768 AQUATIC DR - FIRE WALL REPAIR r-j y\J\,
�" \ , CITY OF ATLANTIC BEACH
"" " j 800 SEMINOLE ROAD
\ z"'� a ��' 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: 16-RAAR-62
Job Type: RESIDENTIAL ALTERATION
Description: FIRE WALL REPAIR - DUE TO FLOODING
Estimated Value: $27,830.00
Issue Date: 1/8/2016
Expiration Date: 7/6/2016
PROPERTY ADDRESS:
Address: 768 AQUATIC DR
RE Number: 171818-5256
PROPERTY OWNER:
Name: MORRIS,
Address: 768 AQUATIC DR
GENERAL CONTRACTOR INFORMATION:
Name: PAUL DAVIS RESTORATION OF
Address: 5795 MINING TER QA MICHAEL G. MUMFORD
Phone: - -
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
• CELL /mss per(
<-' BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH / "•800 Seminole Road, Atlantic Beach, FL 32233 AL O/ 17 IS/ LI
• Office (904) 247-5826 Fax (904) 247-5845 1 (,_(A fl, -T-, 7 _
Job Address: 7 b P Ilq Va.i-/L. 01 Permit Number:
Legal Description (Z.ES 01 &-I r1 V NI•i- f i,'L AC- Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$a`)) .3 U Proposed Work heated/cooled c1(,, 8 non-heated/cooled
Class of Work(circle one): New Addition Alteration 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 : N/A
Florida Product Approval#,
For multiple products use product approval-form
Describe in detail the type of work to be performed: I/,e E GO/1// 4 E/947-46.
Zit Td ihmil .
Property Owner Information:
•
Name: t�'1{1(1-IZ)S T,� i�✓t. /}(�?V r4�'l C_ DA
-WE Address: 7 - ✓E
City A'l`t- i-s'1 L_ E,! Staten Zip 3X 1 l Phone c!py/S;1 - t..QC-y
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: PA vi- Orly K 0P N OitT)I PLvItM I : ifying Agent: Ali C -L. Ph vui.'c..;
Address: L 4. • t a, • v a. •b • 'ity JtitK.,3ur.1/it_t_E State Zip 3 Olt..
Office Phon:-•t* mire re r N Job Site/Contact Nu 1 .er• cj/ jIS --004 y Fax#
State Certification/Registration# C'.1 C.. I a;.s,a'7 c ,
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 sus ended 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 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.
I hereb 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 ofwork 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 /j/
Print Name S�1.,n, y Ko✓r t S Print Name Al■ C Olt-1- ri'l ti Ai ft i6
Before me Before e
his 5 Day of , I_ - ,,A 20 6 ' this 1 Day os7 i u 41`f 1U/4r
JUDY G DANT
�r•u JUDY G DANT Qy MY COMMISSION#FF16370
�t r Pu is I. .,.........,.. � � r:����_
y MY COMMISSION#FF163700 4111IA `':EOM n ' EXPIRES September 28,2011
''.:1•:',? (407)398-0153 FIoridallota
a,,,I EXPIRES September 28.2018 ryService.com
Revised 01 26.10
(407)398.0163 Floridallotaryservice.com
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of FL 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: •RE-,J PI V ?)--t t 0t-LA 1& felt,
Address of property being improved: -7L, ,4 Q v I4'1 L .0yt.k ye
fl- Lein L .1Si CO P�:,(Lt 14 3A.3 33
General description of improvements: \A,i ll 1L £/4'ti►e}{j f'l.r,�AtIt..
Owner fil°Yl_14.IS •1 i47L-0it- .
Address 7Lv t3 L), T)L & Lk VI ) erLa9)..' Ic deic 4, r—t,Dit43.1 4 a 33
Owners interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Paul Davis Restoration of N.FL
Address 21 1 1 N.Liberty St..Jacksonville FL 32206
Phone No. 904-739-6047 Fax No. 904-739-1596
Surety(if any) NA
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name NA
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 NA
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 NA
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): OWNER
THIS SPACE FOR RECORDER'S USE ONLY \?�oT
Signe DATE/-5-i°14
Before this day in the
ty of Duval.State of Florida.has personal appeared
�� 11 P r e rt t3 ��,n�y
hhmsel/ and affires it l`t tements and declarations ry�re�n
Doc#2016004495,OR BK 17421 Page 2401, are true and accurate =o °<�; JUDY G UANT
Number Pages: 1 • MY COMMISSION#FF163700
Recorded 01i08/2016 at 10:13 AM, 1-..es.c o;
] Ronnie Fussell CLERK CIRCUIT COURT DUVAL oFr, EXPIRES September 28,2018
COUNTY 0 / ,k 153 FloridallotaryService.com•RECORDING$10.00 My!ommissi•Sexp Large. zo rs! ounty of Kva
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