331 SKATE RD - INTERIOR REMODEL , ,,-- „,,ts-'1-1.- Jr,
C ''" \1, CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
Jr: 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-56
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR REMODEL
Estimated Value: $7,800.00
Issue Date: 1/14/2016
Expiration Date: 7/12/2016
PROPERTY ADDRESS:
Address: 331 SKATE RD
RE Number: 171677-0000
PROPERTY OWNER:
Name: REVERSE MORTGAGE SOLUTIONS,INC
Address: 2727 SPRING CREEK DR
GENERAL CONTRACTOR INFORMATION:
Name: TRACC, LLC
Address: P 0 BOX 1450
ST AUG FL 32084
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $44.50
BUILDING PERMIT FEE $89.00
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $44.50
STATE DBPR SURCHARGE $2.00
Total Payments: $182.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
r51„tvy�, City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assig by the Building Department.)
800 Seminole Road 5
,: __� Atlantic Beach, Florida 32233-544
Phone(904)247-5826 • Fax(904)247-5845
> E-mail: building-dept @coab.us Date routed. /(l/
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: S3 / Jt/17--
De nt review required Y//
es/'No
/ Building
Applicant: 1119- ee. �iL v Planning &Zoning
^ � Tree Administrator
Project: 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: pproved. ❑Denied.
(Circle one.) Comments:
BUILDIN e
PLANNING &ZONING �_�!��6
Reviewed by: Date:
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:
Revised 07/27/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OFFICE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904) 247-5845
Job Address: 3( J k\-. 2J Permit Number: 1 "' /2/)f —
,tk a Z_oT°t trKa\-k
Legal Description 31-tto \'l—a E- of fr o f d P��w.S Parcel# i 1 l` o l- OOo.
Floor Area of Sq.>~'t. Sq.r't
Valuation of Work$ 780d. c90 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial (Residentia
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes cm' N/A
Florida Product Approval# F1- a S3 - R\S P&'C" €YCAe C
For multiple products use product approval farm
Describe in detail the type of work to be performed: _ r 1 Ne.w C014
e,w 4 t l is e_Nr eat r./ Can, Ov ,
Property Owner Information:
Name:Vi l.,d 5,, r (rot.{ c.52. (a\ai i5S Address: t SS ' A
City )a c.Ks v r tl-e StateZip 37aSo Phone
E-Mail or Fax#(Optional)
A W h o1 c ci- e 711''F'1• Cam
Contractor Information: r ti'C C - LL- C,
Company Name: 'f p.,/J C( LLC-• Quali ing Agent: w `
Address: Pz (LX ly Sb City �J 5 t/& State FL_ Zip�a0%5
Office Plfditek oa°t 33 S �3 Job Site/Contact Numbe4lv'1 Lo(off -3351 Fax# 9 i 3k7
State Certification/Registration# GC-S-G So Co 3`3Q
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(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 hereby certify that I have read and examined this plication and know the same to be true and correct. All provisi•ns.,: 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 t. gt 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 _A-& a Signature of Con actor \�
� V 1 1
Print Name Q��kv r 1 U SS Print Name _.. SI. 1 �j-
Sworn to and subscribed before me Sworn to and subscribed before me
this q Day of Ja/)u2/' ,20 /6 this 71- Day ofJ n,2/>rt ,20 /4
/I ) r`' ,oa ti MARY R.KENT al*//% /` 4 0�+�►r r�,/ti,ic �o - ° Notary Public- Florida No ry ublic •�:° `ii Nr Florida
' a'My Comm.Expires Sep 16,2017 I , ! '' •e lily C E As Sep .2017 i
--���p•' Commission 0 FF 42286 -'+F����P,o�'lSe FF 42286
Bonded Through National Notary Assn. 0 Bonncn Through National Notary Assn. 0
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NOTICE OF COMMENCEMENT OFFICE COPY
State of \" Tax Folio No t (c,.1 7'---C L ,T,
County of -^)_ (,,\_
To Whom It May Concern: P'rm) 7L /6 -- 12/Mg- 54
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: i;i —�L \ l— a�k 6 Rho z P (� 1.1r.
J F ee,i tJ L,f Ik.m S
,... ,A — fa 'Lc`r.cA ft. gL as
Address of property being improved: 3 t 1 S 1(.cc .- ft ` `
General description of improvements: N t --k t l e•1 ry Q 1,JI C U b LIN-t4 i t n7 �lt`le(.i.°1 0—. i i ke C 4 n I
I�e .T`c-N,.-f 0.,j c C a(,,��``��c') r'i e.,-t c�i 60c)(--
7 Owner: ,, L Sc. ‘ I\ot`I-.5 0•;�:.. At,k t'',r 5S Address: I r7 'S Ave AA(- icl C.k s o".oliU `1>cL. (CL
Owner's interest in site of the improvement: .3a`;5
Fee Simple Titleholder(if other than owner):
Name: t--�-
Contractor: _1 i\r•a i-• L U -- -`c(L1 74 c' v
Address: aj r>� 1 9 S L' 6--t ry u) S -7,..e.. rc - at, c(,s
Telephone No.: <1(L i Q)6s'ck 3 •3-1 Fax No: t a f' Cc5a4 7'-)7
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 in
Doc#2016003758,OR BK 17420 Page 2360,
Name: Number Pages:1
Recorded 01/07/2016 at 12:41 PM,CO UN
Address: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
TY
Phone No: Fax No: RECORDING$10.00
Name of person within the State of Florida, other than himself, designated oy ow...,. ..F.,.. .._
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 tt i
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNS —\ f f
Signe& �(� 1 ik) /
/Date: J /'Co
Before me this 9i.a. day of 24 2Ri/ in the County of Duval,State
Of Florida,has personally appeared
Notary Public at Large,State of Florida,County of Duval.
My commission expires: 9//(0/f 7
Personally Known: 1/' or
Produced Identification: ■ I'
�..� ;'o'�., MARY R.KENT
U j�C .�,r-� '�a�`y,."�`N Notary Public-State of Florida
C1 �G✓( ar•1 4 My Comm.Expires Sep 16,2017
V-4..--"--,..V.
.° " Commission#FF 42286