2025 SEMINOLE #104 - SIDING AND TRIM fiI. '' S, CITY OF ATLANTIC BEACH
f si 800 SEMINOLE ROAD
t j ` '�� ` 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-1464
Job Type: RESIDENTIAL ALTERATION
Description: REPAIR AND REPLACE SHEATHING, MISC FRAMING , LAP
SIDING AND REPAIRS AROUND CHIMNEY
Estimated Value: $3,712.00
Issue Date: 7/5/2016
Expiration Date: 1/1/2017
PROPERTY ADDRESS:
Address: 2025 SEMINOLE RD 104
RE Number: 169723-0208
PROPERTY OWNER:
Name: COSBY, PATRICIA A
Address: 2025 SEMINOLE RD APT 104
GENERAL CONTRACTOR INFORMATION:
Name: LANG'S GENERAL CONTRACTING LLC
Address: 2201 SAWGRASS VILLAGE DR QA JOHN R. LANG
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $34.28
BUILDING PERMIT FEE $68.56
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $106.84
1'ERMII IS APPROVED ONLY IN ACCORDANCE \\'17'11 ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
,,:o.tvp.o City of Atlantic Beach APPLICATION NUMBER
;; , \\ Building Department
„� (To be assigned by the Building Department.)
rW 800 Seminole Road
• r) Atlantic Beach, Florida 32233-5445 I(p—RAR - l 464
- Phone(904)24,7-5826 • Fax(904)247-5845 /
��;09'r' L E-mail: buildin -de t coab.us /Z4 9 p Date routed: �O / f�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 2_0 : €LI-Y y F* /o4- Department review required Yryclo
:uildin•
Applicant: LA CE-kjGapt` CONT, _ -nning &Zoning
Tree Administrator
Project: eTh EIVE2.P L EPA( R Public Works
Public Utilities
Public Safety
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: roved. ❑Denied.
(Circle one.) Comments:
BUILDI
PLANNING &ZONING
Reviewed by: Date: 7-l •/6,
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 FILE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax (904) 247-5845
Job Address: 2025 Seminole Road#104 Permit Number: I -RPA -I4 wet
Legal Description 09-2S-29E North shore Condominium Dwelling Unit B-2 Parcel# 169723-0208
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$3,712 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Warr, Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial �: - '.- e '
If an existing structure,is a fire sprinkler system installed?(Circle one): .es MD N/A
Florida Product Approval# /7y 72.•1
For multiple products use product approval form
Describe in detail the type of work to be performed:
Pressure wash exterior forpainting
Paint 2 coats Sherwin Williams super paint
R&R approximately 121f band & cap trim on right wall
R&R approximately 12sf of lap siding on right wall
R&R garage door bucks
R&R approximately 4If band & captrim right of gars a door
R&R approximately 24sf of lap sidig right side of chimney
R&R approximately 12lf of chimney band & cap trim
R&R approximately 121f right side of chimney corner trim
k&R approximately 79sf of lap sidin from chimney face
R&R approximately 5sf of lap siding from back of chimney
k&R approximately 121f corner trim from back left corner
R&R approximately 161f band & cap trim from back left side
Pressure wash rear deck
R&R any damaged sheathing and or framing found behind siding& trim
Property Owner Information:
Name: Patricia Cosby Address: 2025 Seminole Road#104
City Atlantic Beach State FL Zip 32233 Phone
E-Mail or Fax#
(Optional)
Contractor Information:
Company Name: Lang's General Contracting&Renovation,LLC Qualifying Agent: John R.Lang
Address:13653 Macapa Road City Jacksonville State FL. Zip 32246
Office Phone 904-422-6690 Job Site/Contact Number 904-626-1962 Fax#na
State Certification/Registration#CGC 062543
Architect Name& Phone#na
Engineer's Name&Phone# na
Fee Simple Title Holder Name and Address na
Bonding Company Name and Address na
Mortgage Lender Name and Address na
Application is hereby made to obtain a permit to do the work and installations as indicated. I certifr 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 Electrical Work, 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 certify that I have read and examined this plication 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 ofa permit does not presume to give authority to violate or cancel the provisions
of any other federal,state,or lo law regulating construction or the pe rmance of construction.
Signature of Owner -J7c l (\CC Signature of Contracto Iii' // i�
Print Name 6./2 iG/ts _COS Print Name jeAA, X ,-,n/t/G• _
Sworn to and subscr' d before me // Swo ar . and subsc ibed before me
this r" Day ,20/lam this ayoik _ doge:,
• AII
•.P..1 Public XHIRAMIG `otary 'u. tc
COMIASSIONiFF Reed Ol.26.10
**'Pe
* EXPIRES:August11,2018
r gpgedThtuMew/Mks
_,,-ON. TONI GINDLESPERGER
,• MY COMMISSION i FF 924951
EXPIRES:October 6,2019
'4:0:v. Bonded TTru Notary Pubic Underwriters
NOTICE OF FILE COPY
Permit No. 6 - i9R-)y64/ COMMENCEMENT
Tax Folio No.
State of Florida, County of Duval
THE UNDERSIGNED.hereby give notice that the improvement will be made to certain real property
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencementty m.accordance with
1. Description of property(legal description of property and address if available):
09-2S-29-E North Shore Condominium Dwelling Unit B-2-2025 Seminole Road#104
2. General Description of improvements:
wood rot repair and painting
3. Owner Information:
a)Name and Address: Patricia Cosby 2025 Seminole Road#104, Atlantic Beach, FL. 32233
b)Interest in property:Residence
c)Name and address of simple titleholder(if other than owner):
'gfl 4. Contractor Information:
a)Name and Address: John R Lang 13653 Macapa Road, Jacksonville, FL.32246
fyb)Phone Number:904-422-6690
S. Surety Information: Doc#2016143099,OR BK 17608 Page 2402,
a)Name and Address: Number Pages:1
b).Phone'Number: Recorded 06/23/2016 at 09:39 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
c)Amount of Bond: $ COUNTY
6. Lender Information: RECORDING$10.00
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be:served as.
provided by 713.13 (1)(a)7,Florida Statutes:
a)Name and Address:
Pb)Phone Numbers of Designated Person:
8. In addition to himself7herself, Owner designates of to receive a
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
4 YOUR NOTICE OF COMMENCEMENT.
0 Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated
.-tl3er-:. ... true to the best of my kowledge and belief.
��J� 0 Al , acs- 6 A Patricia Cosby-owner
Si till ature of Owner or Owner's Authorize 'icer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The foregoing instrument was acknowledged before me this. day of v'� c ,2016 ,by
Patricia Cosby as owner for Patricia Cosby -
(Name of Person) (Type of Authority, i.e.Officer/Attorney) (Name of Party Instrument was Executed for) 0
NOTARY PUBLIC, STATE OF FLORIDA
STEVEN a HANNAN Print Name: S"t'ev-v_-. R. 14 ,1 n c..�
Notary Public,Stets of Florida
My Comm.Expires Jun.11,2017
Commission No.IT 26335 [Personally Known
❑ Identification/Type:
Revised 10/1/2010