The URL can be used to link to this page

375 Seminole Rd - Replace 2 Doors - 1 ._,j-\.1 \ 1 f• . Y �s CITY OF ATLANTIC BEACH I 800 SEMINOLE ROAD ?) r ATLANTIC BEACH, FL 32233 �� INSPECTION PHONE LINE 247 -5814 s. �J131c-i`' WINDOW AND /OR DOOR PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814 JOB INFORMATION: Job ID: 15- WIND -2972 Job Type: WINDOW AND /OR DOOR Description: REPLACE - 2 DOORS Estimated Value: $4,600.00 Issue Date: 1/5/2016 Expiration Date: 7/3/2016 PROPERTY ADDRESS: Address: 375 SEMINOLE RD RE Number: 170435 -0000 PROPERTY OWNER: Name: LOPEZ TRUST, IRIS M Address: 5824 REBA ST GENERAL CONTRACTOR INFORMATION: Name: HOMERITE WINDOWS AND DOORS Address: 4801 Executive Park CT N BLDG 200 STE 207 Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $36.50 BUILDING PERMIT FEE $73.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $113.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 01 City of Atlantic Beach APPLICATION NUMBER J Building Department (To be assigned by the Building Department.) i ! s) 800 Seminole Road D ,, Atlantic Beach, Florida 32233 -5445 ( -‘,./1 N I - 2 '7 Z Phone (904) 247 -5826 • Fax (904) 247 -5845 2 j f �? E -mail: building- dept @coab.us Date routed: 1 Z. l30 /1-5 City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address:3 - 7 `. '.A&I NOS R(:-. D ment review required Yes o I . uildi e Applicant: 14 R\`Tc- \ Planning & Zoning Tree Administrator Project: RS- PLPtCC Z, boo S 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: [1pproved. ❑Denied. (Circle one.) Comments: BUILDI PLANNING & ZONING % Reviewed by: Date: 7 TREE ADMIN. Second Review: ❑Approved as revised. ❑Deni . 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 .0 .. 1 S - iNb - Z97Z . • nil ". 1 Pr 0 .ii I 1 CITY OF ATLANTIC BEACH _ t 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 09 I I I I • ;_.. ;,: t OFFICE: (904)247 -5826 • FAX NO.:(904)247 -5845 BUILDING -D E PT @C OAB. U S _ ; 11E BUILDING PERMIT APPLICATION DUVAL COUNTY 1. JOB ADDRESS: 2. VALUATION OF WORK: 3. SQ. FT. UNDER ROOF ' ) 5 S � M 1.>� /4 ,LL PI L (� �, r " 1 � l ate , 4. LEGAL DESCRIPTION: 5 CLASSOF WORK 6. USE OF STRUCTURE: ❑ NEW BUILDING ❑ DEMOLITION ❑ RESIDENTIAL LOT _ BLOCK SUB DIVISION ❑ ADDITION ❑ CONVERTING USE ❑ COMMERCIAL 7. DESCRIPTION OF WORK: ❑ ALTERATION ❑ ACCESSORY BLDG. 8. FIRE SPRINKLER: L �� - / ❑ REPAIR ❑ POOL / SPA ❑ YES ❑ N/A ••7? 0.. -<c M tf- / ©G2.> ✓ j 1 ❑ MOVE ❑ OTHER ❑ NO (r 7 PROPERTY OWNER: CONTRACTOR: ARCHITECT I ENGINEER: 9. NAME: 15. COMPANY NAME: 23. COMPANY NAME: Pe i ) / S C 4 F'`c V-, :<c., r „(..L.;--..1. 16. NAME: 24. LICENSEE NAME: L ...!n elp 4 -,, 10. ADDRESS: 17. STATE OF FLORIDA LICENSE NO.: 25. STATE OF FLORIDA LICENSE NO: 3-75 s -1, I -f 4 OA c., 6 (..2,4-4-. I� 1 18. ADDRESS: 4 4. 4 26. ADDRESS: 801 3 3 • 33 - sH,k ,,,)G , 41J, . al 11. OFFICE PHONE: 12. FAX NO.: 19. OFFICE PHONE 20. FAX NO.: 27. OFFICE PHONE: 28. FAX NO.: -.� asps - ab•a 13. CELL PHONE 21. CELL PHONE: 29. CELL PHONE: ')' '', ,Z2 c) - I?4/ 43'f- girL 14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS: 0 1.X 7 4 0 . - < - )J /k n. -s iz• F-<4 G FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER: (IF OTHER THAN OWNER) 31. NAME: 33. NAME: 35. NAME 32. ADDRESS: 34. ADDRESS 36. 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, Air Conditioners, etc. OWNER'S AFFIDAVIT - 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law. *** WARNING TO OWNER: *** YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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 RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER or AGENT CONTRACTOR ) (If rit, P er of Attomey or Agency Letter Required) //�� 1 f (0 ' er 0 ) Signed: L k D ate: C •� -- i Z"1 I 1 Signed i1 6� v� / f Before me this � da y of C �' / S 2009 in the of Before me t his vP day of -- r ,-- '/ S , 2009 in th - county of county coun Duval, State of F - • - - - e .. I • DEAEiEN III Duval, State of Florida, h- •.- • -. • „R�� •Y;�� A I. RO GATES DEAF I II k '= O nmmissinn AL # FF 190928 :�� ° Y� ''. 190 928 herin by himself ,' ". •�Tfit ii9e a�rai enats' and decla :bons are henn by h imself ! elf .• ' 9rr � } � § ly � gpt 29te �nd decly • ' ons are ',+ ! r , : ? f� :: Fain Insurance 800395-7019 true and accurst- � • pF Fr gpdaC i nns Tro Fein lnau 800386aot9 true and accurate. , e 4 .-..• F 4 , Bonded th Notary Public at Large! State of r4 ' "'-^- , County of 04-1 ✓ <- 1 Notary Public at L- , , r ° -1 .t, County of 4 i%'L-( laPersonally Known ErPersonally Known ❑ Produced Identifi ❑ Produced Identifi 'o Notary Signature f - Notary Signature i 'I - 0i 5 - d, l 3. BLDG01 Permit Application Bldg: REVISED: 12/18/2008 F l 5'� i ] . 3 it r i ,. ,A,� t NOTICE O F COMMENCEMENT (PREPARE IN DUPLICATE) i Permit No. Tax Folio No. State of i w r c C County of (JL ✓ , • 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: /O- SS / - a S -- 2-- c ? E S Address of property being improved: 375 6 ZY l 6 1 3ar333 F- lo.. -1 As General description of improvements: 0 s Owner Li," d S to Address 2-15 6 /no -r �� Q�F� t l� 3�2 Owner's interest in site of the improvement 1 ,, c.. ( 1 , Lc, k r: . Fee Simple Titleholder (if other than owner) Name Address 1 Contractor 1. -Lev)- q 4:1—f t�'�j A l a L A off l Address Igo/ r L d( 1C.: 'WV ALA- k C/ >&r ; ,p(A) ,A0) Phone No. 6 /64'- 9'3'6. as Fax No. idlF 4G -a �f4 3dv3 /G Surety (if any) Address Amount of bond $ • Phone 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 Phone 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 Statutes. (Fill in at Owner's option). • Name Address Phone No. Fax No. Expiration date of Notice of Commencement (the expiration datg is one (1) year from the date of recording unless a different date is specified): 1Yore.4. ✓1 - .2o /A THIS SPACE FOR RECORDER'S USE ONLY ( 4 'n c r,w ER 1 2 ` 201 16 Signe h �✓l� lX— J Befor this 9 < day of • 7 S DATE in the A C t , Du al StaV°f lorida, has personally appeared Doc 2015295139, OR 8K 17413 Page 829, `�, ` herein by Number Pages: 1 self herself and affirms _ _ _ _ _ _ _ _ __ __ are rue and accurate • +:p ROYAL GATES DEAREN III Recorded 12/30/2015 at 01:06 PM, COUNTY Fussell CLERK CIRCUIT COUR1DUVAL • .•: Commission # FF 190928 • ; r r�a. Expires May 20, 2019 RECORDING $10.00 / ''•F -'•'° Bonded Thru Troy Fain Insurance 800- 395 -7019 Not.' Pu•lic at Large, = (=v. State of �' , County of_ • I✓ M y co mmission expires: b _ q Personally Kw ,� or Produced Identinofin cation