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1021 ATLANTIC BLVD UNIT 967 - INTERIOR REM - FIRE SERVICE City of Atlantic Beach APPLICATION NUMBER �• ` Building Department (To be assigned by the Building Department. ��.. �•s� 800 Seminole Road �� 115 ___• '�r Atlantic Beach, Florida 32233-5445 c�M & Phone(904)247-5826 • Fax(904)247-5845 `� • ffr E-mail: building-dept©coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM 41-96 Property Address: 1d2/ 7172_ /v Department review required Yes No uildi� Applicant: S Co Planning &Zoning _ Tree Administrator Project: l alp B a Public Works Public Utilities AfolIeS C Pux Fire Services Review fee $ Dept Signature • Other Agency Review or Permit Required Review or Receipt of Permit Verified By 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: ❑Approved. ['Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING 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: nApproved as revised. ['Denied. Comments: Reviewed by: Date: vised 07/27/10 r 1-=;9;-7,. City of Atlantic Beach � APPLICATION NUMBER Building Department (To be assigned by the Building Department. P 800 Seminole Road /� p • j � Atlantic Beach, Florida 32233-5445 //5 emir ` 2 (i) Phone(904)247-5826 • Fax(904)247-5845 '.0i 9• E-mail: building-dept @coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM ,,QQ Property Address: /ó2/ �J/✓ Department review required Yes No uildi Applicant: s Co Planning &Zoning Tree Administrator Project: /2)Tao , 7) d Public Works Public Utilities GQ�S C�. 1 J�'� Phu 2lic� ety3 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: APPLI ION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: , Date:/2 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑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: 1021 Atlantic Blvd#967 ,�� 1Ib'7I '4 Permit Number: /5-- CM/T~ 7 J'8' Legal Description 38-2S-29E 14.040 - CASTRO Y FERRER GRANT Parcel # PT RECD O/R 8130-2297 Floor Area of Sq.Ft. Sq.Ft Valuation of Work Proposed Work heated/cooled non-heated/cooled 7o, 0Od Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structures)(circle one): ommercia Residential If an existing structure,is a fire sprinkler system insta el . ire e one): Yes No N/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: Interior Renovation,ceiling and floors Property Owner Information: Name: Equity One Atlantic Village,Inc. Address: 1600 NE Miami Gardens Dr City North Miami Beach State FL Zip 33179 Phone 305-947-1664 E-Mail or Fax#(Optional) Contractor Information: Company Name: Bosco Building Contractors,Inc. Qualifying Agent: Todd A. Bosco Address: 2158 Mayport Rd City Atlantic Beach State FL Zip 32233 Office Phone 904-241-0320 Job Site/Contact Number 904-241-0326 Fax# 9.04-241-0326 State Certification/Registration# CBC 1250212 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 thisplication and know the same to be true and correct. All provisions of laws and or tai ances governing this type of work will be complied with whether speci red herein or not. The granting of a permit does not presume to give a/ " to iol or cancel the provisions of any other federal,state,or j i r- lat construction or the performance of construction. / Signature of Owner < Signature of Corp : Print Name 'VT ci•A- Cb d r 4.5a,. 1— Print Name Todd A. Bosco Sworn to and subscribed befor me Sworn to and subscribed before me this /G Day of //4 ,201 S this 16 Day of /1/6.-re---4.-,A, ,20 2SS Notary Public 'I ,si WIWi:, w: .7 MY COMMISSI:O',+rh 242630 r WILD"L POPrite3ds 01.26.10 � y EXPIRES:October 19,2019 • ,. ., MY COMMISSION FF maw `! -4 Bond•d Thti Notary Puhk UMeiwriters :•} EXPIRES:October 19,2019 r.w-- Wiled Thru Notary Public Undenvritets OFFICE COPY n EQUITY ONE November 12, 2015 Owner: Equity One (Florida Portfolio) Inc., a Florida corporation 1600 NE Miami Gardens Drive N. Miami Beach, FL 33179 RE: Culhane's Irish Pub 967 Atlantic Blvd. Atlantic Beach, FL 32233 To Whom It May Concern: This letter serves as confirmation that Equity One (Florida Portfolio) Inc., a Florida corporation hereby authorizes: Bosco Building Contractor, Inc. & their authorized agents to secure permits for an interior renovation, provided said work meets all building code requirements. Please be advised the property owner(s) approve sign offset. Should you have - questions, please contact Property Manager, Kevin Hollenbeck, of our Jacksonville office at: (904) 2• - 2. Thank you. X 411, Ken Choque e, ice President of Construction As Authorized Agent for: Equity One (Florida Portfolio) Inc., a Florida corporation STATE OF FLO A COUNTY OF Individual Before me, this 1 2 day of November 2015, Ken Choquette, personally appeared and executed the foregoi g instrument, and acknowledged before me the same was executed for the purposes therein expressed. NOTARY STAMP: Signa e of Not at / iko My commission expires:_ Print Notary Name Identification Method: • _ personally known Produced I.D. - Type: _______ USSETrE G.BAJRA :; MYCOMMIS$O 1I FE1S?1CK If% 'd F.XFIRES:February 24 201E a ? 9onoed?hru NuGm Palk Undorwr;!_;■ Equity One Inc. i '.6:', t' :, _; ::r f_;r ee P.'r; Miami f r-:i;cl i .?3'.1`i , Main's:'c _ ; .. I:r• a I wwwequityone.net Doc # 2015262485, OR BK 17369 Page 1219, Number Pages: 2, Recorded 11/16/2015 at 02:12 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $18.50 NOTICE OF COMMENCEMENT Permit No./5--(-1/11. T c2 4Y-'cr Tax Folio No. State of Florida,County of Duval THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement. 1. Description of property(legal description of property and address if available): 38-2S-29E 14,040-PT RECD 0/R 8130-2297-1021 Atlantic Blvd#967.Atlantic Beach. FL 32233 2. General Description of improvements: laavi Interior Renovation,ceiling and floors Q 3. Owner Information: a)Name and Address: Equity One Atlantic Village,1600 NE Miami Gardens Dr,North Miami Beach,FL 33179 b)Interest in property:General ■. c)Name and address of simple titleholder(if other than owner): ♦ ,w 4. Contractor Information: Prep a)Name and Address:Bosco Building Contractors,Inc.2158 Mayport Rd,Atlantic Beach, FL 32233 IL by: b)Phone Number:(904)241-0320 0 5. Surety Information: a)Name and Address: b)Phone Number: c)Amount of Bond:$ 6. Lender Information: a)Name and Address: b)Phone Number: 7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as provided by 713.13(1)(a)7,Florida Statutes: a)Name and Address: b)Phone Numbers of Designated Person: 8. In addition to himself/herself,Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. a)Name and Address: b)Phone Number of person or entity designated by owner: 9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment to the contractor,but will be one(I)year from the date of recording unless a different date is specified: WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of pe ' .i,I declare that I have read the foregoing notice of commencement and that the facts stated therein are truer%• • I owledgc and belief. /// /\ �� rock( 63Y. I4113 re of•wner or Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Name itle/Office The foregoing instrument was acknowledged before me this /6' day of /f 4-•-°;4-- ,20/1-, by '7'00,10 doJc:' as f/6pn it for }-�K.Ce/t n-/Avr (Name of Person) (Type of Authority,i.e.Officer/Attorney) (Name o Party Instrument was Executed for) YAwo t■h 4 ,11' 'C"t =coMMISSICNeFFmos NOTARY PUBLIC,STATE OF FLORIDA ."-''' T,.- EXPIRES:October 1e.2C I 1 ''+.�,,1, ex•..,nmWW1,PytKUet,MMI Print Name: 9 Personally Known IdcntificatiorrType: (Affix Notary Seal Above) Revised 3/15/12