1750 SELVA MARINA DR - INTERIOR REMODEL /
t \s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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-1733
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR REMODEL , KITCHEN & BATH - REPLACE
SIDING
Estimated Value: $50,000.00
Issue Date: 8/12/2016
Expiration Date: 2/8/2017
PROPERTY ADDRESS:
Address: 1750 SELVA MARINA DR
RE Number: 172008-0000
PROPERTY OWNER:
Name: ONDREJICKA, JOHN A
Address: 1750 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: NORTH FLORIDA COASTLINE
Address: 546 BLACKFIN CT DAVID R LAW
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $150.00
BUILDING PERMIT FEE $300.00
STATE DCA SURCHARGE $4.50
STATE DBPR SURCHARGE $4.50
WORK W/O PERMIT BUILDING $300.00
Total Payments: $759.00
I'ER'I11 IS :U'PROVI:I) ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
5 Lvi•1� City of Atlantic Beach APPLICATION NUMBER
�s
.-41.
-f• . \ Building Department (To be assigned by the Building Department.)
800 eaRoadj4 Atlantic Beach, Florida 32233-5445 I ( `R^kR_ 1 / 33
Phone (904)247-5826 • Fax(904)247-5845
!Jr;19'e E-mail: building-dept@coab.us Date routed: (c
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
02
Property Address: 75O SELVA ty\ 2NA Departme
nt review required Yo
Buildi
Applicant: 10R,16-1 —( A
Hing
Tree Administrator
Project: \ -(E-k) apty, gGykopEC.- Public Works
Public Utilities
(0 ( 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: jVctl-
PLANNING
&ZONING Reviewed by: Date: I�
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
OFFICE COPY
�1`,,,'�'f� BUILDING PERMIT APPLICATION
JS
ts1
r CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
iter Office:(904)247-5826 • Fax: (904)247-5845
Job Address: 50 , I. Ai i ' ~1 I.. I it / Permit Number:
um
Legal Description _ .�iit� 1 C _ 1 /: r /' E# ' Vic!1 g�Co
Valuation of Work(Replacement Cost)$_c"?/00"N Heated/Cooled SF 900- Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteratio Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one . ommercial esidentia .-___-- •
• If an existing structure,is a fire sprinkler system installed?(Circle one): Ye 'o IV-LAY
■ Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: k.+4,,..„ Je e 1 , Be,-+1..Yt�.•y-., Pe J' (
ReplAA1 A! ('GI,'n DP x(/07 , A./A-/' ;74) / u$e /vf' gAvieE 4,e S:%s
Florida Product A proval# I I ()).(4 ., t" ' r 4.!f for multiple products use product approval forni
Property Owner Information
Name: MAW-4- ZDvcAotjts4ez Address: 1-150 S L Vid. Mlto(N4 Ott)ii(*,
CitytTtti,rf i Q, 13104.444,t. State$IZip 3u-33 Phone goZ t-4.4 2÷, p r',
E-Mail PM 3:45 0c-&t4.✓t� e &MAUL-CPA I } U
L.
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required) LI 1
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE CF I1 iIMiV�P,Neb9vI 1fT
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PRO; RTY. IF YOU INT' . 1
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A ..." ' . ' -
RECORDING YOUR NOTICE OF COMMENCEMENT.
Contractor Information: tichOh 151C--7: .
Name of Comany: 4/04- 17dO IAApl( • (2I1Qualifying Agent: t�c�,tilc1 Ly,j
Address: 6 L a C - City _ ,_ . „,, , State Zi. 39925
Office Phone -- ..41t i J b 1 / ontact Numbe . i
State Certification/Registration# �i
NOTICE OF COMMENCEMENT `
State of F7()(`/JO County of D.,AfrAI Tax Folio No. I /? CJg'oc O
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 ated in th' NOT F C 142E NT.
Legal Description of property being improved: `� 75 1 � ✓� �nom, ( ) ��
ru-, lJn�
Address of property being improved: I 95.0 cJ Ailincca)f
General description of improvements: I yr i??r G�'JA O ) I 4 I C Y' Qvi CCj hed-A
pfo5 ((ace to ,dr
Owner: A0,--1.-__, . a 5v less:less: �f 1►
Owner's interest in site of the improvement: n("[ f $ j c
Fee Simple Titleholder(if other than owner): Al7
Name:
Contractor: �d( O -- I ae_ C.016-1-67% `CI A
Address: 5 N \11 C-(-- Q c , n o (l! ,S�
Telephone No.: 04—7[(4,- 73 9 Fax No:
Surety(if any) Ni/�
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improv(
Doc#2016187143,OR BK 17671 Page 14.43,
Name: 11/ Number Pages:1
Recorded 08/12/2016 at 03:10 PM,
Address: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Phone No: Fax No: RECORDING$10.00
Name of person within the State of lorida,other than himself; designated by of _
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)(6),Florida Statues. (Fill ' at Owner's option)
Name:
Address: (V/
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
Signed: 1 / 4.0.,40- / Date: D//Z �4N
Before hi i.y of ;, ft in the ounty o uval, ate
• •.. . onally appear A .. r . it 1 J a ite I
Personally Kno, • ( p,Yt- or
'ro 1 uce 1 Identificati�� 1
Notary Public: # -, i �y�_/�y/�
My commission .(res: / i1
t
4.4;1";% LAUREN LAUREN DELLINGER
.1•( II' • MY COMMISSION #FF077124
1i'?.... •. EXPIRES December 17,2017
j7)398.0153 FloridallotaryService.com