848 OCEAN BLVD - ALTERATION , WOOD ROT S!r,'y,',e, .iti�� �- .‘ , CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
J
t � 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-595
Job Type: RESIDENTIAL ALTERATION
Description: wood rot at chimney
` Estimated Value: $6,580.00
Issue Date: 3/25/2016
Expiration Date: 9/21/2016
PROPERTY ADDRESS:
Address: 848 OCEAN BLVD
RE Number: 170340-0000
PROPERTY OWNER:
Name: STREIT, JILL &THOMAS J, *
Address: 848 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: MATHIEU BUILDERS
Address: 1778 OCEAN GROVE DR QA DUSTIN MATHIEU BROWN
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $41.45
BUILDING PERMIT FEE $82.90
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $128.35
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
1
L.A4,,. , City of Atlantic Beach APPLICATION NUMBER
r, 4 ' .o Building Department (To be assigned by the Building Department.)
Al ti 800 Seminole Road //„ _ Dq� _ JC ��
115 lEj Atlantic Beach, Florida 32233-5445 tWU IL�!
Phone(904)247-5826 • Fax(904)247-5845 �Q /
Jrt r.) E-mail: building-dept @coab.us Date routed: ((J
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: kg 4(: e Q-71 De• • • 1 ent review required Ye o
Building
Applicant: c )/ '`' 1 '- nmg &Zoning
Tree Administrator
Project: 4)ôôii ,4 ✓ 1S (?J)/ T)) h Public Works
Public Utilities
Public Safety
Fire Services
` j® ,o rs' fL a _ ..: P '
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: [oved. ❑Denied.
(Circle one.) Comments:
BUILD!
PLANNING &ZONING J/ l/
Reviewed by: f�,}� Date: 2�/ 6
TREE ADMIN. Second Review: Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH I,^ r"r -"*3*^ w, .„
800 Seminole Road, Atlantic Beach, FL 32233 k :V` ii I
Office (904)247-5826 Fax (904) 247-5845
Job Address: SY S 6'c earl 61 vc/ Permit Number: /6- MN-- S 9s
Legal Description/S--‘o /6'aS -a9E v.,� leir*ccA 51O PT Lai Er Parcel# /703`ie - aao a
6.o Floor Area of q.Ft. Sq.Ft
Valuation of Work$ 6�F0_ 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 ' ', -• 'al
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes 10 N /A
Florida Product Approval #
For multiple products use product approval form
D e s c r i b e in detail the type of work to be performed: /F e ,, , ,, t
I-A/inn t 51111111111111111111 1 1
Property Owner Information: 111111 'UR 0lUM N
Name: —Thom aS 51 ee t-/ Address: egg Q ce-art li .i
City
(co(coi%c- 13egc-h State 3z-E-35 Phone V L__ /\1I��(41) -nlil 1
E-Mail or Fax#(Optional)
Contractor Information: /
Company Name: Ma-/h feu b' aerS /tvc_ Qualifying Agent: I)d541 /bra&."4
Address: 3 8 W 9f11 Sf City /lf/q,71 - ac h State F---,-- Zip 3.2.1-33
Office Phone Job Site/Contact Number To 4. 1'13.36 6/ Fax#
State Certification/Registration# C-(3L 1Z 5 7 5 n
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 certi that no work or installation has commenced prior to the
issuance ofa 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 ElectricalWork,Plumbing,Signs, Wells, Pools, Furnaces,Boilers,Healers,
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 this application 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 granting of a permit does not presume to give authority to violate or cancel the
provisions of any other fed a, tate,or local law regulating construction or the performance of construction.
Signature of Owner G(,� Signature of Contracto --
Print Name 1( ( -371. t''' Print Name gig-
01114:.x.),. 6/t.--C.- .--------
Sworn to and subscribed before me S . . and sub ed •- • - m- /,
this /0 D of it,ch ,20/Le Al I/I Da o' ai// C/(.� 20 /
Notary Public ' 'u; i.
Revised 01.26.10
* • .. MY OMMIS IS ON#FF
t....,„7-41 EXPIRES:July 17,2018
Rf til Bonded Thru Notary Public linden/den
rrr ni.171 -# /6- R4 AR–– S-9 s- P r 7
I 11 am ins
NOTICE OF COMMENCEMENT
State of 1 l o Y t d r- Tax Folio No.
County of 17Lk v�l
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: /5— X00 /6' aS— 9
/4,-A /errec e. A s/D P7 La T g
Address of property being improved: .Y,/,s7 2( a /j/�� 4!/44L;c fje4 c,A ,i. 342.33
General description of improvements: 0 ea',r ,6 IT ec( W od LV prt c Lc i.-14,-i L .
Owner: 1-4#-.14 514r i Address: 1/Y l/Ceast ei✓(
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: fA;e u Ou i /c/e,r•s /I L
Address: 38 W 9 71-M ,S'f 47'/a,1, ;c e a c. !1 r 32-2.53
Telephone No.: 190/1 P/3 366/ 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 OWNE'
/
Signed: _._, J611" Date: 3/ /Lo
Before me IF I O' i. day of V i rc_h in thiCounty o Duval,State
Of Florida, i•s personally appeared I I .I 'Gail
Notary Public at Large,State of Florida,County of Duval.
commission ex.Tres:
Personally Known _ //_!ri or
. .eat' 'cation:
—t
0.44:„ ELISE FERNANDEZCASHMAN
e 762,
OR BK 17488 Page g+, •!� �+ MY COMMISSION•FF 120872
Doc#2016054r94, ;h., � ,: EXPIRES:July 17,2018
Number Pages:1 %fi pF F Bonded Thru Notary Public Underwnters
Recorded 03/10/2016 at 02:15 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING 510.00