246 MAGNOLIA ST - SIDING ,,Jf.
(1) CITY OF ATLANTIC BEACH
SS's
i , - 800 SEMINOLE ROAD
t ATLANTIC BEACH, FL 32233
J INSPECTION PHONE LINE 247-5814
SIDING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SIDE-1425
Job Type: SIDING PERMIT
Description: SIDING OVER SIDING FL 13192.2
Estimated Value: $10,000.00
Issue Date: 6/18/2015
Expiration Date: 12/15/2015
PROPERTY ADDRESS:
Address: 246 MAGNOLIA ST
RE Number: 170535-0000
PROPERTY OWNER:
Name: CHASE III, JACKSON E
Address: 246 MAGNOLIA ST
GENERAL CONTRACTOR INFORMATION:
Name: JUSTIN LARSEN CONSTRUCTION INC
Address: PO BOX 1942 LIC # BELOW 4 GERALD GOLLOBIT
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $100.00
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $15.00
STATE DBPR SURCHARGE $2.00
Total Payments: $119.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
s y sir City of Atlantic Beach
APPLICATION NUMBER
1 Building Department
►+� (To be assigned by the Building Department.)
j
800 Seminole Road
Atlantic Beach, Florida 32233-5445 15- S,oL• e- 1 ^ ^� c
Phone(904)247-5826 • Fax(904)247-5845 'T �-�7
71 r. E-mail: building-dept @coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 296 MAe.jo�.l ��
7q � , _De artment review required Yes No
uildin
Applicant: ` as—r ! N LARSs� �S Planning&Zoning
Tree Administrator
Project: S ` D l Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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.
❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed by:
Date: 6 1' 1 5
TREE ADMIN.
Second Review: ['Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
i CITY OF ATLANTIC BEACH 1��'JUN I 800 Seminole Road, Atlantic Beach, FL 32233 fl/
��Office (904) 247-5826 Fax (904) 247-5845
Job 1d -•V �� .J'
�.>.u�l ` i 1 1' Permit Number:
Legal Description 1 1- - t --1 S--Z •G
J 1 Se c. Parcel# 0 35--e-soco
Valuation of Work y /0 oor ea o q. 't. t
f Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures (circle one): Commercial dential ,,,�tX,7+
If an existing structure,is a fire sprinkler system installed? (Circle one): eSr es - o N/A 17
Florida Product Approval# fa - /311 , ��, '
For multiple products use product approval form
Describe in detail the type of work to be performed: S��; . J '0 v, 3;,.,k;,, , , „,--ter
,.
- o
Property Owner Information:
Name: /u vLt j ‘004 Sd0 Address:
City iii _. ._ ' ,�. _ State �,eZip phone gay 5y"S- �'n2 94
E-Mail or Fax# (Optional)
•
Contractor Information:
CONTRACTOR EMAIL ADDRESS:
f Company Name b.14.,� Lj. F*0--1 nrS
,r
Address: �{10� i�•l�n�r.��_ Si- � 1�'� 111/4,c_.Qualifying �.�a-(liCc'�J
Office Phone �f o �... er lam' O°�� so State -( Zip 3z_o�g”
K)� 43l( Job Site/Contact Number 91�- Zg�i Fax#
State Certification/Registration# CT ' — 12 s9 -3)
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 made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
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 null
and void tf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
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 hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and or 'nances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give author to iolate or cancel the
provisions of any other federal,state, or local law re:ulating construction or the performance of construction.
signature of Owner ' AA',1 4e/La
{,� Signature of Contractor �►
T a tint Name h . Q
�S5'h \---d fS-e.
Print Name ,1
3eforue Before me
his 13 Day of ,20 this �5 Day of ���Q
,2015
lotaly Public � �':. .....,,
`•.`•� `' SCHALEASE LARst�V Public L _ I"
a
l?' A 'P MY COMMISSION#FF022491
6, :•1 MY COMMISSION#FF022491 f .�� E
'•`1`..� :�•) ...'fF"tCeviseCTU ife. y30.2017
''Apii :r` EXPIRES May 30,2017 407 398.0153
,,,,,•,,,,, ,,•__ ( 1 FloridallotarvSarvicw c.m
DO NOT WRITE BELOW- OFFICE USE ONLY
Applicable Codes: 2010 FLORIDA BUILDING CODE
Review Result (circle one):
Approved Disapproved
Approved w/ Conditions
Review Initials/Date: ` k
Development Size
Habitable Space Non-Habitable
Impervious area .
Miscellaneous Information
Occupancy Group •
Type of Construction-s[' c
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
Flood Zone
Conditions/Comments:
IC�-L to M►+l�i-t'��'�'y � � �G..�Ups ►.t C
J �
;i ' 800 Seminole Road
Atlantic Beach,Florida 32233
Telephone(904)247-5800
FAX(904)247-5805
Construction Site Management Plan Compliance
A construction site management plan conforming to Atlantic Beach City Code Sec 6-18
has been approved as a part of this building permit. The Construction site management
plan was approved based upon the following information.
1. Parking plan—parking plan showing how site will be accessed and all onsite
and abutting street parking areas.
2.
3. Location of construction trailers, loading/unloading area and material storage
area.
4. Location of chemical toilet area.(chemical toilets must be kept out of City
right-of-way and not further than 15 feet from structure under construction)
5. Location of dumpster. Dumpster must be from an approved waste company
(in accordance with Chapter 16 City Code) as of 2009 the permitted
dumpsters are Advanced Disposal,Realco Recycling, and
Shappells. Dumpsters will have tarp covers or rigid covers on windy days.
Dumpsters must be removed prior to issuance of Certificate of Occupancy.
6. Traffic control plan, showing access with dimensions, area to be stabilized,
narrative on phasing of construction with adequate parking and delivery of
materials.
7. Site cleanliness. Contractor must have the entire construction site cleaned by
Friday of each week. This means removal of scrap lumber, concrete remnants
and other such construction debris including cans, metal,plastic and paper.
8. Erosion and Sediment Control. Contractor must maintain all elements of the
approved Erosion & Sediment Control Plan(silt fence, catch basin filters, etc.)
until sod or other stabilization has been placed and approved by Public Works.
9. Other activities, where special conditions are identified by the Building
Official.
Failure to comply with the Construction Site Management
Ordinance may result in a Stop Work Order being issued in
accordance with City Code Sec. 6-17 (3)
Revised 5/2009
NOTICE OF COMMENCEMENT
State of �(y,i i pA
County of .v A
To Whom It May Concern: Tan Folio No.
The undersigned hereby informs you that improvements will be made to certain real property,a
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEME NT.
Legal Description of property being improved: r y and in accordance with Section 713 of
- v-
Address of property being improved: L 6 41'4& •c r.41 :5
General descri tion of improvements: � "K /- Z Z
�L /; .
•
w "i
•
Owner: /%tea,.)-r - •
nc-o 1
Owner's interest in site of the improvement: Address:
/14 46 x•tii �✓•t• Sat
Fee Simple Titleholder(if other than owner):
Name: LZ.3,3
C ntractorF ..1 . —
• CO Ai"�� Address:_j__,`a ( , A
\---.. 1
•
Telephone No.: N �• - / v
Surety(if any) Fax No: L 32
1� 0
Address:
Telephone No: Amount of Bond$
Name and address of an Fax No:
yperson malting a loan for the construction of the improvements
Name:
Address:
Phone No:
Fax Name of person within the State of Florida, other than imselfdesigoinated by owner
served: Name: upon whom notices or other documents may be
Address:
•
. Telephone No:
In addition to himself, owner designates•the following Fax No:
713.06(2)(b),Florida Statues. (Fill in at Owner's option) person to receive a copy ,s Notice as provided in Section
Name:
py of the LSection
Address:
Telephone No:
'expiration date of Notice of Commencement(the expiration date is one 1
pecified): ( )year from the date of recording unless a different date is
MS SPACE FOR RECORDER'S USE ONLY OWNER
Doc#2015137785,OR BK 17202 Page 1065, Signed,
Number Pages: 1 `/�/'
Recorded 06/16/2015 at 03:42 PM, Before a this ) `day of > ` ' pate:
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Oefore i a,has pelsonall a in t)ne Cou
COUNT`! Personall Y pPeared L� �, o Duval,State
RECORDING$10.00 Y Known; . ,�A
Produced Identifi .tio
Notary Public: - or
I
My commission expires: ik, . I01 i�.'•••.-•""��•.
i LARSEN
MY •►r • #FF022491
'lam ': EXPIRES May 30.2017
..,E .. ,�:
1f M1•,
men 398-0153 FtoridallotarvSorvice.corn
r r•�,y;/., City of Atlantic Beach
APPLICATION NUMBER
�S Mfr..�\ Building Department
:- „3 (To be assigned by the Building Department.)
At')ri 800 Seminole Road
,� Atlantic Beach, Florida 32233-5445 15• Sto E„ 4 2S
Phone(904)247-5826 Fax(904)247-5845
''-r;i 91- E-mail: building-dept @coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 2.96 MAiU,iVoLt A i. _De•artment review required Yes No
:uildin•
Applicant: OSZ l►..I LAQgs,,., aok,ai Panning &Zoning
Tree Administrator
Project: S k Q t t 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: `Approved. ['Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING -�
Reviewed by: :. :34%---. Date: 6 I t 1 t
? TREE ADMIN.
Second Review: Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. El Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
R
■ a BUILDING PERMIT APPLICATION
iC C� CITY OF ATLANTIC BEACH \C‘ -- • • ' 800 Seminole Road, Atlantic Beach, FL 32233 1
JUN 1 Office (904)247-5826 Fax(904)247-5845 fl/
A J._ iJ
Job .? ;:,,.jh. i a ' $+ , Permit Number: ,
Legal Description 10- , /, - S-Z G • , 5e c Parcel# 0 5 3 5- -aOOO
oor A ea o q. t. t
Valuation of Work s /G,tX Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed g/proposed structure(s)(circle one ): Commercial idential '
If an existing structure,is a fire sprinkler system installed?(Circle one): es o N/A I/0!
Florida Product Approval# fL' - /51g.
For multiple products use product approval form aer fi Describe in detail the type of work to be performed: 0 i A i D v� 3). �; /
I c �^�s, /
v U / I
_ , tl
Property Owner Information: /
Name: fa wc.tJ onk P s vlv Address: p'�y4, /1/ta o[/ci I
City / State`LZip 59.2:3 3Phone , 9— �a 96
E-Mail or Fax#(Optional)
•
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name:J bs4u., 1,44-4c,-) L5)-rtiic4 �Tttic_Qualifying Agent: Sd-,/,1
Address: 1 b� )1,�,c.A.�_ S4- , City p 1.no f,.L„p„ip— State t -j Zip3ao P"
Office Phone /foci •z.-4)1( . Job Site/Contact Number qt s.- 28b7 Fax#
State Certification/Registration# (j3C - 1?59833
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 made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced prior to the
issuance?fa permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a_period of six(6)months at any time after
work is commenced I understand that separate permits must be secured for ElectricalWork,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
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 hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and or,• antes governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give author' • to iolate or cancel the
provisions of any other federal,state, or local law re: lating construction or the performance of construction. ,
—A
Signature of Owner ���� ,A.A,a Signature of Contractor PIrli,
Print Name t a O.L(p C c>
Print Name c-+.^ \--0454(1
Beforpse "' Before me
this I J Day of 20 this (5 Day of -cc.v.:4\e ,20 15
1. ,o. ._ • , i. • •' , SCHAL ASE 1 ARSEN
Notary Public
"O�" _
1•
,.,..\'"A"`°, , SCHALEASE LAR 1I Y PU 1C MY COMMISSION#FF022491
MY COMMISSION#FF022491
"%:!1;. ... .�°°e EEp�pp qq��
� ' ' o `AOF A evlSef f lil . y 30.2017
''�'ii'ao!;•` EXPIRES May 30,2017 (4071 398-0153 FloridallotaryService.com
(407)398.0153 FloridallotaryService.com
800 Seminole Road
\,_;J Atlantic Beach,Florida 32233
� '''' _ 5-) Telephone(904)247-5800
FAX(904)247-5805
'�032191
Construction Site Management Plan Compliance
A construction site management plan conforming to Atlantic Beach City Code Sec 6-18
has been approved as a part of this building permit. The Construction site management
plan was approved based upon the following information.
1. Parking plan—parking plan showing how site will be accessed and all onsite
and abutting street parking areas.
2.
3. Location of construction trailers, loading/unloading area and material storage
area.
4. Location of chemical toilet area.(chemical toilets must be kept out of City
right-of-way and not further than 15 feet from structure under construction)
5. Location of dumpster. Dumpster must be from an approved waste company
(in accordance with Chapter 16 City Code) as of 2009 the permitted
dumpsters are Advanced Disposal,Realco Recycling, and
Shappells. Dumpsters will have tarp covers or rigid covers on windy days.
Dumpsters must be removed prior to issuance of Certificate of Occupancy.
6. Traffic control plan, showing access with dimensions, area to be stabilized,
narrative on phasing of construction with adequate parking and delivery of
materials.
7. Site cleanliness. Contractor must have the entire construction site cleaned by
Friday of each week. This means removal of scrap lumber, concrete remnants
and other such construction debris including cans, metal,plastic and paper.
8. Erosion and Sediment Control. Contractor must maintain all elements of the
approved Erosion & Sediment Control Plan(silt fence,catch basin filters, etc.)
until sod or other stabilization has been placed and approved by Public Works.
9. Other activities,where special conditions are identified by the Building
Official.
Failure to comply with the Construction Site Management
Ordinance may result in a Stop Work Order being issued in
accordance with City Code Sec. 6-17 (3)
Revised 5/2009
NOTICE OF COMMENCEMENT
State of F(o�i p4 County ofT
To Whom It May Concern: U Tax Folio No.
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description ofproperty being improved: with Section 713 of
► -- . - 3- MENCEMENT.
c
Address ofproperty being improved:
,u✓f6, • IA S i. 4-,4401...1-x- B •
General descri.tion of improvements: . Z 2_33
• _
Owner: j •
ICY ) �;�Sti
Owner's interest in site of the improvement: Address: /1446.,...)
Fee Simple Titleholder(if other than owner):• 3 22 33
Name:
C tractor: .., � 1 o. -
WW VV Address:
Telephone No.: �" -
Surety(if any) Fax No: `
Address:
Telephone No: Amount of Bond$
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No:
Name of person within the State of Florida, other than himselfFdesignated by owner u
served: Name: _ than upon whom notices or other documents may be
Address:
. Telephone No:
In addition to himself, owner designates the following person a to receive a cop of th
713.06(2)(b),Florida Statues. (Fill in at Owner's option) y e Lienor's Notice as provided in Section
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
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Doc#2015137785.OR BK 17202 Page 1065. Signed: "'�' '
Number Pages:1 Before i e this ALA'dil
1, day of ! Date:
Recorded 06!1612015 at 03:42 PM, in the Cou
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Of Florida,has personallyeared • ,� o uval,State
COUNTY
Personally Known: •' - -�• • •.�_
RECORDING$10.00 Produced Identifi .do • or
Notary Public: _ ti My commission expires: fir,, —L ' S...'.'.
PI +•` .. ..f.i- LARSEN
1•` 4 •1 MY •i r ON#FF022491
"�o„vo?" EXPIRES May 30.2017
(4171 398-0153 FlondallotarvService.corn