212 MAGNOLIA ST - SHED SyL, r
jr,
:S lie, CITY OF ATLANTIC BEACH
A ) 800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
SHED PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-SHED-731
Job Type: SHED PERMIT
Description: shed 9x10
Estimated Value: $4,100.00
Issue Date: 4/5/2016
Expiration Date: 10/2/2016
PROPERTY ADDRESS:
Address: 212 MAGNOLIA ST
RE Number: 170538-0000
PROPERTY OWNER:
Name: DALCERNO, RICHARD J & SUSANNE, *
Address: 212 MAGNOLIA ST
GENERAL CONTRACTOR INFORMATION:
Name: JUSTIN LARSEN CONSTRUCTION INC
Address: PO BOX 1942 LIC # BELOW 4 GERALD GOLLOBIT
Phone: 904-327-4311
PERMIT INFORMATION: PUBLIC WORKS: UTILITY DEPT.:
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.
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.)
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible.
A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1
concrete box with metal lid. Cleanout to be set to grade and visible.
FEES:
ENG REV RESIDENTIAL BLD $100.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
0 LAltri„
� CITY OF ATLANTIC BEACH
;., ii s 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
PLAN CHECK FEES $35.25
Total Payments: $139.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
. b.C 811\7ED
JS
,,:o-uptif City of Atlantic Beach
MAR � $ 2016 APPLICATION NUMBER
Building Department + (To be assigned by the Building Department.)
k A� 800-Seminote Road
-sha
u� Atlantic Beach, Florida 32233-5445 i a
Phone(904)247-5826 • Fax(904)247-5845��`"-°""'"°"- /�
'!0100 E-mail: building-dept @coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: a/a rna 9 A/a 1/4 A Department review required Yes No
jitcS4-in L�J�I�� s• Z g
Applicant: -.. ��
Tre- I.iiinistrator
Project: _ Public Wo
u lic Utilities
Public a e y
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:
APPL ATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: 3/'; //(,
TREE ADMIN. Second Review: Approved as revised. ❑Denied.
�IC WOR r4. Corn ents:
r 'UBLIC UTILITIES
Z /to
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
•
City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Buildin De artment.)
1 i>1 r� X00 Semmote-Road - ------ -- --- --- j � /
�r Atlantic Beach, Florida 32233-5445 ��G!CJ ��/
Phone(904)247-5826 • Fax(904)247-5845 �j�j�
n 9 E-mail: building-dept @coab.us Date routed: a
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: aka rna 9 �4 C/ L De•artment review required Yes No
Applicant: jit64-in i -' i
'' ^^ Tre- _•18 inistrator _-
Project: ___ 5ill � Public Wo
Public a e y
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:
BUILDING
PLANNING &ZONING Reviewed by:��.s � �/�---� Date: 3f3y/1
TREE ADMIN. Second Review:
'Approved as revised. I '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
. 'r
s_;a,yfl� City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
Dr. 7. ' 1
\`� 800 Seminole Road �+-��--�.�.•l�ED l6 �h col-
�, Atlantic Beach, Florida 32233- 45 l
Phone (904)247-5826 • Fax( 04)24 84,1 8 2016 J 1 r //-
�c s "0 E-mail: building-dept @coab.0 Date routed: d U/
City web-site: http://www.coab a • ,
APPLICATION REVIEW AND TRACKING FORM
Property Address: c;'24a /774 9 do 114 Department review required Yes No
Jikfri-in l :u• t;Ao,Applicant: + ' _.'.'. :. '' g
1� Tre- :•is inistrator
Project: Public Wo .
Oa. . Utilities
Public a ety
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: Approved. ['Denied.
(Circle one.) Comments: du Ihrie(i/J 6014✓
BUILDING
PLANNING &ZONING Reviewed by: ate: J- 9'- /�
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
y,,,,rl TREE & VEGETATION AFFIDAVIT
is r City of Atlantic Beach
+ ��sf1 City
r Department of Community Development
U Planning&Zoning Division
800 Seminole Road Atlantic Beach,FL 32233 app)
��1�0'� �� (P)904 247-5800 (F)904 247-5845 PERMIT#
SECTION I-APPLICANT INFORMATION altsh,.. ...v.r Owner(s) r Legal Authorized Agent*
NAME OF APPLICANT J L�a r / J L_a o,,,
rr
NAME OF COMPANY ,��
ADDRESS OF COMPANY f67O #+4. (f/' /'�"!/�I �.i�l' ?Jaffee
PHONE goy-fJa7 // CELL ------- EMAIL ,--
CONTRACTOR CERTIFICATION NUMBER at /o259833
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION II-SITE INFORMATION
STREET ADDRESS OF PROPERTY yfol f1 m/0. ,#L6 d.,.,,Lf/� 3 33
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 J57 500 3F�e ' / 34,0#4'',-
LOT BLOCK SUBDIVISION
REAL ESTATE NUMBER LOT OR PARCEL SIZE: SQ FT AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
1 affirm that 1 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. Subsequently, I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
from the above-described or adjacent properties in conjunction with this project.
s --9A-P .'—'74--1-4 ,(_.t—
GNATURE OF OWNER SIGNATURE OF OWNER
Signed and sworn before me on this day of , ,by State of
County of
Identification verified:
Oath sworn: r Yes E No
Notary Signature
REV-TVA-v10.12 My Commission expires:
--at42 Aro%et-fir-4ot 16 -fA(a� 2///
Go¢'
100. 4-f k -j'0 .rte
AdapttivA lq,/ X II/ 76 /9J7
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triae4r21,3,)c
leNtwadeta /0 k bo 60
� /4v
NOTICE OF COMMENCEMENT
State of // County of Tax Folio No.
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: 4)7_ )O 5'0 j I ///4 -
Address of property being improved: 62/a it,e51. 5
General description of improvements: Sit", Q'
Sijkt Z tr-ro
Owner: Address: _ 33
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):•
Name:
;l78r7?,,)ZC7
Contractor: i:51 K n o, o p
Address: /67d A /Ad (�f /17,4 /G� p ,.G °— o
v �/ b`dlD� � m W m
Telephone No.: ,Qy—At/Ad Fax No: ;, P N ai
Surety(if any) o '
0
Address: Amount of Bond$ - 7:7
o
Telephone No: Fax No: 0D u;
D
Name and address of any person making a loan for the construction of the improvements o ��
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 joa
20/6
Signed: Date:`)
Before me this day of i7707-‘4, JO/b in the County of Duval,State
Of Florida,hasp rsonally appeared
Personally Known or
Produced Identif Lion:,
'�4c DAVID 404.1144' ���.
V pees: 4y„
V. � ::!.!MISSION�ffpf021
'IRE S November a.301 IEOliEc lN1 •
N07) wMa.+NaaryMrrlorrin L40,01 i:. :i-.
/ f435O ?I . _
BUtDING RERIIT APPLICATIOV J S°
-' ' CITY OF ATLANTIC BEACH
J
800 Seminole Road,Atlantic Beach FL 32233
��°';i.9r- Office: (904)247-5826 • Fax:(904)247- 845
Job Address: c Ape)-A_ c5 4/�4. � V,, Permit Number:
Legal Description N RE#
Valuation of Work(Replacement Cost) $ y/OTC Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool 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
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: 0
Sy
Florida Product Approval# for multiple products use product approval fonn
Property Owner Information
Name: 504,1- `'p.icuarsi L Ce-rc Address:
City .,,/,, 4 State/2_Zip,M/33 Phone
E-Mai
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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.
Contractor Information:
Name of Company: TSu`&I ,pj� Qualifying Agent: Jt Lc&rae .
Address: //b76 ! / c" City /f�0)te
q r � y� State Zip � 3�r�?,p•
Office Phone !0.J,L) �./�f/� Job Site/Contact Number S,7"-le/ , f0/
State Certification/Registration# Cdc /759833 E-Mail '3 I arse rl-c.;,\ 42-,,, ,,e)
Architect Name & Phone#
Engineer's Name &Phone#
Worker's Compensation
Exempt / Insurer / Lease Employees / Expiration Date
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 susaende or abando,- jor a
period of six(6)months at any time after work is commenced. I understand that separate permits must be secured for -.41'1 Wor , 'lu bing,
Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks a d Co itioner, tc.
0 .00.'
Signature of Property Owner: Signature
Befg�e e / g e of Contractor
this Day of A� 0 v Before me this �y ►,ay of /4,-/ j-19f4
Notary Public: . , • _!' "" .. i., t i'• , -. • , _ • Notary Public: w ��
r' I:�1h1iSSIQN#FF935021 +•i! (:;)•,N,,c•SSION N FF935021
I hereby certify that.'�'t.?., ad and�eefctq dotkA ypp fgton and know the same to be true •., %ct. Atit t-t9u4 •eg)i g ,
ordinances governii _, '�;,r,ypg o w ray .rte ie luth whether specified herein or a& '•: -antic • • e.- , es no
presume to give aut'. • • • • • - • - _ : s of any other federal, state, or loca n i. i',;t . • • s
performance of construction.
Rev. 3/14/16
U r �rt} p OFFICE COPY
NOCE State of `/ County of Lvt.nia.k
Tax Folio No.
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
Address of property being improved: 02/g rtedk. Si-
'
General description of improvements: j 6' S. F'
enro
Owner: /), Address: p /,
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):•
Name:
MO7JXZO
Contractor: 7-47,154t.
Address: y�p7 /-1,,,t4,..,/4 ' rG o L a ^='
�� T o
�
Telephone No.: 'if- X W� o
7-93I Fax No: -
o
°
Surety(if any) $
Address: Amount of Bond$ o, c'
no
Telephone No: Fax No: C
D
Name and address of any person making a loan for the construction of the improvements o �
o
Name:
po
Address: o
Phone No: Fax No:
Name of person within the State of Floriei, 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 R a/e 7
Signed: �' /
Date:v`� -�
Before me this � day of /f7 4 02,0/b in the County of Duval,State
Of Florida,has p sonally appeared
Personally Kno
Produced Identi tion: or dr_
Jr` DAVID N � Tu• 11L�" ano c :o�cttori
t CYO S$1001 OFF/NOV
� es: �•�
'IRmller Olr.201Y tLOSe,. ��• UV
ES wow
4n.,.,na,ry�«vera� dj010 :;- ']'itb0
fF935cam?I ._�
TREE & VEGETATION AFFIDAVIT OFFICE COPY
I- I , i,, City of Atlantic Beach
4k c Department of Community Development
Dv": : "f Planning&Zoning Division
800 Seminole Road Atlantic Beach,FL 32233
(P)904 247-5800 (F)904 247-5845 PERMIT# �6--Sn.4- 731
SECTION I-APPLICANT INFORMATION fl Owner(s) f Legal Authorized Agent*
NAME OF APPLICANT 1 A. 6A,S1/14.47 .`k& / c/ _7:� L tt
t n J
re-
NAME OF COMPANY
ADDRESS OF COMPANY y6,o 144a_ 5 �44, 3 e
PHONE CELL�,�
Spy-O527 EMAIL ,--__
CONTRACTOR CERTIFICATION NUMBER ac /o269833
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION II-SITE INFORMATION
STREET ADDRESS OF PROPERTY j4Q �d0n0. A4 4d. q 3,2.233
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 , r 500 ,S / JcNT Ike
LOT BLOCK SUBDIVISION
REAL ESTATE NUMBER LOT OR PARCEL SIZE: SQ FT AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
I 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. Subsequently, I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
from the above-described or adjacent properties in conjunction with this project.
s '..-2-.A.--'74--AKnet..--
GNATURE OF OWNER SIGNATURE OF OWNER
Signed and sworn before me on this day of , ,by State of
County of
Identification verified:
Oath sworn: r- Yes r- No
Notary Signature
REV-TVA-v10.12 My Commission expires:
. °.j-r;yJ City of Atlantic Beach APPLICATION NUMBER
�S Building Department (To be assigned by the Buildin Department.)
r --1-"' 800 Seminole Road _ —76Acd 9 Y 9 p Atlantic Beach, Florida 32233-5445 7� r
Phone(904)247-5826 • Fax(904)247-5845
''''40.2''''40.21,Y1-' E-mail: building-dept @coab.us Date routed: a Z /Q
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: aka /7)4 9 WO 114 De•artment review required YrNo
:u• • •,.. •Applicant: n LifiSid g
�� _ Tre- A.•Iinistrator
Project: Public Wo .
'u• .c Utilities
Public a e y
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
I Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: 1 proved. 5•4-0-/I f t ❑Denied.
(Circle one.) Comments: Value !l crl- a ed G n Of PPl i c . 1-,OY∎ ,�y�J.�,l..
BUILDING. '''� ���
PLANNING &ZONING
Reviewed by: Date:3744 0
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
MAP SHOWING BOUNDARY SURVEY OF
LOT 500, PLAT OF SECTION NO. 1 SALTAIR, AS RECORDED IN PLAT BOOK 10, PAGE 8.
OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
RICHARD DALCERO
■ FIRST NATIONWIDE
PONTE VEDRA TITLE/RICHARD G. HATHWAY, P.A. Copy COMMONWEALTH LAND AMERICA
LOT 488
50.00' (PLAT)
N 29'51'04" E x OFFICE COPY
FOUND 1/2• IRON PIPE X I 50.00' (MEASURED) FOUND t/2• IRON I'VE
NO tOENTIFICATION O•/0.9• c19' 0 NO IDENTIFICATION
-x x--- +-x x X x x-
LOT 500 "
I • . '
S I r p
1i' ' W
25.2*
I (1::i ,_.,.
a w 3� LJ a
a M f o.a1, •y n
`�
A 5.4',
00 TWO STORY e
r) 00
d O FRAME 00 o
LOT 501 ^ O x n POSTED # 212 LOT 499
I ~ W
x x O_p COVERED • c 1 .z
11,4 0
r I ENTRY b•
P >K I in ; 'I O
Z I%\ I X m r
.4• 12.7 PLANTERS•1 x x-
APPROVED 1 J i i
// •
a
o0
(,V 41flflC/ ( S 29'19'00• w
/ ! 49.98' NCASORED)
/y �1.. FOUND 1/2' RCM PIPE r n iOID 1/2�IRON PWE �O
3!�!/✓ V0 NO I I/2. CM PI S 29'53 44 W NO OENftiICAPON FOUi+O RO• PIPE
7Y, STAUPEO 'FRAN NELPER'
50.00' (MEASURED)
50.00' (PLAT) MAGNOLIA STREET
(50.0' RIGHT OF WAY)
NOTES ACCEPTED BY:
LEGEND:
R — RADIUS —x— ° FENCE
L = LENGTH E) - CONCRETE
NOTES: I REVISIONS
T. BEARINGS ARE BASED ON THE _ASSUMED _ BEARING OF __N 60'0000' W ALONG THE
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