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319 19TH ST - INTERIOR REMODEL, MASTER BATH tr- AL - '' S CITY OF ATLANTIC BEACH SS 800 SEMINOLE ROAD I 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-2829 Job Type: RESIDENTIAL ALTERATION Description: INTERIOR REMODEL - MASTER BATH ROOM Estimated Value: $18,000.00 Issue Date: 12/15/2015 Expiration Date: 6/12/2016 PROPERTY ADDRESS: Address: 319 19TH ST RE Number: 172020-0920 PROPERTY OWNER: Name: SIROIS, STEPHEN Address: 319 19TH ST GENERAL CONTRACTOR INFORMATION: Name: KOHN CONSTRUCTION LLC Address: 15 Guana DR Phone: 803-243-0395 PERMIT INFORMATION: FEES: PLAN CHECK FEES $70.00 BUILDING PERMIT FEE $140.00 STATE DCA SURCHARGE $2.10 STATE DBPR SURCHARGE $2.10 Total Payments: $214.20 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. City of Atlantic Beach i�,/:0...A;9,41, 6•j Building Department APPLICATION NUMBER 800 Seminole Road (To be assigned by the Building Department.) J Atlantic Beach, Florida 32233-5445 I Q _����\ Phone(904)247-5826 • Fax(904)247-5845 ` _ �`�` E-mail: building-dept @coab.us Date routed: 2- I-3 City web-site: http://www.coab.us !NI APPLICATION REVIEW AND TRACKING FORM Property Address: 3 I -- - 1 ' - . • - ,t review required Yes o k 4 Buildi,. Applicant: bt-}•IV CO&S-Z-•Rik)0'no AD Planning &Zoning Tree Administrator Project: i .1-C a a f• E✓ Q Public Works V\7\- S re-P---- Public Utilities AT cf R_O© M Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified B 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: I Approved. (Circle one.) Comments: nDenied. :UILDIN PLANNING &ZONING Reviewed by: irl Date: f 2'k '/,- TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie 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 OFFICE COPY BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach,FL 32233 i Office(904)247-5826 Fax(904)247-5845 1 5-- RA{I1 e-z 6 2 c) Job Address:3/9 /9" 66; Af/Qr7/, .I9 .i 4,`L ,3.2.1,43_Permit Number: Legal Description Lo/8 .tf/eve.A.3 Glifif// Parcel# co Floor Area of Sq.Ft. Sq.l•t Valuation of Wor Proposed Work heated/cooled $O non-heated/cooled —O r f$oaa,,o0 Class of Work(circle one): New Addition tern Repair Move Demolition pooUspa window/door Use of existing/proposed structure(s)(circle one): Commercial en If an existing structure,is a fire sprinkler system installed?(Circle one): es N/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: i&MO / //Ij4'r oc /Y Sk/'Ah4 - 71064- /j [r.kCS�Q` n d/-r<o - ,-,- - -3 ', r/../41 / / Property Owner Information: Name:,54_,Ya°4 V-_Jail,S/Ro/S Address: �/7 /Q"7.i7< City At/a,Ivt. BeacA StatefZip,?.2a.3.3 Phone 109-a96. -474-96, E-Mail or Fax#(Optional) sect y3 20/. con./ Contractor Information: [ I ' //,� Y `I Company Name:I44N COlrbifi 144". (J�- Qua'. in.,A:e`t: ,,, . G.AJ1IK Address:'5 ( v /` City .�. ,,'71,7 State _ Zip a b. Z Office Phone 8'b 32 0395' Job Site/Contact Nugther �f•K.c. Fax# State Certification/Registration# G AC t{ s 3 e,G a6 Architect Name&Phone# N!,¢ Engineer's Name&Phone# NA. Fee Simple Title Holder Name and Address Bonding Company Name and Address N//_ Mortgage Lender Name and Address I Applicatton 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 ofa permit and that all work will be pe ormed 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 oppeeriod of six 16)months at any time after work is Tanks and Air commenceondid tiI understand stand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Healers,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 II COMMENCEMENT. I hereby certt&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 Ywork will be complied with whether specified herein or not. The granting ofa permit does not presume to give authority to violate. cancel the provisions ofany other federal,state,or local law regulating:onstruction or the performance of construction. / Signature of Owner �1%lam g TT c Signature of Cont .ctor (�II 4 .L _ Print Name lit - C..Y°Qne°t/ '.J//`04.S Print Name I f " I Sworn t and subscr d before a Sworn to and subsc'bbed before n e this Day ��t.,r +►- .20)5 this Day of 20 Notary Public ,/)Q j Notary frli b!>c A� . Revised 01.26.10 0 f. S S�I���Zta_ �, (.19.407 .1 �r`=T�4'' BARBARA STEEG Notary Public-State of Florida ,,,,;':;-4;�`s'; z •�; BARBARA STEEG Zy� �dT; My Cbmm.Expires Jun 8,2018 ; • ,., .• Notary Public-State of Florida I .44:%%0* Commission•FF 108182 T; �iT •• My Comm.Expires Jun 8 2o1a f 01.;"-At,., ,,t�,, Commission I FF 108182 OFFICE COPY Petard- dr. / 3 gA i2 P9 NOTICE OF COMMENCEMENT State of Flop td t Tax Folio No. County of /Jd✓p e 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 OMMENCEMENT. Legal Description of property being improved: Lod 8 Z7/ ci 3/ i ii//// Address of property being improved: 3/i /1 / /9-)7alJfic. 41164 / FL General description of improvements: /Yjp 4/el" hu,/inaoni ie/!?D Owner: .17e9 2k4 i S 5%/et,/s Address: , -7/j /7 Pei „5",1, /5/f/.r it A - , JC/ Owner's interest in site of the improvement: ,OQ/`4oyi4/ re.(7d,eiee, Fee Simple Titleholder(if other than owner): Name: pol Contractor: kvl+H Cu./S vti r, LC-c.� n Address: t s CT/4A2 . v�-� 'I�.�.La V e)jc. �. k'L01, N A Telephone No.:' L>i - 3 D 3 9 14Y ep Fax No: Surety(if any) NM Address: Amount of Bond S Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: u pr— Address: rr 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(20b), 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 / / Si. .... • �. / !� A f Date: I�-CI-16 IS Before me this ''-I day of 2 v i S in the County of Duval,State Of Florida,has personally appeared ?r S S. S;r G S •"`.N"'�o, TREBOR M.OfVERTER Notary Public at Large,State of Florida County of Duval. s+P,�� Nolary Public Stata of Florida My commission expires: (Vt G,r G. 2 G I My Comm.Expires Mat 30.2018 Personally Known or _, ,, . %' "' Commission N FF 107521 Produced Identification: Doc it 2015276.60,OR BK 17308 Page 207, Number Pages. 1 Recorded 12'04.2015 at 11.44 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING$10.00 (41LA COAMA di'A.)(i-,‘ 0,-, :-, U\(`( L N v ','' :'air: 0.. . ''' 4 II OFFICE COPY j., . i . . 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UL-- A-FT -P-- 8°; -7*1., 63 cr c ------'1:4 c-,,i, m 31i (9 — OFFICE COPY 3 . • �.z -t-517- s0 jpJ 1 a VI a ,,_ ..)- 4, 36, • I \ n .?``b1oS"(1 o 1 U � u m� 4_____, ��St,�S Sr.1k- a } T' 8" i 2►-1 linen 6-3" 9'-6" 6'-1 0 3'-4" 3'-0" over-toilet cabinet C W� , 1 11111VIIIVIVIIIVIVIVIIIIII /`4r p`tV - Print Date: e " ' 12/4/2015 11:45:52 AM Transaction#: 2924933k,a`"`'' Receipt #: 2844092 Cashier Date: 12/4/2015 Ronnie Fussell 11:44:33 AM Clerk Circuit Court (KJEWELL) Duval County 501 West Adams St RM 1051 Jacksonville, FL 32202 (904) 255-2000 Customer Information Transaction Information Payment Summary DateRece i ved: 12/04/2015 Source Code: BEACH KOHN CONSTRUCTION LLC Q Code: OEACH Q Return Code: Over the Total Fees $10.35 Counter Total Payments $10.35 Trans Type: Recording Agent Ref Num: 1 Payments '>i..9. $10.35 LQl CREDIT I PASS 14386694 IPASS Convenience Fee I 101 $0.35 I Recorded Items NBK/PG: 17388/207 CFN.2015276460 (N/C) NOTICE COMMENCEMENT Date:12/4/2015 11:44:32 AM From: SIROIS STEPHEN ETAL To: KOHN CONSTRUCTION LLC INDEXING 3 $0.00 RECORDING 1 $10.00 10 Search Items I 10 Miscellaneous Items I I tile:///C:/Program%20Files/RecordingModule/default.htm 12/4/2015