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310 AND 312 4TH ST - PERMIT MISC -; s<.,. City of Atlantic Beach RE Di -.. Building Department FIVE f APPLICATION NUMBER j 800 Seminole Road (To be assigned by the Building Department.) JUN 2 5 2015 i,,, '"` :) Atlantic Beach, Florida 32233-5445 IS e ` LI Phone(904) 247-5826 Fax(904)24 :.> 15 t ,. 6, �c�:.:=' E-mail: building-dept @coab.us j_0 2_L,_4___. _____ City web-site: http://www.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: 312. 4Ph Soy. _ a' • - it ent review required All WIMP — iini No A MINI pplicant: _� Project: —G _ Il i� Tree Adminis—--- �- iN T, itaime—Mto) UciA/Ay ■Nol _ U• r Or►�.v _- y Milli Fire Services Review fee $ Z r Dept Signature f(-► —. 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 — 'I Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. nDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING /� Reviewed by: Cam✓ `!�i r1 /tom TREE ADMIN. -— Date: Z� Second Review: ['Approved as revised. Deni I n ed. wet LIC WO'KS Comments: PUBLIC UTILITIES OUBLIC SAF_ Y Reviewed by: Date: FIRE SERVICES Third Review: (Approved as revised. nDenied. Comments: Reviewed by: Date: evised 07/27/10 _ City of Atlantic Beach T CF.IVED IiATlONNUMBEBuilding Department £300 Seminole Road (To be assigned by the Building Department.) JUN 252015 IS Atlantic Beach, Florida 32233-5445 . ��' Phone(904)247-5826 • Fax(904 247-5845 — E-mail: building-dept @coab.us �Y; City w L± Tiiiiili APPLICATION REVIEW AND TRACKING FORM Property Address: 3%2. 4 ST . . - . ent review required q d Yes No Applicant: 150 S -4" -snin• &Zonin. Project: G RACA. A ,O Tree Admmis rator to /. ue.wA ■Liesagazz• - e 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 6-at �`TJAcNi �o�'ors PLANNING &ZONING Az-Pc-4 Reviewed by: Date: , 2¢ 1-1-- TREE ADNIIN. Second Review: []Approved as revised. •'enied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: QApproved as revised. ['Denied. Comments: Reviewed by: Date: 2evised 07/27/10 .;_ _,,, City of Atlantic Beach ` '' Building Department APPLICATION NUMBER 1i`' 800 Seminole Road (To be assigned by the Building Department.) I Atlantic Beach, -5826 • Fax 32233-5445 . 5 e Phone(904)247-5826 • Fax(904)247 5845 `� E-mail: building-dept @coab.us jliON____, _____ City web-site: http://www.coab.us Date routed: APPLICATION REVIEW AND TRACKING Fs- RM Property Address: 3%2. 4 ----- sT______- ent review required Yes No aosc...0 ' "Applicant: - .min. &Zonin.G, w� i Tree Adminis rator Project: �- 'u. or't.•• TAT, RAVICOSto, uciAiAy ■einuatadm ii, Fire Services I 11111 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.Attorjj ill (Circle one.) Comments: Le BUILDING i PLANNING &ZONING // Reviewed by: l/ Date: 3'11'1/4 j TREE ADMIN. _ Second Review:AINpproved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: / . 1. Date: FIRE SERVICES Third Review: [Approved as revised. ❑Denied. — i Comments: 1 _ _ Reviewed by: Date: Revised 07/27/10 '•i= ;, City of Atlantic Beach -,,j4;'', i. 11 Building Department APPLICATION NUMBER -- 800 Seminole Road (To be assigned by the Building Department) ,%�~ 'i_• Atlantic Beach, Florida 32233-5445 'S R, Phone(904)247-5826 • Fax(904)247-5845 5,q —;i �� ,� E-mail: building-dept @coab.us __U_L2___4_. ______ City web-site: http://www.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: 312 _4 ' S BO -- -- ______ ent review required Applicant: �■;- --- ----- — — �. _Inin. &Zonin• OM Project: ., A ' Tree Admmis rator _- orb u. _- ?r1T. -Mt, u�.wA • - + - �NE -1+ _ e Fire Services == Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection Florida Dept. of Transportation of Permit Verified By Date St. Johns River Water Management District Army Corps of Engineers MEMDivision of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: roved. nDenied. Comments: BUILDIN PLANNING &ZONING TREE ADMIN. ___ Reviewed by: - 7,r S',IS--ate: Second Review: nApproved as revised. ❑Denie��/ PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: — Date: FIRE SERVICES Third Review: — --- nApproved as revised. ❑Denied. Comments: Reviewed by:_________________Date: Revised 07/27/10 CITY OF ATLANTIC BEACH os Building Department .,.-�+ ) 800 Seminole Road J ;r Atlantic Beach,Florida 32233 (904)247-5800 r4 J;310';' rr p PLAN REVIEW COMMENTS r Permit Application # iS- '/)pj _/S1i£/ Property Address: 361 9/4 S f , J /3 Applicant: BO co s Project: raze ac/c/,1,o4 min r�-1'riog R'emcee/ &, //4/a/ This permit application has been: 0• Approved Reviewed_and the-following items need attention: ') C1jpc)s-e co"nplda/cf /,?eMoo/ /ro✓n Y J f) i Code a o/0 T 4/kera//or? L e tie / Re - sc, es/ rl Co Qr Pia 31ruc . /n,oerJet - cav-'Y ci 7 i1lit S / n /'ma Thoth O/I Aeor-r oi,/am -Ai 'l 7' orc o Prod(' /7 , ', roil / e 'mS r0,1"\--"-' /JvIi fr 0-ei20r 7Y1 e-n 4? l Ov f' -r all . /A-2 `6,0;- ►pon-Pecks clap/o /03 for a J !o_ ?. ccpi e S V-ecIteutncd Jci/ c lir �NX SPr r rJ Please re-submit your application when these items have been completed. Reviewed By: /71k- Date: �' 13- j Pe-11-0)26 = � CITY OF ATLANTIC BEACH %} `i-; 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 (904)247-5800 Revision Request Sheet Date: 6/30/15 Received by: Resubmitted: Permit Number: Clearance Sheet Number: N/A. Original Plans Examiner: Project Name: Regante Residence Project Address: 312 4th Street(and 310 4th Street)Atlantic Beach,FL Contractor: Bosco Building Contractors,Inc. Contact Name: Todd Bosco • Contact Phone Number: 904-241-0320 Contact Fax Number: 904-241-0326 Revision/Plan Check/Permit Fee(s)Due:$ Description of Proposed Revision to Existine Permit: Pending Hold: Structural: — — O nr lIlf Plumbing: u Mechanical: Electrical: Misc.: Tree&Vegetation Affidavit(no trees removed) Additional Increase in Building Value:$ Additional Square Footage: Clearance Sheet/Site Plan Revised: Environmental Health Approval: By signing below,I Josh Rotta affirm that the above revision is inclusive of the proposed changes. 6/30/15 Signature Contractor/Agent(Contractor must sign if increase in valuation) Date Office Use Only Date: Approved: Rejected: Notified by: Plan Review Comments: Plans Examiner Date C1wad010D3A1Jb TREE & VEGET D B � � TI - . \jy- VEGETATION AFFIDAVIT , s,.), City of Atlantic Beach JUN 3 0 r/ Department of Community Development 6 yr Planning&Zoning Division By ;.:1,0;319% 800 Seminole Road Atlantic Beach, FL 32233 (P)904 247-5800 (F)904 247-5845 PERMIT# SECTION I-APPLICANT INFORMATION P Owner(s) [ Legal Authorized Agent* NAME OF APPLICANT Todd Bosco NAME OF COMPANY Bosco Building Contractors,Inc. ADDRESS OF COMPANY 2158 Mayport Rd-Atlantic Beach,FL 32233 PHONE (904)241-0320 CELL (904)233-0904 EMAIL Todd @BoscoCBC.com CONTRACTOR CERTIFICATION NUMBER CBC 1250212 ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION II-SITE INFORMATION STREET ADDRESS OF PROPERTY 312 4th Street,Atlantic Beach,FL 32233 address AB Building Department at(904)247-5826 to request an address. AC LEGAL DESCRIPTION 5-69 an 16 2S-29E has not been assigned Atlantic Beach LOT 5 BLOCK 5 SUBDIVISION Atlantic Beach REAL ESTATE NUMBER LOT OR PARCEL SIZE:ct the SQ FT RESIDENTIAL X COMMERCIAL to this property,conta OTHER(SPECIFY) Now I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation" of the Municipal Code of Ordinances for the City of Atlantic Beach, FL and/or I have participated in a pre-application meeting with the Administrator of those regulations. Subseque•4 'rm that no regulated trees and no regulated vegetation will be damaged, destroyed and/or removed from the above-de .'�: . . ,ja•• pr.perties in conjunction with this project. - • ATU "e . ' . 4 Qh.4--- SIGNATURE OF OWNER Signed and sworn before me on this 3,..)day of .)`,� , . ,by State of f` :avp 335 Co County of -04 v4L Identification verified: F SCSI.vI*u.r xruo✓.0 Oath sworn: 9, Yes P No WILLIAM L.POPE Notary Public,State of Florida 7, .��� My Comm.Expires Oct.19,20'15 Notary Signature Commission No.EE 128745 My Commission expires: RfV-TVA-v 10.11 �v 5_r W2A I-Ic' nctcIe . caNQ 4 I- _4 ZONING REVIEW COMMENTS s f City of Atlantic Beach 4 Building and Zoning Department 800 Seminole Road Atlantic Beach,Florida 32233-5445 Phone: (904) 270-1605 Fax: (904)247-5845 Email: dreeves @coab.us Date: 6/29/15 Permit: 15-RADD-1514 Applicant: Bosco Building Contractors Review: 1st Address: 2158 Mayport Rd,Atlantic Beach, FL 32233 Site Address: 312 4th St Phone: (904)241-0320 RE#: 169812-0000 Email: N/A Correction Comments 1. Setbacks: The survey does not show the distance between the eastern property line and the existing structure. Please clarify the distance from the new covered porch area and the eastern property line. 2. Tree Removal: Please submit a Tree Removal Permit Application if any trees are to be removed. If no trees are to be removed,then please fill out an Affidavit of No Tree Removal. Both forms are available on the city website under "Planning and Zoning" and at City Hall. Also please be aware that codes have recently changed. If you are unsure about how the new codes effect your project, please submit a Tree Removal Permit and staff can then determine if it is necessary. Derek W. Reeves Zoning Technician dreeves @coab.us nri r2 BUILDING PERMIT APPLICATION C 0 ii CITY OF ATLANTIC BEACH JUN 2 4 • 800 Seminole Road, Atlantic Beach, FL 32233 Office(904)247-5826 Fax (904) 247-5845 Job Address: 312 4th Street (and 310 4th Street) Permit Number: Legal Description 5-69 16-2S-29E Atlantic Beach Parcel# Lot 5 Block 5 Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ I Q L a%() 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 (Res entialJ If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval# F ,7H 0'1 .2 For multiple products use product approval form Describe in detail the type of work to be performed: Renovation and Garage Addition Property Owner Information: Name: Jill Regante Address: 310 4th Street City Atlantic Beach State FL Zip 32233 Phone E-Mail or Fax#(Optional) Contractor Information: Company Name: Bosco Building Contractors,Inc. Qualifying Agent: Todd A. Bosco Address: 2158 Mayport Rd City Atlantic Beach State FL Zip 32233 Office Phone 904-241-0320 Job Site/Contact Number 904-241-0320 Fax# 904-241-0326 State Certification/Registration# CBC 1250212 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 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 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 placation and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give aut ' to olate or cancel the provisions of any other federal,state,or local law regulating construction or the performance of construction. Signature of Owner .' _ r `4u.„&_ Signature of Contract. Print Name Jl +? Print Name Todd A. Bosco Sworn to and subscribed before me Sworn to and subscribed before me this i' T Day of ),,r4;::-: ,20i( this Day of S, ,20, /i/t4- ,� ei,{ Notary Public ` N otary ub'Iic WILLIAM L.POPE WILLIAM L.POPE Revised 01.26.10 Notary Public,State of Florida Notary Public,State of Florida My Comm.Expires Oct.19,2015 My Comm.Expires Oct.19,20,15 L. rr.nn7AC 0 IAN-fir, . ` � CITY OF ATLANTIC BEACH s) 800 SEMINOLE ROAD lir J �" ATLANTIC BEACH, FL INSPECTION PHONE LINE 247-5814 32233 RESIDENTIAL ADDITION MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-RADD-1514 Job Type: RESIDENTIAL ADDITION Description: GARAGE ADDITION, INTERIOR REMODEL AND NEW WALKWAY Estimated Value: $180,000.00 Issue Date: 7/16/2015 Expiration Date: '1/12/2016 PROPERTY ADDRESS: Address: 312 4TH ST RE Number: 169812-0000 PROPERTY OWNER: Name: HOLLOWAY ET AL, MARGARET M Address: 1200 OCEANFRONT GENERAL CONTRACTOR INFORMATION: Name: BOSCO BUILDING CONTRACTORS Address: 2158 MAYPORT RD QA TODD ALBERT BOSCO Phone: - - PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS: Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible. All concrete driveway aprons must be 5" thick, 4000 psi, with fibermesh from the edge of pavement to the property line. Reinforcing rods or mesh area not allowed in the right-of-way. Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. Silt fence must fully enclose work area. All silt must remain on-site during construction. Roll off Container Company must be on City approved list and container cannot be placed on plaitynRightvelfWay.cOpprovet klxaocad Disprasali lieeicctrf tlbI rwkj N5643 RP EAir Daftigir, FLoRn).A in .CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD 15 X ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Waste Pro.) Full right-of-way restoration, including sod, is required. Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10 feet in each direction from the center of the cut. Repair must be shown on the plans. FE ES: ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $360.00 UTIL REV RESIDENTIAL BLDG $50.00 BUILDING PERMIT FEE $720.00 STATE DCA SURCHARGE $10.80 STATE DBPR SURCHARGE $10.80 Total Payments: $1,251.60 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ORDERED BY C ■ � l1 • ,r `$�.k, le Y. ' ` Ly The Law Offices of Rod Schioth -- . �.s 21875 Third St `� Jacksonville Bch, FL 32250 r�t !- y� 904-372-9351 ,�-- 511 - .. beach®rod-law.com -- Awen ` ConeA ',,,.' SURVEY NUMBER: FL1409.1333 FIELD WORK DATE:9/16/2014 REVISION DATE(S):(REvo 9/17/2014) , nJ_'JnBLS 'I) N h/.1-31)( FL1409.1333 JO SaQ1S i.zaM v11 '—SVa •4)N)1_5 1413 BOUNDARY SURVEY H1..1 M k iS Cl C�..L. N c)11, 1 Q DUVAL COUNTY �� 9'7`d PV"7 O S3Qi S— SaM, Q.NH -L D * . O 4th STREET N— - -x—(40, !z/W) a .._..o CAIV - 5 89•37'15'E 99.79'(M) 5 89°45'6 X600.95'(M) N .. .GI. . Co d NI 100'(F') Ate • /2'1046 Cr- 1/2'HPC ..j isles I rA1arINC l -1_,F,---,,97-- En: . Olt oC TABLE: ■ 1 , et N NI L I 50 (� N 0/iii ` I , Q 5 89°52'07'W 49.87(M) L-2 50' (P) n 34.3' c N 89°53'05-W 50.14'(M) in U illb o ry� di 1.� ��_ 0.4' -`° N ta,,. 2.0 !�t (n•Oer' 2 5 • a �� Q o J biu—ai . 'cur p 2 5 r,1 8— "" tt_! —m ' I 310'31 .. o. 96- a "13.3 t` - I —O 0.4' �$ 017 _ K Z Z a2.erv � s I J N ,� .r,110 .r IV tpTl� _ __ K,c 3 .0T 4r'PCAP5 TO BC eceVICCD BY CITY■ ATCR Alto 5CWCP ': L . -tNCt OWrit...546r NOt Otrt.tiNtC K K ON Ulg' 140:9' 117.18 O- L-2 rt i E l'41P /Sle9 LOT 8 LOT 6 LOT a 8LK 5 BLK 5 5Lr. 5 I hereby•. 4, deist Moon M' Mt. • _ : ew4 IAe Ise Ina Fthe ' t 44 FS 40 30 20 10 0 20 40 , . nr r.yB.Hass '' N ! Sate al FloridaRo�,dSumoerdW w GRAPHIC SCALE \�l // LbnrNo.7703 I inch as 40 feet . - / . the of This Survey for Purposes other than Intended 163thart Written Vekiution.wW be at the Use's Sole Risk and Without Ua6YJty to the Surveyor. Nothing hereon slap be Combated to Glee ANY lights or Benefits to Anyone Other than those Certified. FLOOD INFORMATION: POINTS OF INTEREST BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING NONE VISIBLE MUNICIPALITY OR WWW.FEMA.GOV,THE PROPERTY APPEARS TO BE LOCATED IN ZONE X.THIS PROPERTY WAS FOUND IN THE CITY OF ATLANTIC BEACH,COMMUNITY NUMBER 120075,DATED 06/03/13. JOHN WOLFEL JAN SHIELDS REALTOR* REALTOR* CLIENT NUMBER:RS 14.2390 , DATE: 9/17/2014 oitt. ,� �� � r L BUYER:JILL M REGANTE&JANE A REGANTE 104.01.1111 904.153.1004 SELLER:MARGARET M HOLLOWAY,TRUSTEE JOISLIKIIRLIIKONCASTIET 3ASSNN111S411ATSONIEAIYCOI►.0 CERTIFIED TO:JILL M REGANTE&JANE A REGANTE;THE LAW OFFICES AcTA • OF ROD SCHLOTH,PA;OLD REPUBLIC NATIONAL TITLE _ INSURANCE COMPANY;JPMORGAN CHASE BANK,NA Land Surveyors, Inc. t>vna This Is page 1 of 2 and is not valid without all pages. P966-735.1916•E1366.744-7332 p LBO 7337 11940 Fairway Lakes Drive.Suite l•FL Myers.FL 33913 BUILDING PERMIT APPLICATION i E �S a ►� ^� �^ *^^ CITY OF ATLANTIC BEACH JUN 2 4 800 Seminole Road,Atlantic Beach, FL 32233 _ Office(904)247-5826 Fax (904)247-5845 Job Address: 312 4th Street(and 310 4th Street) Permit Number: /5 RA DO-it Sl y Legal Description 5-69 16-2S-29E Atlantic Beach Parcel# Lot 5 Block 5 pp Floor Area of Sq.Ft. Sq.Ft Valuation of Work$ O0/ Cod Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration I Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial If an existing structure,is a fire sprinkler system installed?(Circle one): es No N/A Florida Product Approval# I(a 0-/Q? „2,For multiple products use product approval form Describe in detail the type of work to be performed: Renovation and Garage Addition Property Owner Information:, Name: Jill Regante Address: 310 4th Street City Atlantic Beach State FL Zip 32233 Phone E-Mail or Fax#(Optional) Contractor Information: Company Name: Bosco Building Contractors,Inc. Qualifying Agent: Todd A.Bosco Address: 2158 Mayport Rd City Atlantic Beach State FL Zip 32233 Office Phone 904-241-0320 Job Site/Contact Number 904-241-0320 Fax# 904-241-0326 State Certification/Registration# CBC 1250212 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 work is commenced.o menced.ot I commenced within six understand that separate permits must be secured for Electrical Work,Plumbing,Signs,a Wells,Pools,zFurnaces,months at 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 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordin, ces governing this type visions of any othero federal,state,or local law regulating construction or pew rmance of constructionresume to give aut r' o oJate or cancel the P f y f Signature of Owner ! re.pia i _A _ Signature of Contrac Name 3-112, (Le'' t �.,. Print Name Todd A. Bosco Sworn to and subscribed before me Sworn to and subscribed before me this Y Day of a u.= •20l( this Day of .20,5- Notary Public ` 4 No Pubs' �� WILLIAM L.POPE WILLIAM L.POPE Revised 01.26.10 Notary Public,State of Florida Notary Public,State of Florida My Comm.Expires Oct.19,2095 My Comm.Expires Oct.19,2015 Commission No.EE 128745 Commission No.EE 128745 Doc 4 2015144778, OR BK 17211 Page 1477, Number Pages: 1, Recorded 06/24/2015 at 02:55 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 ��.FILICOPY...• •-," /5-ODD-iS� 1 Permit No. NOTICE OE COMMENCEMENT y Tax Folio No. Y i State of Florida,County of Duval • THE UNDERSIGNED hereby give notice that the' 1provement will be made to certain real property in accordance with Chapter 713,Florida Statutes,the following informati n is provided in this Notice of Commencement. I' 1. Description of property(legal description of property and address if available): I 2. 312 4th Street(and 310 4th Street)Atlantic Beach.FL 32233-5-69 16-2S-29E ATL BCH Lot 5 Blk 5 General Description of improvements: Renovation and Garage Addition 3. Owner Information: I a)Name and Address: Jill Rewrite 310 4th Street,Atlantic Beach,FL 32233 i b)Interest in property:General i c)Name and address of simple titleholder(if other than owner): + 1 4. Contractor Information: a)Name and Address:Bosco Building Contractors,Inc.2158 Mayport Rd,Atlantic Beach,FL 32233 b)Phone Number.(904)241-0320 I 5. Surety Information: a)Name and Address: b)Phone Number s c)Amount of Bond:$ 's I 6. Lender Information: d a)Name and Address: b)Phone Number. a 7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as provided by 713.13(1)(a)7,Florida Statutes: a)Name and Address: b)Phone Numbers of Designated Person: i8. In addition to himself/herself,Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. a)Name and Address: I b)Phone Number of person or entity designated by owner. j9. Expiration date of Notice of Commencement(the xpiration date may not be before the completion of construction ( and final payment to the contractor,but will be on (1)year from the date of recording unless a different date is specified: II 1 l WARNING TO OWNER: ANY PAYMENTS M E BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDER D IMPROPER PAYMENTS UNDER CHAPTER 713,PART I, SECTION 713.13, FLORIDA STATUTES, CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A N CE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIR INSPECTION.IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATT RNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. 1 a y` Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge and belief. .�L at a,2e 1 cknte- Signal of Owner or 's Authorized Officer/Director/Partner/Manager Signatory's Printed-Name&Title/Office 3 4 The foregoing instrument was acknowledged before me this zsf day of J..,u/5, ,20' , t by -- ILA- tLG&AMrE as for . t 6 (game of Person) (Type of Aut city,i.e.Officer/Attorney) (Name of Party Instrument was Executed for) I WILLIAM L POPE `A � '` g OTARY PUBL)C, A I Notary Public,State of Ronda ST T OF FLORIDA 1, *Comm Expires Oct 19,2045 print Name: w,i.A.i ti,. L &'QF. a Commission No.EE 128745 Personally Known Identication Type: {, (Affix Notary Seal Above) fi I Revised 3/15/12 f 1 I n 'b Q o :3 o 5, LLJI C > �' on 0 0 �, o a `< a�°., •o u O 1 c o L" 4.� '.n o ; t 0-; N -8 .° c U a. .° -0 -p, c v' ct rn CW . a, — AC1 o 4.) �; t--. 4 - Z ,.° C a . .b y O O •> c H u.w° :� 0 — ti U .r W 8 '— a H (- c N ct . a, r; O a I-en o O e+) ) o o ° o w c, a I M C ` O W ■� ° "a •v W wa> o pg oa V) U ^8 C C a 0I W x U ) O C4 > <ll B o 'ti ° 'at 0 '-' v •t3 .0 C L. p C O F"' . y) C1. in 04 ii) C� 'W$7 Q 2 0. C_ O d °, c I. 0 ;.r.. y Q ar .-. d O z U C L 'a .c Cw ° �`m° c ° O r' c 3 3 3 E > a a N ° ° 3 , QC a ed 0.0 .fl . :r '" 6b 1 + M .b O C F 'v V n ° -8 U a ° .0 -o b- u = . o � � a°O ' , 0 c a . N ow . O s-,� CL. 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