2025 SEMINOLE RD #101 - SIDING i,, rS r,J\f
' s, CITY OF ATLANTIC BEACH
r l 800 SEMINOLE ROAD
r ATLANTIC BEACH, FL 32233
/ INSPECTION PHONE LINE 247-5814
�
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2541
Job Type: RESIDENTIAL ALTERATION
Description: ALTERATION - REPLACE SIDING WITH NEW
Estimated Value: $3,600.00
Issue Date: 11/6/2015
Expiration Date: 5/4/2016
PROPERTY ADDRESS:
Address: 2025 SEMINOLE RD 101
RE Number: 169723-0202
PROPERTY OWNER:
Name: HALL, RANDALL
Address: 2025 SEMINOLE RD APT 101
GENERAL CONTRACTOR INFORMATION:
Name: LANG'S GENERAL CONTRACTING LLC
Address: 2201 SAWGRASS VILLAGE DR QA JOHN R. LANG
Phone: - -
PERMIT INFORMATION:
FEES: -- --- -
PLAN CHECK FEES $34.00
BUILDING PERMIT FEE $68.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $106.00
•
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
:s,u ;;, City of Atlantic Beach APPLICATION NUMBER
r Building Department
-('2 800 Seminole Road (To be assigned by the Building Dep/a 1rtml
` ent.)
� :i Atlantic Beach, Florida 32233-5445 ` R RR -Z5"�
Phone(904)247-5826 Fax(904)247-5845
o;t 9s• E-mail: building-dept @coab.us Date routed: 10/Z7/4..5'
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
• ICS (
Property Address:2O25 SEYV.I NoLE P.0 Department review required Yes No
Building
Applicant: Lf�NG CEA,GRAL ec, m �- Manning &Coning
Tree Administrator
Project: Public Works
Public Utilities
I iv C 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: roved. ❑Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING
Reviewed by: /71 (\ Date: //' '/
TREE ADMIN. Second Review:
❑Approved as revised. ❑D ed.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233 r'
� � - :� ( ) Fs--RR P\ FZ-2E4 I )
Office (904) 247-5826 Fax 904 247-5845
z
iezi
Job Address: ,ZO 5 ..�L-///i/LV1-,C ,ti,,0 /e / Permit NuidTbet
- L_,- Parcel# i 97-23 - o2oz-
Legal Description b /�' 5 1~'t
'loor Area of Sq.Ft. non-heated/cooled �'
Valuation of Work$ 3/ L O C Proposed Work 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 esidenti �- ,,
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes exc N/A
Florida Product Approval# 3/,sr. /
For multiple products use product approval form
Describe in detail the type of work to be performed: y'/ ' SiDiA/i f A'/�, r.i.-, Gl yirr/,/ .y
/c21`dd,lc 4 G/%T/ G,-ir7,i✓ T lJo,,,,�4e. $/I/A c
Property Owner Information:
Name: /I/ilk/ ,¼2L Address: 222-S S-A//7/X/clik /ow,
City ,pr•L .4,./7:e 4.•rc A Stater' Zip _mZ 13 Phone 20'1/1-.2 y6 6 33/
E-Mail or Fax#(Optional)
Contractor Information: J L<
Company Name:,t/Ax;s 4.41,4471,0
`(7dNrre/;r%5 e-/eki0 A<iQuali fy ing Agent: -Jd/,-- , ///W"
Address: s y Sal,L.leis'( ,OR City ,v !'/2r &e,c I State A c Zip 3:.)G G2
Office Phone foci-Si,,'. -/�.•6 7 0 Job Site/Contact Number %ae/- 5/j.2 i6 9b Fax#
State Certification/Registration# Cl;11,e,/v ZS 5'1 —IA Z44/6, / t rn ,,L-,69A
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 L6)months at any time after
work is commenced. I understand that separate permits must be secured for Eledricaf 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 RCORDING 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 ordinances governing this
type of work will be complied with whether speci>ed 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 Contractoi_ 4
Signature of Owner ` l g L��
/ Print Name .,,,,�.. ��r....> LA/t 16
Print Name /YI�fR� /0/1 .d..... .
Sworn to and subscribed before me Sworn to and subscribgd b forp me
this Day) f' . _ 20 this Day of C O h/- , 20/�
A-, ,, X74, • JtIFMtRt/1N3 tis ,y vn
Notary blic 0,, L Notary Public•State of Florida
No Public r� • MY COMMISSION OFF 1 6 C.* _, My Commmetf11W¢"M
� • EXPIRES:lupur 11,201!
+on iMiA Woe NMrry Wm s;1, ., , Co
�n``• Bonded
Notch lialioml . Au
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FILE co fi,r/yr, . s -FAIR-
9.5
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No.169723-0202
County of Duval
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.
Legal Description of property being improved: 09-2S-29E North Shore Condominium
Address of property being improved: 2025 Seminole Road,Atlantic Beach,FL. 32233
General description of improvements:Remove and replace siding on chimney
Owner: Mary Hall Address: 2025 Seminole Road,Atlantic Beach,FL. 32233
Owner's interest in site of the improvement:Residence
Fee Simple Titleholder(if other than owner):
Name:
Contractor ,4 II/ /t- 4 09/116 y //
Address: 3�/ 5A.L�`�rs 4 i2, fi n-G;' //f�fjR� A,cri9 -7/
Telephone No.: 9r' ' 4'429— d Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for 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 whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
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
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signer _1 v l�^���{ Date:/0"0 ` /s
Before me this day of l9r 7.;p,C'/L in the Courity of Duval,State
Of Florida,has personally appeared 0.4.e ff'� y/ti /14
L L
Notary Public at Large,State of Florida,Cofmty of Duval/
My commission expires: /j Cr c s19 T // 5i/ gi
Personally Known: or
Doc#2015246814,OR BK 17348 Page 2293,
'roduced Identification: iT �i' / — 8� - 0- ; •
Number Pages: 1 t� �� fi��
Recorded 10/27/2015 at 12:26 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL * * F7:1
COUNTY } • EXPIRES: 11,2018
RECORDING$10.00 °�`aa Bade0lMi�NdMyfNMtM