300 5th st relocate 1/2 bath 2015 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-446
Job Type: RESIDENTIAL ALTERATION
Description: RELOCATE 1/2 BATH INTERIOR
Estimated Value: $20,000.00
Issue Date: 3/6/2015
Expiration Date: 9/2/2015
PROPERTY ADDRESS:
Address: 300 5TH ST
RE Number: 169827-0500
PROPERTY OWNER:
Name: JERNAGAN 111, LOUIS R & HOPE V,
Address: 300 5TH ST
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $150.00
STATE DCA SURCHARGE $2.25
PLAN CHECK FEES $75.00
STATE DBPR SURCHARGE $2.25
Total Payments: $229.50
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 MAR 2
800 Seminole Road, Atlantic Beach, FL 32233
* FILE CDP '�'
Office (904)247-5826 Fax (904) 247-5845 8V
Job Address: 300 Street, Atlantic Beach FL 32233 Permit Number:
Legal Description 5-69 16-2S-29E, ATLANTIC BEACH LOTS 1,3 BLK 6 Parcel 169827-0500
Floor Area of §q.Ft. Sq.Ft
Valuation of Work =-jkt�� ,Proposed Work heated/cooled non-heated/cooled
f ?V)0dV ,0i2
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of e�i�ting/proposed structure(s) circle one): Commercial Residential
If an existing structure,is a fire sprinMr system installed? (Circle one): Yes No N/A
Florida Product Approval#---
For multiple products use pro(Tu-ct approval form
-CXA K+41�
Describe in detail the type of work to be performed: relocation of 1/2bath and new wood flooring.
Property Owner Information:
Name: Wingate, Owen W
City Atlantic Beach State FL Zii) 32233 Phone 904-553-2002
-Mail or Fax#(Optional)—
Contractor Information:
Company Name:D&J Builders, Inc._Qualifying Agent: William D Dye
Address:7809 SR 21 City Keystone Heights—State FL zip 32656
Office Phone 904-545-6737 Job Site/Contact Number 904-248-0132 Fax#
State Certification/Registration# CRC006248
Architect Name&Phone#NA
Engineer's Name& Phone#NA
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced prior to I
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes n.
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor a period of sixP6)months at any time afi
work is commenced. I understand that separate permits must be securedfor Electricat Work, Plumbing,Signs, Wells, Pools, urnaces, Boilers, Heate.
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 certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing t)
work will be complied with whether specified herein or not. The granting of a permit does not pre4sumeto ive authority to violate or cancel I
type
provisions of any otherfederal,stat r local law regulating co ction or the performance of construction.
or
Signature of Owner Signature of Contract r
A
Print Name
Print Name 0N...... .................................................
......... ...........0 6 -
....................................
Sworn to and subscribed before me Swora to and subscribed before me
thlst.�D of ��e.b 201 this Day of tyv,rc k--% 20
---PATRICK
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Sta
's Feb 286 20 17
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Notar Notary Public- lawomiel lic
y Public M.
My Comm.Expires Feb 28,2 17 C.BERNARDI
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I'li OF F Commission#EE 879096 F"IRES:Aprd 07,2017
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F I L E C 0 P Y NOTICE OF COMMENCEMENT
State of Florida Tax Folio No.—169827-0500
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: 5-69 16-2S-29E, ATLANTIC BEACH, LOTS 1,3 BLK 6
Address of property being improved:300 5th Street,Atlantic Beach,FL 32233
General description of improvements:Relocating V2bath,replacing wood flooring
Owner:Wingate,Owen W Address:300 5h Street,Atlantic Beach,FL 32233
Owner's interest in site of the improvement: Primary Residence_
Fee Simple Titleholder(if other than owner): Doc#201504-7068,OR BK 17081 Page 962,
Number Pages: I
Name: Recorded 03102/2015 at 12:30 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
Contractor:D&J Builders,Inc. COUNTY
RECORDING$10.00
Address:7809 SR21 Keystone Heights,FL 326456
Telephone No.:904-545-6737 Fax No:
Surety(if any)
Address: Amount of Bond$
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:
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 RECORDE IS USE ONLY OWNER
Signed- Date:y
'!i4&41
Before is day o — — in the County of Duval,State
A dWd6offi Of Florida,has personally appeared LLT2�9 6�
- Public at Laq,,e,State of Florida,County of Duval.
FAMICK TAYLOFRt ommission expires:
OR
Notary Pubk-State of F1j0WrjW&&e nally Known: or
f
My Comm.Expires Feb'28,20 ced Identification:
1b
ji Comagst I Ion#EE 879MI
City of Atlantic Beach
APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 AR Lo
Phone(904)247-5826 - Fax(904)247-5845 :sl?=)
E-mail: building-dept@coab.us Date routed:
Cityweb-site: http://www.coab.us L
APPLICATION REVIEW AND TRACKING FORM
0300 st I'll f;t
Property Address: qD ment review required Yes,/_No
Buildin V
Applicant: D t-,O BLA PIP_anning &Zoning
Tree Administrator
Project: (-�c,�o co+c Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or eceipt 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�obacco
Other:
APPLICATION STATUS
Reviewing Department First Review: R��Approved. FIDenied.
(Circle one.) Comments:
00*
PLANNING&ZONING Reviewed by.-- Date:
TREE ADMIN.
Second Review: E]Approved as revised. ElDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. F�Denied.
Comments:
Reviewed by: Date:
Revised 07/27110