325 19th St - Chimney Repair c "`
t '„- - , CITY OF ATLANTIC BEACH
"" � ' 800 SEMINOLE ROAD
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 -421
Job Type: RESIDENTIAL ALTERATION
Description: CHIMNEY REPAIR - SIDING AND MOISTURE BARRIER
Estimated Value: $5,000.00
Issue Date: 2/18/2016
Expiration Date: 8/16/2016
PROPERTY ADDRESS:
Address: 325 19TH ST
RE Number: 172020 -0906
PROPERTY OWNER:
Name: HERBENICK, NATALIE M
Address: 325 19TH ST
GENERAL CONTRACTOR INFORMATION:
Name: A J WELLS ROOFING
Address: 5432 WELLER PL ARTHUR J WELLS JR
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $75.00
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $37.50
STATE DBPR SURCHARGE $2.00
i
Total Payments: $116.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 / 0 (�n -4 �
Office (904) 247 -5826 Fax (904) 247 -5845 1 l. ' `F\Pt
3;S /ge 9-. /1.1la c R''-� 0 3 3
Job Address: Per Num r:
C- aS sp.-1+69 tiA U '4 a rc el# o1 - r �Si
Legal Description 3
/17WP -090!0
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $,GOOD.Od Proposed Work heated/cooled (08 '1 non - heated /cooled x1 5
Class of Work (circle one): New Addition Alteration ri Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial esidential
If an existing structure, is a fir sprinkler system installed? (Circle one): es o N /A
Florida Product Approval # l (� l4 3 F P,- '7d -
For multiple products use r u ct approval orm .
Describe in detail the type of work to be performed: 1 M n re. pogk - cast—at(
•
-Fly €12- moss 43a,rrl er 1 1 nsfa.l f �d� �e. fa p tick
Property Owner Information:
Name: IVCk4a4 le j- be►" , /
tt, 1 '- - Address:3 :■s 1 'I
City Afia1. State(1Zip .S3 Phone
E -Mail or Fax # (Optional)
Contractor Information: ,,ff Q e ��,���,
Company Name: I U (WI RW e f (1 ' 1d;m.Qualifying Agent:
Address 61 l C...0 hid i d HIM— City Tau State Ft Zip 3 ZT t 1
Office Phone X5 DOLc Job Site/ Contact Num e - ! 1 G. Fax # SS / '0 3
State Certification/Registration # CC_ $$ —1 3 Z 7 1 S 1 / .ZU?—
Architect Name & Phone #
Engineer's Naine & 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 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 of 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, Wens, Pools, Furnaces, Boilers, Ile Ileakrs,
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.
1 hereby certify that 1 have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The grant of a permit does not presume to give author to violate or cancel the
provisions of any other federal, state. or local law regulating construction or the performance of construc
•
Signature of Owner e � [ u , 1 al A � Signature of Con i.: or _�
Print Name 4/4.,.'WC (C 'F3' .. L ' ..............._........_ Print Name '� ✓ ... !1' ` 5 ....._.... ........._............_.._._.._
Sworn to and subscri d fore me Sworn • d subscril� efore me
this ay of �= � 1U_O r1( 20 this a .y of , 20 f (
f I _ _._,_ _ :* ..
.us' . Notary Public State d Florida : �n, d . . ItN Public State Florida
N ry ublic at , Kimberty Baker Kimberly Baker
y p .. Ely Cammesbn FF 012533 a I My Commission FF 012533 Re Sed O1 .26.10
Expires 04/26/2017 l expire' 04/28/2017
02/09/2016 at 09:36 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
Permit No. .... Tax Folio No
State of Florida, County of Duval
THE UNDERSIGNED hereby give ootloo that the improvement will be made to eettain teal property in accordance with
Chapter 713, Florida Statutes., the follmving information is provided in this Notice of Commencement.
iq t`.6. C1
J. Description of property (le 1 description of pmperty, and addreim ilavailable): Pt+Ittryhe. 6.r.ch
- if 14+
2. General Description of
tt7. plc, V' e . p laCe. a.5019 / - 51 ) ojte, opt-
3. Owner Information:
1 A 41, ql.c la f4 g:1 g;;;4;;t33
a) Name and Addresslits—I a.
• 4 • ?•■••••
b) Interest in propertye,rir (
c) Name and addrens of simple titleholder (if other than owner):
4. Contractor °
a) Name and Address: tt:1 I1V te And ecrictrucbcii 5 " 10 , , , -of type
b Phone Number. IQ./ 5 t)C
5. Sorely Information:
ai Name and Address:
b) Phone Number-.
c) Amount of Bond: $
6. Lender Information:
a) Name and Address:
It) Phone Number.
7. Person within the Slate of Florida designated by owner upon whom notices or other dooms:Ms ma■.; be served as
provided by 713.13 ( 18a1 7, Florida Statutes:
a) Name and Address:
b) Phone Numbers of Designated Person:
8. In addition to hiinselfitierself. Owner designates of to receive e
copy of the Lienor's Nonec as provided in Section 713.13 (1) (b), Florida Statutes.
a) Name and Address:
b) Phone Number of pswaon or entity designated by oWner:
9. Expiration date of Notice of Commencement (the expiration date may not be before the oompletion of construction
and final payment to the contracum-, but will be one (1) year from the date of recording unless a dilletent date is
specified:
. WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER TIIE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1,
SECFION 7 I3.11, FLORIDA STATUTES, AND CAN RESULT PN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB sm.: BEFORE THE FIRST INSPECTION. IF YOU INTEND TO ()Bra rN FINANCING,
CONSULT WITH YOUR LENDFlt OR AN ATTORNEY BEFORE COMMENCING WORK OR REC.ORDING
YOUR wricr. OF COMMENCEMENT.
Under penalty of peljury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true lo the heat of my Imowi#ge and Itelid.
t • a
44 / cA j‹.
Signature of Owner or Owner's Authorr • d Offieer/DiredoriPartner/Manager Signatory' S Printed Name & Title/Office
•
Ihe foregoing instrument was acknowledged betbre me th day ofrb" WU. 4 .1 1 _ .20 w.rt
b /61411 Her 6 ,. te.,6 t'Pent:4 for _
(Name of PeriOni ffype of KinTieroTfieprtAttorney) (Nme of PVi9.umcntas uted for)
•
s p. ° Nat. Netary Pdryc Srate or uvula
• .....
., Kimberly Baker AR PIJ719 TATE OF rumqm
Commission FF 0 12
Expires 045M2017 Print Name: !Mixer .
Of W.
Personally Known
<c
Notzry Nea) Abo
Revised 3/15112
•
A.J.WELLS ROOFING AND CONSTRUCTION
DATE: FEBRUARY 18, 2016
1
Send to: ATLANTIC BEACH BUILDING DEPT • From: KIM
Attention: Office Location: 5651 Colcord Avenue
Office Location: Phone Number:904 -553 -0069
Fax Number: 247 -5845 Number of Pages, Including Cover: 3
J URGENT J REPLY ASAP J PLEASE COMMENT J PLEASE REVIEW J FOR YOUR INFORMATION
COMMENTS:
MR JONES SAID HE WOULD BE BACK BY THIS AFTERNOON. HE
REQUESTED THAT WE ACTIVATE THIS PERMIT. PLEASE CALL
904 - 553 -0069 WHEN YOU ARE READY FOR PAYMENT SO IT
CAN BE ISSUED.
THANK YOU,
KIM
A.3. Wells Roofing and Construction
5651 Colcord Avenue
Jacksonville, FL 32211
(904)553- 0069 -Office
(904)551-4283-Fax