900 PLAZA #116 - INTEROR REMODEL rir,J\1f
''c s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
COMMERICAL ALTERATION/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-CAAR-2164
Job Type: COMMERCIAL ALTERATION
Description: UNIT# 116 - INTERIOR REMODEL - NEW CABINETS, TILE,
PAINT, MOVE W/D HOOK UPS
Estimated Value: $7,500.00
Issue Date: 9/28/2015
Expiration Date: 3/26/2016
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 CONTRACTOR INFORMATION:
Name: MASTER BUILDING CONTRACTORS. LLC
Address: P.O.BOX 11565
JACKSONVILLE, FL 32239
Phone: 904-463-3895
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $43.75
BUILDING PERMIT FEE $87.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $135.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
1
AI.I ER RECORDING–RETURN TO: C
PERMIT NUMBER:/S
—C/!nn- (0/99)01601 a/6/, a/6,-/a/63, ..,2/6°
/6
NOTICE OF COMMENCEMENT
The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,
Florida Statutes,the following information is provided in this Notice of Commencement. I J
I
I. DESCRIPTION OF PROPERTY(Legal description of the property&street address,if available)TAX FOLIO NO.: l 1 1 / 1)-(-> —D J K
D Z)
SUBDIVISION BLOCK TRACT LOT BLDG UNIT
Selk D a S ( opt) r a* Ofri v, W'b't ,, cob, 6 y, 17f 'w 1- 1/ 0
2.GENERAL DESCRIPTION OF IMPROVEMENT: I n to 0 r red tit.2 I Li t-vkfi rrn
3. OWNER INFORMATION OR LESSEE.INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
a.Name and address: 6 -i'��`n]Oa,1�L% Jt,r) 1 /1A1/0nt \LC(.-11))7 J
b.Interest in property: f'p/►V th l�l T U`I O LV V Y/ lam)� ,
c.Name and address of fcc simple titleholder(if different from Owner listed/above): /���J / .
4. a.CONTRACTOR'S NAME: t•'l'i Bi,U I.611 ri {�Cel o t�li L�v /y ,J�
Contractor's address::1 V �1 Jac]6 V 1 r'dl, ,,/ b.Phone number: q o`l-`-f /dg c
5. SURETY(if applicable,a copy of the payment bond is attached): " d•4 ✓2.X v
a.Name and address:
b.Phone number: c.Amount of bond:S
N t I
6.a.LENDER'S NAME: ►V 1 A
Lender's address: 111 b.Phone number:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(l)(a)7.,Florida Statutes: {/ {J 1r�n
a.Name and address: (JP Vi//l''��D I Dam e/I�,,�,fei I V�.+ ,
b.Phone numbers of designated persons q 0 vl 4 1 ' "J .- y
8.a.In addition to himself or herself,Owner designates of -I 0 II-. -41' -,21-/
to receive a copy of the Lienor's Notice as provided in Section 713.139(1))(b),Florida Statutes. r� �(��'�/�
b.Phone number of person or entity designated by Owner: 'F 1 1 Y l tR, eA (11-t/1'ti�,'(.1A. �� G
9. Expiration da e of notice of commencement(the expiration date will be 1 year from the date of recording unless a different date is
specified): 20_
WARNINO TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I.SECTION 713.13.FLORIDA STATUTES.AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING.CONSULT
. WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT,
_ n9. CAO lA61 C7L1eV/ i 1tiJ (y 6101e'
(Signature of Owner or Lessee,or Owner's or Lessee's nut Name and Provide Signatgry's Title/Office)
Authorized Officer/Director/Partner/Manager)
State of
County of 1.11.
The foregoing instrument was acknowledged before me this .21 St- day o(f' �4�A ' ST ,20 }(S �,r
by !Y V t l l�l 1 UJeitiC ,as C o'C J 9{A,I I v �{j/''`v
9...a. C ) TIc o rs�> I L ov` L L e (type of authori .e.g..officer,trustee,attorney in fact)
for -� ill l_l
(name of party on behalf o whom instrument was executed)
Personally Known %./or Produced Identi c.U. ... Type of Identification Produced
fat at, Notary Public State of Florida ( . .vi I A i l""z
r° �, Efizabsth E Qttpe(? —``f '(J
• My COlntnission`EE172364
yF / Expires 02/22/2016 (Signature of N tary Public)
(Print,Type,or Stamp Commissioned Name of Notary Public)
1 Rev.10-15-12
64, ;si.=v.i)., City of Atlantic Beach
Building Department APPLICATION NUMBER
..1..., 800 Seminole Road (To be assigned by the Building Department.)
Dv - ,, Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 ���/�y I
" 011)9 E-mail: building-dept @coab.us Date routed: 9 / t. l / 1 5
City web-site: http://www.coab.us / LL4
APPLICATION REVIEW AND TRACKING FORM
Property Address P CJ PL437 R 4 - 1 ( Co Depa ent review required q Yes o
ilding
Applicant: MAST G;1< CALpttici Cop.:) .r lanrTfitig &�bning
Tree Administrator
Project: 1 (\) r C(Z.10 R ,f-Y\00ec,, 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: roved.
['Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: /V �j� Date: ?-/ 7-IS
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:
sed 07/27/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
(ANTI-4%f' 1' Office (904) 247-5826 Fax (904) 247-5845 13 -C R R R--Z1 CA
Job Address: 9 00 P I Pzini- 19 1" (?r+L i DCH ) J Yaw.? Permit Number:
Legal Description St l 5 /4 Pip 0.170 t Parcel # ) / / 70 5 - O 5 O 0
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 5 Proposed Work heated/cooled (&5-0 non-heated/cooled
Class of Work(circle one): New Addition Alteration R-.ai Move Demolition pool/spa window/door
.t 14/2 rrq c�7 5
Use of existing/proposed structure(s)(circle one): ommercial ' Residential
If an existing structure,is a fire sprinkler system insta es . irc e one): Yes Q.12.4..;
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: C11-6400-_,J t our'T 'L Tarr, T1Z€) PAt-vVY-
1M.0 U r; WO 1106K �5
Property Owner Information:
Name: 5 O1�15 i}CQ.u 1 J7 t c n/ J- k- Address: , L( S Th *y Pa 2 I ���
City }- 11'�N TrC 43C M State 11 Zip".?7 Phone °f D Z4- 9,`-i _ 5.3'3`-f
E-Mail or Fax#(Optional) 5 12)N M pr5rea l 3 U T1 9../A 6 c otvin fcrorLS . Cory/
Contractor Information:
Company Name: kl fl 5 TQ 6U;1 blyv L CbN T. Qualifying Agen : SEA 3(�MNSo'/U
Address: 3 r 0 i T f P ) City fij(L.�Pi NI C State P '6/
Office Phone '161 15444) Job Site/Contact Number 1f-N 63-79`) 5 Fax# t-}d 7-424- -(5 9 y. g
State Certification/Registration# 5 S a`f 3
Architect Name&Phone# N'/PR
Engineer's Name& Phone#
Fee Simple Title Holder Name and Address P M L A5 if/.f30✓&-
Bonding Company Name and Address 1"--)/
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. /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 f 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. /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.
/hereby certify that/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 or cancel the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name ( � Print Name )ON 50 n1
Swornss'o' and subscribed before rye Sworn jt and subsc ' f re
this Y Day of , o�Cvhh-ti ,20 /-j this di" Day of �T �Ul •20
Li A. INDER
Notary Public .my NOTARY PUBLIC atc State of Florida
• :4 . Elizabeth E Peters
y STATE OF FLORIDA My Commission EE 172364 Revised 01.26.10
• Coma*FF189043 o;ao Expires 02/22/2016
4. **II; Expires 1/12/2019