor
Print Name -CIA
Print Name V - ......................
Sworillo and subscribe e ore me Sworn to and subscribed before me
A Lk Day of 20 this I Dayof 20 1
X0 Not�y?Ub--lic JEREMY C BONNER I)
Notary Public-s
MY COMMISSION E W: Wa e f Florida
13,2018
EXPRES June 23,2016
40 3 Rod& Am .116110 COMMission#FF 11 I)n-z-
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ADDITION
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SCRN-142
Job Type: SCREENED ENCLOSURE
Description: 20 x 10' screen enclosure
Estimated Value: $24,575.00
Issue Date: 2/11/2015
Expiration Date: 8/10/2015
PROPERTY ADDRESS:
Address: 781 CAMELIA ST
RE Number: 170937-0010
PROPERTY OWNER:
Name: SCHRADER, MATTHEW H
Address: 781 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: WHYRICK BUILDERS INC
Address: 4242 LEXINGTON AVE QA KENNETH D WHYRICK
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $86.44
BUILDING PERMIT FEE $172.88
STATE DCA SURCHARGE $2.59
STATE DBPR SURCHARGE $2.59
Total Payments: $264.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
B24erj
LKi in
LLS OUNG
January 27,2015
w.Ken Whyrick,CGC
4242 Lexington Avenue
Jacksonville,FL 32210
Re: Screen Room Addition 781 Camelia Street,Nassau County,FL (BEE Job No. 15-08)
Dear Building Inspector:
Please accept this letter as acceptance that a new 4x4 post maybe used at the beam to house
connection. Attach the post to existing wood framed wall with(1)1/2,"diameter galvanized lag
screw(counter sunk)at 24"on center vertically and set 1.511 into the existing wall studs. Use
Simpson LSTA,MSTA or equivalent flat strap at the top of the post.
Shouldoome additional information or have questions,please feel free to contact me at 904-
064 520.
21
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1P
in. cly, Ilk
60000
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1334 Walnut Street Jacksonville, Florida 32206 Phone:(904)356-8520 Fax:(904)356-8524 Fax
CA#26227 CGC#1 520142 CCC#1329871 www.bakerklein.com
NOTICE OF COMMENCEMENT
state of �9 ID F-COA 01 TaxFolioNo.
County of p�k\I
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMkNT. C,
Legal Description of property being improved:—LS--��:q 15S Lf: At(afxti
&01c�\ t5
Address of property being improved: '7
ts. loof
C)o
General description of improvements:
Address: Ck-
Owner: �—ke
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: Y,
Address:
Telephone No.. Fax No:
Surety(if any) Amount of Bond$
Address:
Telephone 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:
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:
Addres����
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 jDate:
Signed:
V
-a in the C unk of Duval,State
Before me this NA day of 0
LYNN HICHBORN ZEDIAK Z C- rs D-6 P--
My COMMISSION#EE204WO Of Florida,has personally appeared
Notary Public at Large,State of Florida,County of Duval.
EXpIREs June 23.2016
40 F.M.Nt�- My commission x i or
Personally Kno
Doc#2015027 226,OR SK 11-1056 Page 1,245 Iroduced Id
Number Page& 1
Recorded 02-104�201 Sat 0311 PM.
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
R F c,.r)P In i to r-, rul
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 d: 124
E-mail: building-dept@coab.us LDate rout�e
City web-site. http://www coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: rl 00 1 (:Djqqj� De.Da t review required Yes No
n
irtment review required
'I rtm
Plannin &Zoning
Applicant: cy,
Tree Administrator
,1 P, hli, Wor ,
SC"r Public Works
Projec; Publi-_ Utilities
A:
onwx�__,� Public Safety
swlo 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 iotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: EbA-p-proved. DDenied.
(Circle one.) Comments:
BUILDI G
PLANNING&ZONING Reviewed by: Date-.,) 3-1
TREEADMIN. Second Review: FlApproved as revised- [—]E)eJd
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 07/27110
APPLICATION NUMBER
A CAT
City of Atlantic Beach PPL',
(To be assigned by the Building Departmqnt�].)
Building Department
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904) 247-5826 Fax(904)247-5845 EDate routed�
E-mail� building-dept@coab.us
Cityweb-site. http�//wwwcoab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1-100 De artment review required Yes No
B
Plannin &Zoning
Applicant: W b�q n ck, Tree Administrator
s -C Public Works
cr rco
r_�q
Ci
Project: Public Utilities
�a—y-) o n 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 H tels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other
APPLICATION STATUS
eview: [-]Approved. Denied.
Reviewing Department First R ^Dened
(Circle one.) Comments: A��-44te)
BUILDING -to—N COyn ry-)uvtz
PLANNING &ZONING Reviewed by: Date. Jhz/`�
TREE ADMIN. Second Review: � Approved as revised. [-]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
Reviewed by Datei
PUBLIC SAFETY 700�--
FIRE SERVICES Third Review: [:]Approved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 07127/10
4
TREE & V EGETATION AFFIDAVI 71 L� L� U
City of Atlantic Beach
Department of Community Development
I,! Planning&Zoning Division LBy
- 80OSeminoleRoad Atlantic Beach,FL 32233 PERMIT#
(P)904 247-5800 (F)904 247-5845
SECTION I-APPLICANT INFORMATION F Owner(s) NLegal Authorized Agent*
NAME Or APPLICANT Aw�ffiw f5chroiff
NAME OF COMPANY IM01c'L rt) TY)c-, I I
ADDRESS OF COMPANY e X A 5ac-;4 D
PHONE CELL a
EMAIL �QkyfF&_b '(JAerj�-,(q
t�o/0��p --7--
CONTRACTOR CERWICATION NUMBER OA" _ I
_..'
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION 11-SITE INFORMATION
STREET ADDRESS OF PROPERTY fj 'I n-
-5826 to request on address.
if an address has not been assigned to this property,contact the AB Building Department at(904)247
LEGAL DESCRIPTION 'AJ
I -�-r I
LOT �5- BLOCK I qq SUBDIVISION
REAL ESTATE NUMBER �(A 5r7- LOT OR PARCEL SIZE: —SQ FT AC
RESIDENTIAL V1 COMMERCIAL OTHER(SPECIFY)
I affirm that I hove reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation*of the Municipal Code of
OrdinarKes for the City of Atlantic Beach,FL andlor I have participated in a pre-applicotion meeting with the Administrator of those
re ulati s. Subs t tl I offirm that no regulated trees and no regulated vegetation will be damaged,destroyed ondlor removed
t _�n '
reg th ove-, �or adjacent properties in conjunction with this project.
,to
ATURE F NER SIGNATURE OF OWNER
S130 W 5,worn before me on thio-�) day of by State of
1 4 1 ) Co
)k� r untyof
YeL F– No
FRO
't*q !
3,
00
0, Notari7ig-ria—ture
Nl�
P1 0
...... My Commission expires:
REV-7;'*�,t�i,'�te ok
WEST NINTH (9TH ) STREET ul
50' RIGHT-OF-WAY
FOUND 3/4- IRON
PIPE (NO CAP)
0—) 0
c� LOT 4
0 Lo
LOT 4
(N89-04'08"E 101.94' FIELD) FOUND 1/2- IRON
N89002'00"E 102-00' PIPE (LB 3295)
FOUND 1/2- IRON X— FOUND 1/2- IRON
PIPE (NO READ) 0.4' WOOD E E 1.2
0.3 PIPE (LB 3848)
CONCRETE xr, 0.2' SOUTHERLY
20.3' 0,
52.3' C:)q
Ed
Ld
> 6 0
d' LLJ 6 CONCRETE DRIVE 40 RETE U).
U) NCPAD
W c5 LOT 5
10 ONE STORY STUCCO k-6 I
< n 3: 12.0' :: Lo
0 RESIDENCE NO. 781 r/
20.X3' Li
rK C)lo
E ANCE WOOD 0 rK
0 Lr)
0 -m
N
'04
C-4 0
u V)
40.S
0 v- -
Z o X-t t3
0.3!
cq rioo FENCE
z
FOUND 1/2-
FOUND 1/2- IRON PIPE (LB 1048
PIPE (LB 1048) S89*02 00"E 102-00
(102.05' FIELD) LOT 6 .
-_j LOT 6 tKu
eA
IS A BOUNDARY SURVEY.
WILDING RESTRICTION LINES PER PLAT.
IINGS BASED ON SOUTHERLY LINE OF LOT 5 BEING
)O"W PER PLAT.
THIS SURVEY WAS MADE FOR THE BENEf
MATTHEW SCHRADER; STEWART TITLE
ROPERTY SHOWN HEREON LIES IN FLOOD GUARANTY COMPANY; BARTLETT & DEAL
"X" (AREA OUTSIDE 500 YEAR FLOOD N
AS DETERMINED FROM THE FLOOD All
i%NCE RATE MAP, COMMUNITY PANEL
R 120075 0001 D, REVISED APRIL 17,
FOR ATLANTIC BEACH, FLORIDA
7_)�TFM
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH JAN 2 0
FILE COPY ' 800 Seminole Road, Atlantic Beach, FL 32233
office (904) 247-5826 Fax (904) 247-5845 Bv
hie 5C R tv— 41;L_
Permit Number:
Job Address: 0,
Legal Descriptionse)"I'l
,%V1 oo:r ea o q- t.
12 d Work heated/cooled Zn"-heated/cooled—1900
Valuation of Work �415-1____Propose
Class of Work(circle one): New Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial
If an existing structure,is a fire siDrinkler system installed9 (Circle one��eesnt i a N/A
Florida Product Approval#_p d u cAt—ap—p—r o—va F row in
For multiple products use ro
Describe in detail the type of work to be performed:_�2�
�, k ............
Property owner Information:
Name: W —Address: �gt
City StatdaZiP 52aZbPhone 4
A,Ueq (Z
AM& , I I I -P c
E-Mail or Fax# (optional) M&J:MA620 Cn� ol c rs a C—oo S
Contractor Information: Y—i
P. Qualifying Agent: WK
Company Name:W Kq r�C�_/ -city State Z i
Address: Job Site/Contact Number ax#
office Phone
State Certification/Registration# o,
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Addres
Bonding Company Name and Address
Mortgage Lender Name and Address
dt to do the work and installations as indicated I certify that no work or installation has commencedprior to the
Application is hereby made to obtain a perry, f, d t t the standards of all laws regulating construction in this jurisdiction. This permit becomes null
issuance ojra permit and that all work will be per orme omee or work is sus W t any time after
peizded or abandonedfor a Period of six(6)months a
ommenced within six(6)months, or if construction Boilers,Heaters,
and void ff work is not c separate permits must be securedfor Electrical-Work,Plumbing,Signs, ells,Pools, Pirnaces
work is commenced I understand that
Tanks and Air conifitioners,e1c.
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.
cation and know the same to be true and correct. All provisions of laws and ordinances governing this
I here certify that I have read and examined thl's flZ Ithcerein or not. The granting of a permit does not presume to give authority to violate or cancel the
V ork will be complied with wheth ect egulating construction or the peiformance of construction.
� w'
p�ovisions of any otherfederal,state, 10 1 tor
Signature of Owner Signature of Contrac
Print Name I Print Name ...................................
\A..A. ............... ..................................
swo o and subscribed before me sworn to and subscribed before me 201S
rri I this I Dayof _)AP-�A(21
Day of (IV 20
JEREMY C BONNER
N 0 kt ?u _1C
1 69174 14M 1;ke ot ?U ic S Notary Public-sta f Florida
0
My COMMISSKM#E
Z- W4 W 13.2 018
6 June 23,2016
EXPRE"= '18181"'0 COMMISSIOr?#FF 112058
,Mw�
(407) W-0153 p4roNowyeerviow"