1671 BEACH AVE - INTERIOR REMODEL fCITY OF ATLANTIC BEACH
.\SSl
_ 800 SEMINOLE ROAD
J r: 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-1141
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR REMODEL
Estimated Value: $95,000.00
Issue Date: 5/19/2016
Expiration Date: 11/15/2016
PROPERTY ADDRESS:
Address: 1671 BEACH AVE
RE Number: 169658-0000
PROPERTY OWNER:
Name: GAY TRUST, SHIRLEY W
Address: 1671 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: BOSCO BUILDING CONTRACTORS
Address: 2158 MAYPORT RD QA TODD ALBERT BOSCO
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $230.00
BUILDING PERMIT FEE $460.00
STATE DCA SURCHARGE $6.90
STATE DBPR SURCHARGE $6.90
Total Payments: $703.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
rslayk City of Atlantic Beach APPLICATION NUMBER
s� Building Department (To be assigned by the Building Department.)
,. 800 Seminole Road• //
Atlantic Beach, Florida 32233-5445 b Co -R Pt RR-l1.4
Phone(904)247-5826 • Fax(904)247-5845 /
\os:!>'- E-mail: building-dept@coab.us Date routed: S 1 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: t G7 cc4-( I-4TC Department review required YveyNo
ildii.
Applicant: ('S CQ ' arming &Zoning
Tree Administrator
Project: N T�RI � - ' 'rt 0 Public Works
Public Utilities
Public Safety
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: ft/0+- 4-0 Ton n th r S p-e r m�4- s'4-a 's. 4/ e led r, -
ft t rr ';y5 Lucia 40 < dock€ (2xpecf'/Ao tatir^,
ILDING
PLANNING &ZONING Reviewed by: / r , Date:gi-S-V8-16
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
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: 1671 Beach Ave, Atlantic Beach, FL Permit Number: i G-rzitkaR--t (4 l
Legal Description 15-10 09-2S-29E .240-N ATLANTIC BEACH UNIT NO 1 PT Parcel# Lot 15
Floor Area of Sq.Ft. Sq.r't
Valuation of Work S '9O € 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 system installed? (Circle one). o N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: Interior renovation: Floors, electric, plumbing, painting, cabinets, tile bathroor
Property Owner Information:
Name: Adam &Jenice Dunayer Address: 3309 Caruth Blvd
City Dallas State TX Zip 75225 Phone
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: Bosco Building Contractors, Inc. Qualifying Agent: Todd A. Bosco
Address: 2158 Mayport Rd City Atlantic Beach State FL Zip 32233
Office Phone 904-241-0320 Job Site/Contact Number 904-241-0320 Fax# 904-241-0326
State Certification/Registration# CBC 1250212
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 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 ElectricalpWork, 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.
1 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 of work will be complied with whether s.eci ted herein or not. The granting of a permit does not presume to give author's to violate or cancel the
provisions of any other federal,s .,e, .r to : regulating construction or the performance of construction.
I , ,,aw
/ /
Signature of Owner J�IL� !� Signature of Contras �'+-
Print Name I ( 1. D✓V Print Name Todd A. Bosco
Sworn to and subsc '�b,,e,�d�beefore me Swo to and subscribed be ore me
this <<f Day of /. ""' , 20 / this 5 Day of t 1 ,20 IC
46A/Z4j
yNotal � ���� Nota ublic
Revised 01.26.10
,"Q:'d�o PEGGY LOUISE STOWERS
Denis'A.Ennis
e'
3= `= Notary Public,State of Texas .` NOTARY PUBLIC
•`, ?»; My Commission Expires STATE OF FLORIDA
�s�Fa:�•°� February 19, 2017 -�'.,,,: Cam*FF966426
Expires 3/1/2020
L9tOZ L l AVIS
�l AD 3 O ]
/ NOTICE OF COMMENCEMENT
Permit No._I(, gP fag•-)/C//
Tax Folio No.
State of Florida, County of Duval
OFFICE COPY
THE UNDERSIGNED hereby give notice that the improvement will be made to certain realro ei in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of property (legal description of property and address if available):
1671 Beach Ave, Atlantic Beach, FL - 15-10 09-2S-29E .240 - N ATLANTIC BEACH UNIT 1 PT LOT 15
2. General Description of improvements:
Interior Renovation
3. Owner Information:
a)Name and Address: Adam & Jenice Dunayer- 3309 Caruth Blvd, Dallas, TX 75225
b) Interest in property: General
c)Name and address of simple titleholder (if other than owner):
4. Contractor Information:
laa)Name and Address: Bosco Building Contractors, Inc. 2158 Mayport Rd, Atlantic Beach; FL 32233
b) Phone Number:(904) 241-0320
5. Surety Information:
a)Name and Address:
b) Phone Number:
c) Amount of Bond: $ jECEli1-
6. Lender Information:
a)Name and Address: , VAY I
b) Phone Number: 11
7. Person within the State of Florida designated by owner upon whom notices or other d
provided by 713.13 (1)(a) 7, Florida Statutes: I C L WAi lE 11
a)Name and Address:
b) Phone Numbers of Designated Person: MAY 1 7
8. In addition to himself/herself, Owner designates o toltece'
copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
a)Name and Address:
b) Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor, but will be one (1) year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR 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 COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under pen,4lty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein4' e to best of my knowledge and belief.
OA! 464/1/1, st "ii a yqf
Signature of Owner or Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The foregoing4..file-i
instrument was acknowledged before me this /4 L- day of f , 20 /& ,
by s lz,, as a-4vv�f for 4C1-0". f �^J-64' •
(Name f rson) (Type of Authority, i.e. Officer/Attorney) (Name of Party Instrument was Executed for)
4-
(c/'
�•'a"",,," PEGGY LOUISE STOWERS NOTARY P > L C, STATE OF X24 1-/Ac
..i-�a.., S,�w
'_°'�i�,'`�: Notary Public,StOte Ot TexosI
Pei
y
7i...'%-.� '14 My Commission Expires Print Name: -(7
-"7,;;;:).;.;;;;V< February 19, 2017
1Personally
Known
''•cc#20 6085787 OR 5K 17530 Page 1986, Identification'Type: t)'t- 4'S ,---44-e--z-z---e-,
'umber Pages:' V
Ref:::rded 04;+8P2Ot(i at 01:29 PM.
r2unnie Fusses; L.ER.K C;RCUlT COURT DUVAL Revised 3/15/12
COUNTY
nECORDiN( I+::00