1853 SEA OAKTS DR - INTERIOR REMODEL 4 CITY OF ATLANTIC BEACH
, s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
r ,3 s'
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RAAR-792
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR REMODEL
Estimated Value: $65,000.00
Issue Date: 4/6/2016
Expiration Date: 10/3/2016
PROPERTY ADDRESS:
Address: 1853 SEA OATS DR
RE Number: 172020-0542
PROPERTY OWNER:
Name: LYON, MARIA J
Address: 108 TROON POINT LN
GENERAL CONTRACTOR INFORMATION:
Name: FGC,INC
Address: 3787 PALM VALLEY RD GLENN AMERSON
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $170.00
BUILDING PERMIT FEE $340.00
STATE DCA SURCHARGE $5.10
STATE DBPR SURCHARGE $5.10
Total Payments: $520.20
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
• � Building Department (To be assigned by the Building Department.)
4 , j 800 Seminole Road ' ** : C _ 9Z
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
o• E-mail: building-dept @coab.us Date routed: A 5 lG
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 8S3 SEA C3 -
Q ent review required YeV
o
Applicant: F��C ( me_ Br
&Zoning
Tree Administrator
Project: ', ICERI,O R REA\n 6 c,L Public Works
Public Utilities
Public Safety
Fire Services
"!.•tgy+ $('^ '3$
t`.i *' Lid"sd-. ,v... ti-,s....� ...a, b..,..,a 3 L�,,.S,il...i
Other Agency Review or Permit Required Review Receipt Date
of Permit or 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: 1 proved. ['Denied.
(Circle one.) Comments:
CM---717111
PLANNING &ZONING Reviewed by: ri7 Date: 11'5'/6
TREE ADMIN. Second Review: ['Approved as revised. ❑Denie
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 OPT
800 Seminole Road,Atlantic Beach, FL 32233 FILE C/
Office (904)247-5826 Fax(904)247-5845
Job Address: I$63 SEA DAers R . / 2#2-3 Permit Number: J -MAR "79 g.
t ` 1?Zo2O - 0s42
Legal Description 1(o-21) OQ^2$•29�� WH J�t� I.ar21 Parcel#
Floor ea of Sq.Ft. ,
Valuation of Work$ Wt?K Proposed Work heated/cooled $OO otk-Cnon-heated/cooled
Class of Work(circle one): New , Addition Alteration epair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial
i
If an existing structure,is a fire sprinkler system installed?(Circle one): es No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: NEW Fop 9.1,a t v?C ziG �t.TeR C4-L. o••t�
i
Qw M Pass is ;-A.1-,d2. u E N PA-I..t r
Property Owner Information:
Name: LXo N M/art t A- 'S Address: 10$ T12001.-1 Poi 1.MT 1-14.
City Qn,cc V Ri b-e44— State FA-Zip 137/R2.., Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: f C 1 .1-14c- • Qualifying,Agpnt: 6(04i..I /471‘II:R4Dni
Address:239-13 At A l . 4i 1109 City awret ago Fvfisrki— State Pi,. Zip 52o92.-
Office Phone(o) 53'1'323(p Job Site/Contact NumbertAimaf,ikiO4W-1923 Fax#
State Certification/Registration# GCzL tcoto23k
Architect Name&Phone# N fq4i
Engineer's Name&Phone# 14 /P
Fee Simple Title Holder Name and Address 34 /,L,
Bonding Company Name and Address N A
Mortgage Lender Name and Address N ,Ac
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 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 certify that I have read and examined this cpplication 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 spec d herein or not. The granting of a permit does not presume to give authority to ''elate or cancel the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
1.41.--._ , aj
Signature •+ Owner )e. 0 \i - Signature of Contractor /
. i_
CI LeXit4 4nl 1 4Oi t
Print Name � J% _• �C��.+ii.� Print Name
Sworn to and subscribed before one Sworn to and subsc '•ed before me
th' 3 1 Day of t Y C ,20 1 (p this . Day of :u.t •201(.9
:71((2--Notary Public No'rip„A 74. 7., A'r.
' Note Public Stale d Florida Notary Public-State of Florida
Dennis A van Deusen ► "My Comm.Expires SIMON%..i 11.26.10
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Notary F 1 „'s--�- Commission al FF 158568
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Pe r m f V `6r IP AAte— 29.1.
NOTICE OF COMMENCEMENT
FILE COPY
State of 6.0R.Ida Tax Folio No. 11 iO •0- O S I-I 2
County of 12)v VA.t.--
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: 90-2o o9-2S-29 E Sew*.MAAZIN A\'WIT q POT 2.1 t
Address of property being improved: 1 2)3 SEA aws DA. 4Ttpiric 1 z4 Pt 32233
General description of improvements: Z141111R R. REMDe t_.
Owner: -Y014 AnAgAA 3' Address:%O',TA:Dl i[oidT L. POKTeVeiR460141 FL 32012
Owner's interest in site of the improvement: I 0011'
Fee Simple Titleholder(if other than owner): N /A
Name:
Vontractor: F4C.t IU C • / Erutwi.iPirivrit Sto4
tA
Address: t3SD-U 3 A 1A 14. *WI b`I ?orcre Y ERA tract.s. ft, 1-2,,2,2_
Telephone No.: (Q0Lf) 537'323 tp Fax No:
Surety(if any) N /A
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of an person making a loan for the construction of the improvements
Name: N A
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
E
served: Name: ONI4 An%kP2$ '.4 O /�
Address: -13 Mkt k kl.' t iD t 1 t It:` lrA QA j 2 7-og2-
Telephone No: (4°4) s31 -323 tp 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):
Doc#2016074092,OR BK 17513 Page 2412,
Number Pages:1 -� b
Recorded 04/04/2016 at 01:27 PM, I1� t� 3 ' / '_a�'j
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Signed:70 I" .. L''"--- Date: ve
COUNTY Before me this St.,+ day of ,nilar c.k 1 the County of Duval,State
RECORDING$10.00 Of Florida,has personally appeared 1 roc, L L. b 1. Iii k 4-a,4--
Notary Public at Large,State of Flpp da,County of Duval.
My commission expires: Q�/1I4D..e 1'7
'ersonally Known: or
„01' Notary Public State of Florida roduced Identification: Fa.-1:>16,
�; Dennis A Van Deusen /J
ass, My Commission FF 010846 � � (/
"oaf fl Expires 06/14/2017 `b