900 PLAZA #12 INTERIOR RENO CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALVOTHER
MUST CALL BY 4PM FOR NEXr DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-481
Job Type: RESI DENTAL ALTERATION
Description: INTERIOR RENO UNIT 12
Estimated Value; $11,000.00
Issue Date: 3/13/2015
Expiration Date: 9/9/2015
PROPERTY ADDRESS:
Address: 900 Plaza
RE Number: 171725-0500
PROPERTY OWNER:
Name: SEA OATS ACQUISITIONS, LLC
Address: 645 MAYPORT RD SUITE 5 645 MAYPORT ROAD SUITE 5
GENERAL CONTRACrOR INFORMATION:
Name: PLATINUM BUILDERS OF PALATKA
Address: 2987 S ATLANTIC AVE APT 2103 JAMES LEAKE
Phone: - -
PERMIT INFORMATI(ON:
FEES:
PLAN CHECK FEES $52.50
BUILDING PERMIT FEE $105.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $161.50
PERNInI IS APPROVED ONLY IN ACCORDANCE WrrH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach
Building Department
8DO Seminole Road
Atlantic Beach,Florida 32233-5445
Phone(904)247-SM - Fax(904)247-SM
ti, Email: building-dept@coabus
City web-site: hftp://�.�b.us
APPLICATION REVIEW AND TRACKING FORM
Property Ad 412- nt review required Ye No
Building
Applicant: . ......... Ling
Tree Administrator
Project: PublicWorks
Public Utilities
Public Safety
Fire Services
Im
Review fee Dept Signature
N Other Agency Review or permit Required Review or Receipt
of Permit Verified Date
Florida Dept.of Environmental Protection
Flonda Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tob,=
Other.
M
APPLICATION STATUS
Reviewing Department First Revim: Approved. ODenied.
(Circle one.) Comments:
rPLANNING &ZONING Reviewed by: rn D'�' Date: -3-7-t-201
TREEADMIN. Second Review: 0EIApproved as revised. DDenled.
ad.
P 13 0
UBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ElApproved as revised. DDenied.
Comments;
Reviewed by: Date,_
ftvlWd07n7110
BUILDING PERMIT APPLICATION
Crry OF ATLANTIC BEACH
UA 800 SeminDle Road,Atlantic Beach,FL 32233 FILE COPY
Office(904)247-5826 Fax(904)247-5945
ZZ3
P,j
Job Address: .1 OC) 21,qD AgAII-1, _V) off Number:
Legal Description Parcel#
Valuation of Work$ 00� ot
ed Work NNF"led_ �nqont-theated/eooded
Class of Work(circle one): New Addition Alteration Repur Move Demolition pool/spa window/door
Use of existing(pr=ed str%=de one): Commercial Residential
If an existing arm e,is a fire sp er system isstalled?(Circle one): Yes No N/A
Florida Product val#
For multiple prvomts use P—r-OUict-255—F-0-075—rm
Describe in detail the type of work to be performed:—37,—A-cZt�z
Property owner Information:
Name; Sea Oats Acquisitions, I,IC. Address:645 Mavoort Rd
City Atlantic Beach State_FlZIP—1ZZ2L---Phmm 904-853-6909
E-Mail or Par#(Opfional)
Contractor Information:
Company Name:Pla=- muBuildera;OfP tkahi
Z9105. k4fu, �C. nb��k Jim Lash
gent
to
�S
&St�V A
ity-D rate��zipj?�4(T
Office Phons q v4 41-7 tki 0'7 Job SitcV Contact too
State CertificationAtelpanaticale Ccr C ls� - Sl # V�140
AmhltectN=e&Phme# V
Engmeer`sNams&Phooe# V�
Fee Simple Title Holder Name and Address V\
Bonding Company Name and Addreas A
Mortgage LtralerName,and Address ml�
Application is hemby made to Obtain aP-ermi to do the work and i-falladow as indicated I e,*that
M`44�ofa Permit and LAW all woek wilt be perfwnted to met the standardr ofall low k
and mid ffwwk is not conase,wedwithin sie no wm. or innallation ha,cos,n,nmd=
wa
6)monda �vConst,=d.or w Is smgu ngcOne� ono,dolsialediction. 77nispertnirb
I - need or abandonedJar a&dod ofra
T:k=&1 ,g!a,4�,a.d that eeparate pei6 Most be se�djar E4919N =at any Up.&
erc O'k Pla-ung,sknsv d pools, I Bailer",
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMN(ENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR MPROVEM[ENTS
TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
'M NOTICE OF
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING W)
COMIENCEMENT.
lhem�cejify that lh�mad and examined this j- an nd bn,, b,so,M,to be ani,
Y on a Allpvvision, laws and
in ,
iYng to. dv,nor P""W"to
'"'Oh"ify d.
Flonda am tim
Ehzat�eflh E Petem
MY C—.�EE 1723M
Eve�02QM016
�cm,e
isMature Of Owner 7;s a
ogQ
riat Name
Name '�)jjm MW
re me SW and subsciibcd��me
thia'" Day of T/�?c-k
0 20/(�'
0
rlotaryebhkt&���� Revised0l.26.10
NOTICE: op COMBMNCEMENT
(PREPARE JN DUPLICATE)
Permit No.
Sure of FL TaXFOLINO, 171725-0500
County of -D—W—AL-------
TO Whom It May Concern
The undersigned h...by Inf.m.you that Improvements will be made to certain real property,and in
acOordance with Section 713 Of Me Florida Statures.in&lWhysifing Information 1.stated In MIS NOTICE OF
COMMENCEMENT.
Legal desOrplich Of Property being impmWPer Official Records Volume 5775 Page 713
�oress OfP10liputYbeing mr,mved. ULIV I
Unit Number 78 un rionaa32233 _
General I improvervents: Interior Remodel,New Kitchen and bath cabinets,New faucets
Refficid=mshower,
——————————
Ovm. Sea OatS Acquisitions, L�C Jefty D Klotz
0 Putuft Beach, Florida 322213�
Ovme,'.interest In-fte of the improvement
Fee Simple Titleholder(if Other than owner)
Name
Adu—�
Connector Platinum th'aden opalatka,Inc
Address 2987 S.Atlantic A".Daytime Beach
Phone No�901-Zu-11107
Pa.No. 7o+ 94016t
sui.".any,
Address
Phone No. Pat No. Ount of bond$
Name and address of any"unin m.kft loan(or Mae constructc,offt Improvements
Name
dreas
Phone No. Far.No.
Name of person within the State ofFlordar,other than himashf.dealgrated
documents may be Nad by Owner IPOO whom polices or Ma,
Name Jamas Siver
Adu,—v - - —,--u- u,,,�mianoC beach,Florida 322 3
Phone 140. 904-247 633,1 aKW Fa.No 904-853ZT26
In addition m himself,Owner designates Me following person to receive a copy Of Me Uarm a Notice as provided in
Section 713,M(2)M),Florida Shmares.(Fill st at Owm,,s Option)
Name Turn Broom
Adu,..� - ----l—o1vu,�Ulle L,t narlotte,NC 28216
Phone No 114i��9 Fau,No. 704-394-G462
Exprafforl date our Nolk,e a Copurpencernam(the exp,efiW
different core,is sp,,,,W). date Is One(1)year"I the date Of recording Were a
vwm MCGVMUEW3 USE ONLY OWNER
ser T.zAd jt�
Doc#2015054401 OR BK 17091 Page 1590,
Number Pages I -AW 4— &
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Recorded 03110/2015 at 11:26 AM am.*
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