1969 BEACH AVE - SIDING rL`1
. S ;rj
'. • ,'S, CITY OF ATLANTIC BEACH
' • A J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
SIDING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-SIDE-1706
Job Type: SIDING PERMIT
Description: install cementious panel siding over existing plywood
Estimated Value: $6,500.00
Issue Date: 8/1/2016
Expiration Date: 1/28/2017
PROPERTY ADDRESS:
Address: 1969 BEACH AVE
RE Number: 169698-0000
PROPERTY OWNER:
Name: GREIDER JR, JACK L
Address: 1969 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: ALL FLORIDA CUSTOM HOMES
Address: 10033 SAWGRASS DR #142 QA JOHN CLINTON
RAYMER
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $41.25
BUILDING PERMIT FEE $82.50
Total Payments: $123.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
. t
rs�-1�1jI�� Beach APPLICATION NUMBER
t �� BuildingCityofAtlantic Department (To be assigned by the Building Department.)
-_' .,
800 Seminole Road
"% � Atlantic Beach, Florida 32233-5445 I W ST .13 - -4-0(0
\ Phone (904)247-5826 • Fax(904)247-5845 -1
E-mail: building-dept@coab.us Date routed: 0 T (a 4 I (b
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 19 bP bt&&\ Ave.. D .4sP review required Yes No
a p N ( Building
Applicant: A 1‘• kof ;act SADrei itret,� S - anning &Zoning
Tree Administrator
Project: 5;Ili S-hn p ���WOOdi Public Works
J 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:
APPLICAT ON STATUS
Reviewing Department First Review: pproved. DDenied.
(Circle one.) Comments: OBUILDING /11)
PLANNING &ZONING ?� !�
Reviewed by: Date:
TREE ADMIN. Second Review: QApproved 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
f..-.:1 -1‘4%.rlie-
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OFFICE COPY
\ —
800 Seminole Road,Atlantic Beach FL 32233
-u;s12r 0\ Office:(904)247-5826 • Fax:(904)247-5845
M
Job Address: .3-C44:,-3-- a,a-c.(-i j) Permit Number: 10-SI-06- 11-O(o
Legal Description RE#
Valuation of Work(Replacement Cost)$ OjOf)s 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 tube removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: �.(ar�,� _ -Sc) (_c `%A 4 Fl,ain 19 63
I I 6,.-1,-7.P...1 1-,0,15-"" P L( C/ •-.% _ 5�/-- el
,,,,,„.):),...,
Florida Product Approval# FL- 1 Z2•Th for multiple products use product approval form
Property Owner Information
Name: ---1 ,.Jc. J.eA,Q.0 r Address: i 1. Ci -e Ff.,
City A--1 l l 9,,d, State ( Zip 3 Z1-3- Phone *9 3- 645
E-Mail l..( 0 L 1tey v"e N' lk-9 t - cv'1-
Owner or Ag t (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: -4.-411,
Name of Company: 411 I-io%,J4 eve. *hien ei Qualifyin Agent: X10�t H 1 fN 8./
Address: 10° 7)3 S ,r3 i'4-4S ,91 w tt/'tt- City (1V 1 . / State Zip 52o i-t.
Office Phone 9D y'- -22-0.0/8 Job Site/Contact Number 9)} ' S-3211—Y822,
State Certification/Registration# C&&(:)58.381-/- E-Mail of y mai---2Gt.)i (? Ph Stu • c d si.,
Architect Name& Phone# h
Engineer's Name&Phone#
Worker's Compensation /a 0(..4-1/ti. (-n sc ryze.e- ' — 5-- /7
Exempt / Insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. I cert fy that no work or installation has commenced
pnor 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.
if
This permit becomes null and void work is not commenced within six(6)months, or if construction or work i • , or abandoned or a
period six(6)months at any time after work is commenced. I understand that separate permits must be sec ire'for lectric, Work,Pluming,
Signs, Wells,Pools,Furnaces,Boilers,Heaters, s and Air Con, to ,etc.
/
, '
Signature of Property Owne • _ • Signature of Con
Before nie /^ -fesG
this 27"Day of J ci ' 1 l.' Before me this '2-1 Day : ' ,e. u 'ANN PICKERING
4o,0.j v PVBeic MARY ANN PICKERING ,.Y_ * MY COMMISSION 1t FF 948102
Notary Public: * •'Lir * MY COMMISSION#FF 948102 NotaryPublic: .. °1 _,s 4. ,
Notary EXPIRES:February 19,2020
0. dM -a< EXPIRES:Febtuoty 19.2020
ai FSO Bonded Tilly Budget Notary Servka
-fik. flop` goodmru Budget Notary UMW
•OFI hereby certib,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 federal, state, or local law regulating construction or the
performance of construction.
Rev.3/14/16
NOTICE OF COMMENCEMENT
State of 4-4//.04-//�4- County of Du Tax Folio No. /( 9 5,k J 0 006
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 CO NCEMENT.
Legal Description of property being improved: 15 057 q-as—€
z.‘"/s 35 y' <. d !2 ic.e4 4 v/ ' &S bg38- 4711/ibp
Address of property being improved: /9(.5 4ea c G. 14i1 770
General description of improvements: �i,.,4 z � rz�rt rt.�/ 5,,r7'j-�
Owner: ' 1-C tae fir' Address:
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name: -�-
Cont actor: A- (/ 4 ei,Aw- w
i'A� Address: /Do v 2, 4cc``f�i,.m /a, W /V2.-
VTelephone No.: p(� 2—CD/Y Fax No: 9DY7
Sur (72.-9
ty(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 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
enPrifiar11•
Doc#2016173321.OR BK 17651 Page 403,
Number Pages:1 I OWNER
Recorded 07 28.2016 at 10.50 AM. /
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
• /
Signed` — + Date: Y% l/
COUNTY •
Bef' e me is 11-K day of ' �?�( in theoun Cof uval,State
RECORDING$10.00 �'
0 Florida,has personally appe d
Rvu�, Personally Known: or
2o60.0.,a,e MARYANN PICKERING Produced Identification: �/
* z� * MY COMMISSION#FF 9481tRotary Public: CIO l J Y..'c4� !'
9 o* EXPIRES:February 19,202(k,1y commission expires: 2�—
jF0F.fu ` Bonded lira Budget Ndary Serowe