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2303 FIDDLERS LN - POOL �f�1 CITY OF ATLANTIC BEACH .: r) 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 , :; q• y INSPECTION PHONE LINE 247-5814 SWIMMING POOL - SWIMMING POOL RESIDENTIAL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: 16-POOL-657-01 Description: REINSTATED 07/03/2017 Estimated Value: 15000 Issue Date: 4/8/2016 Expiration Date: 10/5/2016 PROPERTY ADDRESS: Address; 2303 FIDDLERS LN RE Number: 169463 0126 PROPERTY OWNER: Name: WILLIAM P J EBERT Address: 2303 FIDDLERS LAN ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: SURFSIDE POOLS Address; 313 BEACH BLVD QA JOHN CALVIN SCOTT III JACKSONVILLE BEACH, FL 32250 Phone: PERMIT INFORMATION: Please see attached conditions of approval WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU 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 RECORDING YOUR NOTICE OF COMMENCEMENT. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work,a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. %I.. ,10 CITY OF ATLANTIC BEACH . 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 = ► It SWIMMING POOL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-POOL-657 Job Type: SWIMMING POOL/SPA Description: NEW IN GROUND POOL Estimated Value: $15,000.00 Issue Date: 4/8/2016 Expiration Date: 10/5/2016 PROPERTY ADDRESS: Address: 2303 FIDDLERS LN RE Number: 169463-0126 PROPERTY OWNER: Name: EBERT, WILLIAM P J Address: 2303 FIDDLERS LAN GENERAL CONTRACTOR INFORMATION: Name: SURFSIDE POOLS Address: 313 BEACH BLVD QA JOHN CALVIN SCOTT III Phone: - - PERMIT INFORMATION: PUBLIC WORKS: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact Public Works(247-5834)for Erosion and Sediment Control Inspection prior to start of construction. All silt must remain on-site during construction. POOL-Wellpoint(if used) must discharge into vegetated area 10' minimum from street or drainage feature (swale, structure or lagoon). A separate pool permit is required. Roll off container company must be on City approved list and container cannot be placed on City Right- of-Way. (Approved: Advanced Disposal, Realco, Republic Services, Shappel's and Sunshine Recycling.) Full right-of-way restoration, including sod, is required. FEES: PLAN CHECK FEES $62.50 BUILDING PERMIT FEE $125.00 liokztre RC�A aeCCORDANCE6IbIj ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA .,,,,,..,, 4 „ f> CITY OF ATLANTIC BEACH s 800 SEMINOLE ROAD } , ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 STATE DBPR SURCHARGE $2.00 Total Payments: $191.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION FILE COPY CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax(904) 247-5845 I -Poo,- 57 Job Address: ?..303 F I cid) e.f 5 11■1 Permit Number: Legal Description 1-42- 1 O`�°ZS'Z°)E OC.f� 4fAJ< UH ri 'Parcel# Floor Area of Sq.Ft. q. t Valuation of Work$ 15000 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. Residential If an existing structure,is a fire sprinkler installed?system nstalled? (Circle 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: In-Ground Swimming Pool Property Owner Information: i Name: W I LU AM 41:,,i5..FIER.T. Address: 7 o�J i d 1 l n. City AT'LAn r i C. Stated„„Zip;321fL3- Phone Z'' I -999-7- E-Mail or Fax#(Optional) 4,i eb@d'- bcirc.1'h i-4ec-i-S : C.c)1Y”) Contractor Information: Company Name: Scotfam Inc. dba SurfSide Pools Qualifying Agent: John C. Scott III Address: 313 Beach Blvd. City Jacksonville Beach State FL Zip 32250 Office Phone 904-246-2666 Ext. #133_Job Site/Contact Number (904)246-3615 Fax# State Certification/Registration# CPCO -44080 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 f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod 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 certifil 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 of work will be complie with whether s,eci ied herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other feder , tate, r local 0 regulating construction or the performance of construction. Signature of Owner - 1,19, Signature of Contractor /�/ Print Name l L ' . Ezeirri Print Name Jo•. C. Scott III Sworn to and subscribed befes e me tt Sworn to and subscribed before me . this f7 Day of A61 , 20/Jb this ii Day of (•'I 1a(L c r I-I, ,20��o Notary PIZ No . P :1 . • ►�4► 1%Lt>2-i nP �'i' L4 RYAN K.LEHTONEN ���.��N.,,, RYAN K. ENT NEN ett;— : �� Notary Public-State of Florida ir`�, N otary public-State of Florida .•. y4 Revise 01.26.10 • �+. Commission N FF 915564 s Commission N FF 915564! My Comm.Expires Sep 3,2019 My Comm.Expires Sep 3,2019 a evo paedudtfi�tiongPUNyMan. `4'4 IU.dSOMrate Mond NotxyMMi. Pprmy # /6- foci- NOTICE OF COMMENCEMENT FILE COPY State of Florida Tax Folio No. I f.c)9 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 2-�J OF CO iTNCEMENT. Legal Description of property being improved: H 2-� ( " —2 LOT C, o �l Rlr \ rr 3 Address of property being improved: 2,- O 3 Fl i - L,� AT(_.IJTt 'le_ a�W General description of improvements: `Re. ..(mkt._t._ E.X�61 1 ( I/0 —()P()),-) Owner: \N J!a_.1 Al`1 ?s E.`13c.1C Address: O 3 '51 ci G iers Owner's interest in site of the improvement: Simple - FL I-l�.iT/ Fee Simple Titleholder(if other than owner): Name: PIMP oy: Contractor: Scotfam Inc.dba Surfside Pools John C. Scott III Address: 313 Beach Blvd.Jacksonville Beach FL.32250 Telephone No.: 904-246-2666 Ext.#133 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 OWNER r � if Signed: (, I �'� 'r Date: 1/1- Y Before me this da of AiLtki, ?olio in the Coufi o e uva State q�� Of Florida,has personally appeared �V it-..1 iv-A ?A:.-E-13eLALT. Notary Public at Large,State of Flori. f f-Duv: 4 My commission expires: --2p1 ' _..E,,( � 4.04/1d- �j/11■ MEI Produced Identification: Lc;0.1(J+q Z ' C,c i14( Doc#2016060204,OR BK 17495 Page 1512, ,,.a4�" 4,,y RYAN k.•LENTONEN - fir l 40 Number Pages:1 SW"�'\ Notary Public-State of Florida. Recorded 03/17/2016 at 01:45 PM, 1 s'� '• Commission i fF 91556 Ronnie Fussell CLERK CIRCUIT COURT DUVAL %T My Comm.Expires Sep 3,2019 COUNTY ";;S__ I ied drouptillationel Notary Assn. l RECORDING$10.00 016 Property Appraiser-Property Details Primary Site Address Official Record Book/Page • Tile# T WILLIAM P] 2303 FIDDLERS LN 06233-00022 9404 400 W ATLANTIC BEACH,FL 32233-4681 Atlantic Beach FL 32233 FILE COPY 2303 FIDDLERS LN Value Summary Property Detail 2015 Certified 2016 In Progress, RE# 169463-0126 Value Method LAMA CAMA Tax District Total Building Value $326,217.00 $338,652.00 0100 Property Use 0100 Single Family Extra Feature Value $12,512.00 $12,356.00 #of Buildings 1 Land Value(Market) $225,000.00 $225,000.00 For full legal description see Legal Desc. Land&Legal section below Land Value(Agric.4 $0.00 $0.00 Subdivision 04147 OCEANWALK UNIT 01 Just(Market)Value $563,729.00 $576,008.00 Total Area 11421 Assessed Value $404,104.00 $406,932.00 The sale of this property may result in higher property taxes.For more information go Cap DIff/Portability Amt $159,625.00/$0.00 $169,076.00/$0.00 to Save Our Homes and our Property Tax Estimator.'In Progress'property values, Exemptions $50,000.00 See below exemptions and other supporting information on this page are part of the working tax Taxable Value $354,104.00 See below roll and are subject to change.Certified values listed in the Value Summary are those certified in October,but may include any official changes made after certification Leam how the Property Appraiser's Office values property. +'1 Taxable Values and Exemptions—In Progress L---1 If there are no exemptions applicable to a taxing authority,the Taxable Value is the same as the Assessed Value listed above in the Value Summary box. County/Municipal Taxable Value SJRWMD/FIND Taxable Value School Taxable Value Assessed Value $406,932.00 Assessed Value $406,932.00 Assessed Value $406,932.00 Homestead(H)() -$25,000.00 Homestead(HX) -$25,000.00 Homestead(HX) -$25,000.00 Homestead Banding 196.031(1Xb)(HB) -$25,000.00 Homestead Banding 196.031(1Xb)(HB) -$25,000.00 Taxable Value $381,932.00 Taxable Value $356,932.00 Taxable Value $356,932.00 +-I Sales History Book/Page Sale Date Sale Price Deed Instrument Type Code Qualified/Unqualified Vacant/Improved __ ._._ 06233-00022 1 06233-00022 11/18/1986 $56,000.00 WD-Warranty Deed Unqualified Vacant 08997-00657 7/2/1998 $100.00 MS-Miscellaneous Unqualified Improved 12185-01315 11/9/2000 $100.00 QC-Quit Claim Unqualified Improved Extra Features' LN Feature Code Feature Description Bldg. Length Width Total Units Value 1 ._ FPPR7 Fireplace Prefab 1 0 0 2.00 $2,185.00 2 POLR3 Pool 1 0 0 1.00 $9,792.00 3 CVPR2 Covered Patio 1 12 12 144.00 $379.00 I + 9 Land&Legal i-=i Legal Land Land Land Land I LN Legal Description LN Code Use Description Zonin Front Depth Category Units Type Value °'",— – .-- ---.— 1 42-1044 -2S-29E 1 0190 RES POND LD 3-7 UNITS PER ARS 1 90.00 120.00 Common 1.00 Lot $225,000.00 2 OCEANWALK UNIT 1 AC 3 LOT 61 I Buildings i °1 Building 1 Building 1 Site Address Element Code Detail _ 2303 _RS LN Exterior Wall — �14 14 Wood Shingle Atlantic is Bea Beach FL 32233 Roof Struct 3 3 Gable or Hip -,«_,.—n, 4—,,-- , Building Type 0102-SFR 2 STORY Roofing Cover 3 3 Asph/Comp Shng r'"– -"1, r.'- ,--, Year Built 1990 Interior Wall 5 5 Drywall _, e_ L k,. FUA I Building Value $338,652.00 Int Flooring 12 12 Hardwood L ,,i, L I Int Flooring 14 14 Carpet Gross Heated Effective Heating Fuel 4 4 Electric Type Area Area A1ea Heating Type 4 4 Finished Open �0 �.m0 21 ���� Air Cond 3 3 Central Porch Finished Open 140 0 42 I Porch Element Code 1/2 http.//apps.coj.net/PAO_PropertySearch/Bask c/Detail.as px?R E=1694630126 3/1610,16 Property Appraiser-Property Details 4 tie Area 1808 1808 1808 Stories 2.000 Finished Open 96 0 29 I Bedrooms 4.000 I Porch I Baths 3.500 Finished upper 1931 1931 1834 Rooms/Units 1.000 I story 1 Fin Screened 104 0 36 Porch Finished upper 104 104 99 story 1 Finished Garage 550 0 275 Total 4803 3843 4144 2015 Notice of Proposed Property Taxes Notice RIM Notice)_ Taxing District Assessed Value Exemptions Taxable Value Last Year Proposed Rolled-back Gen Govt Beaches $404,104.00 $50,000.00 $354,104.00 $2,860.23 $2,886.37 $2,734.21 Public Schools:By State Law $404,104.00 $25,000.00 $379,104.00 $1,900.91 $1,845.86 $1,859.09 By Local Board $404,104.00 $25,000.00 $379,104.00 $845.02 $852.23 $826.45 FL Inland Navigation Dist. $404,104.00 $50,000.00 $354,104.00 $12.11 $12.22 $11.33 Atlantic Beach $404,104.00 $50,000.00 $354,104.00 $1,167.96 $1,178.64 $1,117.80 Water Mgmt Dist.SJRWMD $404,104.00 $50,000.00 $354,104.00 $111.02 $107.05 $107.05 Gen Gov Voted $404,104.00 $50,000.00 $354,104.00 $0.00 $0.00 $0.00 School Board Voted $404,104.00 $25,000.00 $379,104.00 $0.00 $0.00 $0.00 Urban Service Dist3 $404,104.00 $50,000.00 $354,104.00 $0.00 $0.00 $0.00 Totals $6,897.25 $6,882.37 $6,655.93 Just Value Assessed Value Exemptions Taxable Value Last Year $523,392.00 $400,897.00 $50,000.00 $350,897.00 Current Year $563,729.00 $404,104.00 $50,000.00 $354,104.00 2015 TRIM Property Record Card(PRC) This PRC reflects property details and values at the time of the original mailing of the Notices of Proposed Property Taxes(TRIM Notices) in August. Property Record Card(PRC) The PRC accessed below reflects property details and values at the time of Tax Roll Certification in October of the year listed. 2015 2014 •To obtain a historic Property Record Card(PRC)from the Property Appraiser's Office,submit your request here: i I More Information ontact Us I Parcel Tax Record I GIS Map I Mao this property on Goocile Maps I Oty Fees Record http://apps.coj.net/PAO_PropertySearchBasic/Detail.aspx?RE=1694630126 2/2 `.r- City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) = 800 Seminole Road Atlantic Beach, Florida 32233-5445 1G - t(�°c) - 7 Phone(904)247-5826 • Fax(904)247-5845 3/1(5 C ,r71 q• E-mail: building-dept @coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z 3O ( I DLE S L-N Department review required Yes No gu• .'.. Applicant: U RE S t c ?oc L S ��Ptanning &Zonin. ree Administrator Project: � ► M(y\k N(= Po Q L- _Public Work Public Utilities vubTic Safety Fire Services 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.k ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING d1 1 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 05/14/09 ?s="'1`1- City of Atlantic Beach APPLICATION NUMBER s3s t �' to Building Department RE{1' ���� 4 800 Seminole Road (To be assigned by the Building Department.) 416;- r Atlantic Beach, Florida 32233-5445 MAR 18 20i6 — Pop( —Phone(904)247-5826 • Fax(904)247-5845 .J;t !P E-mail: building-dept @coab.us BY: Date routed: 1 6Q City web-site: http://www.coab.us - APPLICATION REVIEW AND TRACKING FORM Property Address: 303 r- I (c3 DLCR Lt\? Department review required Yes No Built Applicant: (3 R(=S( PocLS `'Tanning &Zoning --Tre�St Project: • u lic Utilities blic Safety Fire Services 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 ON STATUS Reviewing Department First Review: Approved. (Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING ��� �� V2//e. Reviewed by: Date: TREE ADMIJV. Second Review: A roved as revised. ❑ pp ❑Denied. fie IC WORmments: • UBLIC����S P BLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 „ ,,��,� TREE & VEGETATION AFFIDAVIT ' City of Atlantic Beach , „ AP* Department of Community Development n„ ”- Planning&Zoning Division - 800 Seminole Road Atlantic Beach,FL 32233 ' ` ,F (P)904 247-5800 (F)904 247-5845 PERMIT# SECTION I-APPLICANT INFORMATION X Owner(s) E Legal Authorized Agent* NAME OF APPLICANT W I U-I A1-1 CBE P.T NAME OF COMPANY ADDRESS OF COMPANY PHONE CELL EMAIL CONTRACTOR CERTIFICATION NUMBER ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION II-SITE INFORMATION STREET ADDRESS OF PROPERTY 2-.30: ¶, d,ci I ec3 LAIC , ATC_P,NIT iC_ -BEAj1 .32233 If an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address. LEGAL DESCRIPTION y I O.1—ZS-'Z9E OC EAKAW L K LIN IT 1 LOT r 1 BLOCK SUBDIVISION REAL ESTATE NUMBER LOT OR PARCEL SIZE: SQ FT AC RESIDENTIAL X COMMERCIAL OTHER(SPECIFY) 1 affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation"of the Municipal Code of Ordinances for the City of Atlantic Beach,FL and/or I have participated in a pre-application meeting with the Administrator of those regulations. bse.u-ntly, I affi d that no regulated trees and no regulated vegetation will be damaged, destroyed and/or removed from the ab•ve- es 'bed or a Oent properties in con'unction with this project. I►_ !!....SAL. SIGNA V .F OWNER SIGNATURE OF OWNER � Signed and sworn before me on this 17 day of riARr,�,i , Zba ,by State of �J/O`AI Ii9 County of AU VA-L_ Identification verified: rl r i0A, 1JZP1J-P!3 Li C--el,S''C1 Oath sworn: ,Yes (— No �R N K.LEHTONEN .5i l:►' - ra ii New/P 'State 12 F1or ids' Notary Signature lif Ion•FF 915581 Sep 3'"19 q , <„ :, ISO, MAY My Commission expires: /3-� 0=A`- City of Atlantic Beach APPLICATION NUMBER 3i * Building Department • 800 Seminole Road (To be assigned by the Building Department.) 1 G Poot - (25�7 'ter Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 n 9' E-mail: building-dept @coab.us Date routed: 3/15//2j City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Pro p ert y Address: 303 I— 1 s Department rtment review required Yes No <7:Buildi • Applicant: U - S( • PO L s - arming &Zonir Tree Administrator Project: ►& N i L_ - . IC ”01-1,--v- - Public Utilities Public Safety Fire Services 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: $Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: � ,,,,�ll/�j Date: ,3/2i/i‘ TREE ADMIN. Second Review: as revised. nApp roved ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 05!14/09 NOTICE OF COMMENCEMENT State of Florida I r i County of Duval Tax Folio No. ! !O� ; I To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, the Florida Statutes,the following information is stated in this NOTICE OF COMMECEM NT .d m accordance with Section 713 of Legal Description of property being improved: 1--)2-•• Ler c, -°2-S-2q O .RrJ Ai,. qN Address of property being improved: 2 O F/ i - • Lr P T Li 1 a s�,fy L General description of improvements: ., j`, . L. � , �I ZZ33 1 v�tl • •6 L. Owner: I LL t kt ( ? �l ice © / ) ei' s- Address: �I`��./� ��c�/ Owner's interest in site of the improvement: Simple - L. 3ZZ-3� 'E Fee Simple Titleholder(if other than owner): - Name: 'Rap b1f; Contractor:_Scotfam Inc.dba Surfside Pools John C. Scott III Address: 313 Beach Blvd.Jacksonville Beach FL.32250 Telephone No.: 904-246-2666 Ext.#133 Fax No: Surety(if any) Address: Amount of Bond$ 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 OWNER 410, Signed: Ct� I ty1 ill 44 Date: /t7 Before me this day of 2p1,6 in the Couf� o uv. State Of Florida,has personally appeared tiV ILL.I PM Notary Public at Large,State of Florio.— • • Duv. 4 - My commission expires: 'P — Produced Identification: Le ; . W gribulbrilhrWilboArra-- __- . .•,",,,.44 RYAN IC.-LEHTONEN a • 0"(1 44 Doc it 2016060204,OR BK 17495 Page 1512, S iP� y Notary Public State of Florida. Number Pages:1 I Recorded 03/17/2016 at 01:45 PM, Comm Comm.Exp re 411 FF 915564 Ronnie Fussell CLERK CIRCUIT COURT DUVAL I My .Expires Sep 3,2019 COUNTY �g" ; Sanded tKOYgNatIOr1aI Notary Assn. RECORDING$10.00 ?s=ue` City of Atlantic Beach air z' Building Department APPLICATION NUMBER �'� \, 800 Seminole Road ���F�v (To be assigned by the Building Department) Atlantic Beach, Florida 32233-5445 AR 18 2016 1 G -�� - 7 Phone(904)247-5826 • Fax(904) 47-584o ..011 � E-mail: building-dept @coab.us Date routed: 3/1c5 /t City web-site: http://www.coab.us BY APPLICATION REVIEW AND TRACKING FORM Property Address: Z 3O ( I ,j I. t�LC(L'S � Department review required Yes No uilding Applicant: c O R Oc,L S arming &Zoning ra or Project: i t M, N GI P0 l___ �blic Works u is i i ies Vbc Safety Fire Services 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. El Denied. (Circle one.) Comments: 4■1(Area BUILDING PLANNING &ZONING Reviewed by: � Date: 312-3(4r 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 05/14/09