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796 MAIN ST - FIRE DAMAGE ,t ri rAJy .ik �� ' `�, CITY OF ATLANTIC BEACH �� - - 800 SEMINOLE ROAD,,.___j_K 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-578 Job Type: RESIDENTIAL ALTERATION Description: FIRE DAMAGE REPAIRS Estimated Value: $44,000.00 Issue Date: 3/17/2016 Expiration Date: 9/13/2016 PROPERTY ADDRESS: Address: 796 MAIN ST RE Number: 170942-0050 PROPERTY OWNER: Name: SAPIA. PETER C Address: 1655 SELVA MARINA DR GENERAL CONTRACTOR INFORMATION: Name: PAUL DAVIS RESTORATION OF Address: 5795 MINING TER QA MICHAEL G. MUMFORD Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $135.00 BUILDING PERMIT FEE $270.00 STATE DCA SURCHARGE $4.05 STATE DBPR SURCHARGE $4.05 Total Payments: $413.10 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND "I114: FLORIDA BUILDING CODES. `' ,I: S, CITY OF ATLANTIC BEACH ' " 800 SEMINOLE ROAD j * ' °` ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 \0.219r ROOF PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-ROOF-577 Job Type: ROOF PERMIT Description: REROOF AFTER FIRE Estimated Value: $18,000.00 Issue Date: 3/17/2016 Expiration Date: 9/13/2016 PROPERTY ADDRESS: Address: 796 MAIN ST RE Number: 170942-0050 PROPERTY OWNER: Name: SAPIA, PETER C Address: 1655 SELVA MARINA DR GENERAL CONTRACTOR INFORMATION: Name: PAUL DAVIS RESTORATION OF Address: 5795 MINING TER QA MICHAEL G. MUMFORD Phone: - - FEES: PLAN CHECK FEES $70.00 BUILDING PERMIT FEE $140.00 STATE DCA SURCHARGE $2.10 STATE DBPR SURCHARGE $2.10 Total Payments: $214.20 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ,,-.1 ,-"-'1,-/.:, ,, CITY OF ATLANTIC BEACH : ' \s Building Department 800 Seminole Road f -- c) K. �r Atlantic Beach,Florida 32233 / (904)247-5800 PLAN REVIEW COMMENTS Permit Application # /6-ie/94R- S7 . $ /6--noaf - '77 Property Address: 796 a%n S 74, /l Applicant: Pa v! 10aVl 5 Re Siora 7110,'N o -P NFL Project: F r-e ►Oa rna ye. £dEpri r S This permit application has been: proved Reviewed and the following items need attention: CO Fri/ vvf 5.6r, a _vc1J yk S era -4 r► eri1S -r0Ac /nnpl-Ovd/ S,-e'1$, C GO %rac1vj2 S'Act/ / S'vb 'n , il- Q Co i-e j LC,'hevN ck, r1 u Y :, n 'PC:, 0r '1 J-e E 1 -rr --sc b, Please re-submit your application when these items have been completed. Reviewed By: Pia Date: 311 Y//l r51.Al'r'i; City of Atlantic Beach APPLICATION NUMBER • Building Department ■ (To be assi�ne_d b!y hOe Q B u;d_i ng�e a7 rtmt.) `.2 800 Seminole Road 9 • Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 • Fax (904)247-5845 "�JS3 �: E-mail: building-dept @coab.us Date routed: 3 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM •Property Address:—7 tO /n,A4 sT- D rtment review required Yes No Building Pl97,-/))/rViC Applicant: N/C/ Planning &Zoning Tree Administrator Project: Public Works C� A Public Utilities p � Public Safety ,t J ►• 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: ❑Approved. Denied. (Circle one.) Comments: nn II / filled C0 c:, 5 b -c 1'f0duct ilppfcUcr1 w e , BUILDING Otil f if S/ ,SA 1 PLANNING &ZONING Reviewed by: rn 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 05/14/09 aS'A,��r,, City of Atlantic Beach o APPLICATION NUMBER Js �,,,r. �� Building Department (To be assi ned by the Building Department.) ''' `` 1 800 Seminole Road �G—,/�fii2 – �7P �� Atlantic Beach, Florida 32233-5445 `� Phone(904)247-5826 • Fax(904)247-5845 P Jp; !P E-mail: building-dept @coab.us Date routed: .3 9 / i City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property A A AA A w r Departm- • review required Yes o Building Applicant: 4iL ---4n V/S 0 //f Z • ' ' annmg &Zoning ��� Tree Administrator Project: / 1 -) A th`F--- Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Review or Receipt Other Agency Review or Permit Required 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: P pproved. ❑Denied. (Circle one.) Comments: UILDING PLANNING &ZONING ni Reviewed by: Date:3// 1 v 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 05/14/09 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: /4-1 t 4 S"Tnc�-� 3 Permit Number: /6_/91�R _ S7 g- Legal Description (1 t) Oj-I°i Vr4 r?S Q t'- /a C Parcel# L) 01 -O 0-S-0 Floor Area of Sq.Ft. Sq.Ft Valuation of Work $4,94 ) Proposed Work heated/cooled / I 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 �sident'' If an existing structure,is a fire sprinkler system installed? (Circle one): es IVY N/A Florida Product Approval# S r co, For multiple products use product approval form Describe in detail the type of work to be performed: 'hi"- 9 c= (LEQt--, re,� (L� rtoc r Property Owner Information: Name: f L f"E' , S 14PI Y' Address: 9 i.p 411%0 Stern er City A-rt ✓)r-rn L 1" e is State ft_Zip 3aas3 Phone g0Li/soti -(00(90 E-Mail or Fax#(Optional) 1j Contractor Information: bn 3 o'�PC,/ Q PO l Company Name: e Avg. .S 0 17- NotvnA Ft-oft-Aye) Qualifying Agent: GO v'` Address: I; L-t b e.-n-ry ST tt -s- NOe.n4 City 7}c.14_so+∎4 1 to State i-toub -Zip 3cVe(� Office PhonerIO Y/ 73 5- (,o 4 l Job Site/Contact Number 50 y/y- _ aZ 3 1 Fax# State Certification/Registration# C Q C. I S(• •s- C c-(-- I 1 cl y A.c‘ Architect Name& Phone# Engineer's Name&Phone# t_o f ot- "34_?;.)q I 3 O y/boo - S sO 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. 1 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. 1 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 COMMENCEMKNT. 1 hereby certify that 1 have read and examined thisplication 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 s eci red 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 loco w regula '•• construction or the performance of construction. Signature of Owner P Signature of Contractor Name Pelc“.- C• 54f 4- 3 Tj . Print Name Hiciicd Hum T CL Sworn t9 and subs 'bed before me Sworn to and subs rit��d before me this t`,• of 20 /L this ti ay of 1.VlAp h ,20 /(P ' Y••' MELODY ANDREWS IRWIN ELPOY :NDREWS IRWIN' Notary Pu+lic e.;� : " N t P � :� COMMISSION#EE044091 -.71,6,;tat.: EXPIRES October 07,2016 ,;;,3g' EXPIRES October 07,2016 Fbnd.NOtiryServv a corn _ t407;398-0153 FIond$NOt iRe 01.20.10 P p o r i 4- -tics -- /6--RAi2-57R- 6 /6-1ao0-1- C77 NOTICE OF COMMENCEMENT State of `'Loo p A Tax Folio No. County of 1' V►AL OFFICE COPY 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: 1 8-3`I .38 -D..s—' . i - . 17 Sa_ l t}1.1.0,411 L b S 1 a_ O t= LO-r: , LOT(g aLiL 1(fD Address of property being improved: 7 9 Co n'1 4 h..i .Silt E&i l�F►1 T1 C. 6Lxfe 14 v ILI A A ) 3 a a.3-\ General description of improvements: fi .?1.,e- DAM AO 6; YL 016, Owner: P TE'k-- .3 rif 1 Address: 79(., Th4 S.T)t ArTi4.1,j IC.._ 6e, -Ii) 3A3. Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: Co tractor: P/4)-)1- OA VI S P1-ec3 SO r. A-TIO/.D 0 1- r.- \: l-t "t-Oi4 i A A Address: a-1. 1 1 L-( 8 E) r / S ri'La;rT NO-A-4-1-1 Telephone No.:.Q((/23 9 —(oO b-) Fax No: 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 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: 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 date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNS Signed: y / i Date. 212-#9 4(C".Before me this <77d- -day o I `4 k__�in the County of Duval,State Doc#2016053735,OR BK 17486 Page 1968, Of Florida,has personally appeared r '�?.fir" aP a c, Number Pages:1 Notary Public at Large,Stat . Recorded 03/0912016 at 01:45 PM, My commission expires: LA;:r. l MC.,OD1zANDREWS IRWIN Ronnie Fussell CLERK CIRCUIT COURT DUVAL Personally Known: '!' MY COMMISSION#EE841091 or COUNTY 'roduced Identification: 7 ".-,. _a,`c EXPIRES October 07.2016 RECORDING$10.00 '41,940` 14071395-0153 nds ryService.corn (..f7/GJ ia, ____� OFFICE COPY City of Jacksonville-Planning and Development q 161/P Building Inspection Division ` /o ,,s3.,,` Contractor Asbestos Notification Statement Per Florida Building Code 105.9 Asbestos. The enforcing agency shall require each building permit for the demolition or renovation of an existing structure to contain an asbestos notification statement which indicates the owner's or operator's responsibility to comply with the provisions of Section 469.003, Florida Statutes, and to notify the Department of Environmental Protection of his or her intentions to remove asbestos,when applicable, in accordance with state and federal law. 469.003 License Required— 1. No person may conduct an asbestos survey, develop an operation and maintenance plan, or monitor and evaluate asbestos abatement unless trained and licensed as an asbestos consultant as required by this chapter. 2. (a) No person may prepare asbestos abatement specifications unless trained and licensed as an asbestos consultant as required by this chapter. (b) Any person engaged in the business of asbestos surveys prior to October 1, 1987, who has been certified by the Department of Labor and Employment Security as a certified asbestos surveyor and who has complied with the training requirements of S.469.013(1)(b), may provide survey services as described in S. 255.553(1), (2) and (3). The Department of Labor and Employment Security may, by rule, establish violations, disciplinary procedures,and penalties for certified asbestos surveyors. 3. No person may conduct asbestos abatement work unless licensed by the department under this chapter as an asbestos contractor,except as otherwise provided in this chapter. I certify that I have read and understand and will comply with the provisions of this asbestos notification statement and that I will comply with all state and federal regulations pertaining to asbestos. License Holder/Contractor Signature Date rki I cpi ykt L )11 014 n Rt?' t License Holder/Contractor Printed Name Permit Number • 79U mA►►s S.mEfl i9r -P1 nC (3 14 , Ft-On A 3aa33 Address of Project Revised 4/22/15 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: ] '7CA m4-1 t4 S.T -&-s-) ��. a.3i Permit Number: /6-Poof—S 77 Legal Description Q- b g--i 01 vi-4 ?S 8th /?C_ Parcel# ; r ' -1 : _ S J Floor Area of Sq.Ft. Sq.Ft Valuation of Work $(4..1----- . Proposed Work heated/cooled 1) 1 h:?. non-heated/cooled %g ooe Class of Work(circle one): New Addition Alteration (Re ) Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial (—Residential-) If an existing structure,is a fire sprinkler system installed? (Circle one):— Yes No_- N/A Florida Product Approval# S re- co,-M For multiple products use product approval form Describe in detail the type of work to be performed: 'a--. D c." ,4� (LE :Lvc r Property Owner Information: 0 Name: f t ti _S 1=1.1x'1 04 Address: —1 9 i 41 City 4TLtAr-r r1L & rl State FLZip �Z 33 Phone q"O`//:10`t -(oocyo E-Mail or Fax#(Optional) Contractor Information: Company Name: 'c)9 Vt.- ©AVt.S 0 t-- N olvilA A..o,tc'A Qualifying Agent: Address:. -t l■ Lt b(-3"nT• STKeerr NOA.,n4 City J79(,1c:so+�.ti.14= State F(.4.:u0 P4-Zip 3c).')c6 Office Phoner'!o y/ 1 S- 1.70 l Job Site/Contact Number SD i/till - az 3 1 Fax# State Certification/Registration# C GC, /6.), ( r) S( ) (..:.--L 13A.c14. \ Architect Name&Phone# Engineer's Name&Phone# Amt b n..e- t_p f( -i 1 1.4")0)`t t ) ci Z y/LQ io - S")7 U 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 o.f 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 f6)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 ordinances governing this type o work will be complied with whether s.eci Ted 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 loca w regula '•: construction or the performance of construction. /. �. Signature of Owner ` Signature of Contractor C ` ,` ! Print Name &e ( C. S' ��J Print Name f''j..c}la e i Y`11 M+DI Sworn t9 and subs -'bed before me Sworn to and subscrib d before me this : I'D. Tof ,_. . ,20 /L.' this .6'i''')ay of `�,j i�1,� h __ ,2010 V / " ) "`"'' MELODY ANDREWS IRWIN 1l� '• MELODY ANDREWS IRWIN rg . ` / Y C� 6 ,r_, COMMISSION tt Notary Pu lie ,,'VA :; ' ____ ?:; Notary . ? EXPIRES October O7,2016 NOta P EXPIRES October 07,2016 ?a'` \' apt . .:,;r .t^O.Ot53 FtonrlalloaryServt�%e.corn x407}353-0153 FbndaNOtar 01.2.10 co D 7 a• D .0,0,f1.,k C fD v, N N O lD CO ■V CT, l,'i A W N F-� Q1 l!7 A W N N .x.� CO 6 < O -'—' , 3 v D n p = to . 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