257 JASMINE ST - SIDING 'f- r''
.
� 1, CITY OF ATLANTIC BEACH
-, ,; r.�. l 800 SEMINOLE ROAD
''r« '' '1 ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
:�r)S31c)r
SIDING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SIDE-2005
Job Type: SIDING PERMIT
Description: STOP WORK ON JOB SIDING
Estimated Value: $3.137.00
Issue Date: 8/26/2015
Expiration Date: 2/22/2016
PROPERTY ADDRESS:
Address: 257 JASMINE ST
RE Number: 170861-0400
PROPERTY OWNER:
Name: WHELPLEY, ROY E
Address: 4765 HODGES BLVD SUITE 20
GENERAL CONTRACTOR INFORMATION:
Name: BETTER HOME IMPROVEMENT
Address: 538 PARK AVE KEVIN SEAN HURLEY
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $65.68
BUILDING PERMIT FEE $131.59
STATE DCA SURCHARGE $4.00
STATE DBPR SURCHARGE $4.00
Total Payments: $205.27
LITDONLYINCOANcETuoFATLTIcB0s0RmA
UILDING CODES.
(PVIt. 1 City of Atlantic Beach 0`) APPLICATION NUMBER
!��S rkk Building Department 1 " (To be assigned by he Building Department.)
J JcI�s 800 Seminole Road ����/ >Atlantic Beach, Florida 32233-5445 v
Phone(904)247-5826 • Fax(904)247-5845
—01119• E-mail: building-dept @coab.us Date routed: 25.'
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: st; 5' / D_enartment review required Yes No
Buil
App licant: ee g.r /n£ /fly fc VA 11)0712 nning &Zoning
Tree Administrator
Project: I --D n
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: proved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Pri r Date: k'01 S/S
TREE ADMIN. Second Review: Approved as revised. ❑Dented.
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
CITY OF ATLANTIC BEACH 6
OFFICE COPY 800 Seminole Road, Atlantic Beach, FL 32233 V"
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 5i 7 iasievimic U Permit umber: 1�"'S / Y�[ -at�v�a ,tti4 , - C ,
Legal Description I S- LI .3 �- a 5 -- �- 6 at 97 Parcel# 17D gal- O/OO
I Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$3 I .3`?r 0.4) Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition lteratio Repair M e Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial esidentia
If an existing structure,is a fire sprinklers stem installed? (Circle one): es o
Florida Product Approval # FL 17' j5
For multiple products use product approval form `�%
Descr�ib- in detail the type of work t 1be performed: k/t. _
W A ,, _/, ,,r,d1 -3,
Property Owner Information:
Name y 1 pY Address: 2 5 7 J n� 54-Jff k/k
.ac
City , ( c act
StateKZip 34-33 Phone B'l 7 ..?// 40.
E-Mail or Fax#(Optional)
Contractor Information:
Ve)�� y„ 4w/jc
Company Name: - Ne r 7� 4.c —i e"tp" 4.fm-� Qualifying Age t:
Address: J 7 Jo<m t}- City Allcccz--H‘c_6evelft State Zip 3 .. ..25...3
Office Phone ' - r Job Site/Contact Number Fax# '90-/-273 _ /(
State Certification/Registration# (_G 6-1 At)
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. 1 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
work is commenced.o nmenced.ot I undo stand that separate permits or mu t be secured for Electrical Work, Plumbing,or lumb ng,Signs,aWells, Po ls, urnaces,months Boile any
s, 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.
1 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 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 authority to violate,ancel the
provisions of any other federal,state, o local q,,w)eulating co nstruction or the performance of construction. /7 ��
Signature of Owne''►i1•alL V — — Signature of Contracto
Print Name <e.v44 Print Name G\./ t Lp .... cir
Swo/• t• and subscribe• before •e Sworn o ,nd subscr)•ed before me
this//t Day of /__ 20 this A ■ Day of A, ,■ I
A' aIL , ' /, i ' a AI . - % ` II 1 a ! iiiiiM
-,. •:ary Pu• i •
rotary Public •
• �•; '" 'A: M' COMMISSION#EE829175 :•: �*c MY COMMISSION#EE829175
,-r' EXPIRES September 10,2016 �-r•', EXPIRES SoYtif11e 1210
(407)393.0163 FlondeNOta ?Se Mce.� (407)3964153 alloWY� .com
NOTICE OF COMMENCEMENT OFFICE COPY
(PREPARE IN DUPLICATE)
Permit No. /5- S /Dt -c?oes- Tax Folio No.
• State of FL. County of no& 1
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. ` ca
9c description of propert being improved: 3L J "" °. (� , q Li
Address of property being improved: .5
.,¢-ti 4wy cZj-e occ►,- 3 a 233
General description of improvements: 5 j U /t.4j--
Owner ' t C a
Address I "f;] LL/ s t _'_,Lw 2 ,
Owner's interest in site of the Improvement
Fee Simple Titleholder(if other than owner)
Name
Address .
,, {� Contractor My , �� !Vii/
�51 Address � �r 1► 5 i /� G"�
Phone No. Fax No.
,,�//""" Surety(if any)
Address Amount of bond
Phone No. � Fax No.
Name and address of any p- •.• or 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 w •m notices or other
documents may be served:
Name
Address
Phone No. Fax No
In addition to himself,owner designates the following perso' to receive a copy of the Lienor's Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's o• 'on).
Name
Address
Phone 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
Sign,.: �1 ._ �/� DATE
Befor Is da of In the
County qtrlOuva yI,Ste orid he{personally-ppeared
Doc#2015195776,OR BK 17280 Page 1698, himself/ erselelf/and affi s that a staate ents and declarations herein r herein by
Number Pages:1 are tru' •nda urate
Recorded 08/25/2015 at 12:28 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL , f
COUNTY
RECORDING$10.00 III AIIIIIIM,*IT-T; v fw":1
Notary- b is at S.,t= Qt��y 9
My commission ex) :_ 1{il'Y'COM14ribSIVN
Personally Knowi • «�: _ or
Produced Identifi:at'r t
(4011189-01511 FtoridallotaryServica.00m