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1390 ROSE ST - VOID PORCH & GAZEBO 0-lvir,, City of Atlantic Beach APPLICATION NUMBER 64 . J` 1 Building Department (To be assigned by the Building Department.) tr,,y 800 Seminole Road 1�u - -, Atlantic Beach, Florida 32233-5445 I G -R A p R- 4 308 \ , - Phone(904)247-5826 • Fax(904)247-5845 ��,/ // ` >%- E-mail: building-dept@coab.us Date routed: C- 8/j (4:7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 13c?0 RO,Se. 7 _ Department review required Yes No aBuilApplicant: R 1 i Fess. cc'2J _ st FR.I lC Planning &Zonin ree Administrator Project: COVER-.1, ©,(ZC - 14, 1- is orc u lic Utilities GAo-EacD P1�Iic a ety Fire Services Review fee $ Dept Signature / -Fr'?-e Other Agency Review or Permit Required Rev �t)� n • of Pe J • Florida Dept. of Environmental Protection 34r r S Svc' Sy Florida Dept. of Transportation ie��Ut1 > St. Johns River Water Management District Army Corps of Engineers �� Division of Hotels and Restaurants --7- Division of Alcoholic Beverages and Tobacco •y - . Other: // llic;Zi APPLICATION STAT! Reviewing Department First Review: Zroved. (Circle one.) Comments: BUILDING PLANNING &ZONING / Reviewed by: 771La9- s--/ b TREE ADMIN. r\t\I Second Review: Approved as revised. Deni . PUBLIC WORKS Comments: PUBLIC UTILITIES 62/ PUBLIC SAFETY Revi wed b . Date: FIRE SERVICES Third Review: ❑Appr d al evised. UDenie . Comments: .` ly . Reviewed by: 0 Date: Revised 05/14/09 • (; City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) jrt , •tali•,., 800 Seminole Road toit •• Atlantic Beach, Florida 32233-5445 1 -R R(R 1308 Phone(904)247-5826 • Fax(904)247-5845 F '�0;; g- E-mail: building-dept@coab.us Date routed: 454.(42_____ City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 13c Rczs E �7 Department review required Yes No Bui. i. Applicant: v i Planning &Zonin.� Poea.c ree Administrator Project: Ccvei�i t-{ ,diorMIWAS7L danapp G ( 0,Ei5C7 Pu. is a ety Fire Services Review fee $ Dept Signature [ Other Agency Review or Permit Required Review or Receipt 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. XIDenied. (Circle one.) Comments: Su A4e- BUILDING PLANNING &ZONING Reviewed by p ' [ Date: eli7/1 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: ised 05/14/09 City of Atlantic Beach EAPPLICATION NUMBER Building Departmento be aigned by the Buildingbpartmnt.)800 Seminole Road JUN 20 2016Atlantic Beach, Florida 32233-5445s (O _ l 308Phone(904)247-5826 • Fax(904)247fiECEIV 5 `' 1/1 r�;09'r• E-mail: building-dept@coab.us BY: Date routed: 12 g/` (47 _ City web-site: http://www.coab.us l APPLICATION REVIEW AND TRACKING FORM Property Address: 13'70 >4R�cse Department review required Yes No Buil Applicant: R��FedCoN.3%sr. i vc Planning &Zonin ree Administrator Project: Covet�i Po i N .lolra►d177s. -u.Iic Utilities G Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt 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: J 4#1,,a cam,j W 1 BUILDING PLANNING &ZONING C/ Reviewed by: .-'� Date: ( /�l TREE ADMIN. Second Review: DApproved as revised. ODen;= PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ODenied. Comments: Reviewed by: Date: ised 05/14/09 onniC. Co €rJ c Q C( — 70`7— 894(o ,•s' '�`i . City of Atlantic Beach �s,- " ECEIVES. APPLICATION NUMBER 4' � Building Department r ,iii 1 800 Seminole Road ,UN 20 2016 (To1 be assigned by the Building Department.) -• ..- �r Atlantic Beach, Florida 32233-5445 ,R �� Phone(904)247-5826 • Fax(904)247-5 \<:;___!.. eri p-- E-mail: building-dept@coab.us Date routed: cis/1 (42 City web-site: http:/lwww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 13'7 0 R.o,se - Department review required Yes No d Bui••1!_ Applicant: Ilk. , Y -- . ..Planning &Zonin.ib. ree Administrator Project: Coveei Poz.c & R-t.._) �.imwrraym dialgapp G pt.E6rD Pu. is a ety Fire Services Review fee $ "K.- Dept Signature Y.--- V\ Other Agency Review or Permit Required Review or Receipt • 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: APPLI TION STATUS Reviewing Department First Review: Approved. nDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING , Reviewed by: 6C� �v/< Date: to72,A 6 TREE ADMIN. Second Review: [Approved as revised. ['Denied. 46J, G WORK, Comments: BLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: ised 05/14/09 s i,m-.0� ZONING REVIEW COMMENTS :A, _tiPp ,:- .;\ .. 4( s\ City of Atlantic Beach 1:31! 'e \\ __. Building and Zoning Department 800 Seminole Road Atlantic Beach, Florida 32233-5445 10 Phone: (904) 247-5826 Fax: (904)247-5845 Email: dreeves@coab.us Date: 6/27/16 Permit: 16-RAAR-1308 Applicant: 3 Rivers Construction Services Review: 1s` Address: 6694 NW 31st Cir,Jacksonville, FL 32053 Site Address: 1390 Rose St Phone: (386) 209-4214 RE#: 171063-0000 Email: 3rivers@gmail.com p(AZ4'0r@ L-I-i- b , orc Correction Comments 1. Survey: Please provide a legal survey. Setbacks: Please provide setbacks for all new elements from property lines. fipBuilding Separation: Minimum distance between the house and accessory structures is 5 feet. Please how that this is being met. 4. c uilding Height: Please provide the overall height of the detached structure from grade to the highest point of the structure. Tree Removal: Please submit a Tree Removal Permit Application if any trees are to be removed. If no trees are to be removed, then please fill out an Affidavit of No Tree Removal. Both forms are available on the city website under"Planning and Zoning"and at City Hall. f1b RC 0GLf7 i a CRzrMe6-(Eo) -7/-742 coy - f,D 07 6v 1 LO ( 1,3s . :-rpcz-CCK—( 5 oczoi c_ Derek W. Reeves V / d co Planner dreeves@coab.us C9 LO DJC--R- C Ptiv`E I N — 7 44Ec-/ 17 o o e 64 T Pr S H&L) 'C \-(0C P L A Cc--c -z- 1 k) `-I A oz- FO o L 3 v L LC 1 tD —Z—CDCS — ru 0 'T o cu s CT Lf‘' Z GlIl a� � '7-o cHAc._DG& �,..,< I( 107/6 Do lT( © 10 C,& i r k--)C1 p oc\IJ S P- 13�-kboiLD Kk.)-0 CR ►Jc (Js_ s 02-v €7 lb/ ci, ;Sts,, CITY OF ATLANTIC BEACH A 800 SEMINOLE ROAD 3, ,••4 ATLANTIC BEACH, FL 32233 OFFICE COPY (904) 247-5800 �,ii BUILDING DEPARTMENT REVIEW COMMENTS Date:6.17.2016 Permit#: 16-RAAR-1308 Applicant: 3 Rivers Const. Services Site Address: 1390 Rose St., AB Site Address: 6694 NW 315` Circle,Jennings, Review: 1 FL RE#: Phone: 386-209-4214 Email: 3riverscs(a,gmail.com Pop. Owner: Greg& Rhonda Hutto Phone: 571-1033 Correction Comments: Application is disapproved for the following issues: 1. Submit product approval numbers and information for all roof covering materials. The Building Department has forms for these. Xe (-___ riKt/b, Mike Jones Building Inspector/Plan Reviewer City Of Atlantic Beach 800 Seminole Road Atlantic Beach, FL 32233-5445 Ofc (904) 247-5844 Fax (904) 247-5845 1 enNeat I QfVi P w Com meAfi 6 '1? /4 �'r;"...j4ih OFFICE COPY BUILDING PERMIT APPLICATION G—RRAR— 1308 CITY OF ATLANTIC BEACH ,3`I 17 2.5O�e . I(o'{ 800 Seminole Road, Atlantic Beach, FL 32233 � ` Office (904) 247-5826 Fax (904) 247-5845 �w1 •t -7 i � 3y 1 3 O Palk, 4- . ► 7t 6(6 3 ODoa Job Address: WM (1)%eSf S . - •- .� A 4afi` ca c h F'L as 3 Permit Numb•r: Legal Description 11-.15-24C SEC flantc. death S SFr Parcel# . , r i 171063-0®00 Floor Area of Sq. t. 'q.r-t Valuation of Work$ T.OGO ' Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New �dditi Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structures)(circle one): Commercial 'esiden is If an existing structure,s a fire sprinkler system installed?(Circle one): -• 1o. N/A Florida Product Approval # y S 4S `7/ 1Z ?3-2, 4e+c.l ?F A e (s For multiple products use product approval form Describe in detail the type of work to be performed: 1--/kAeS e x;5 `a r oa 1, It on sir u c f (cnuo d t 1P41 eonsku.c4 r2ebo. Property Owner Information: Name: ( re,ory 114.ff-e �'gl0it' IrµPEO Address: 1301 go st S�. City JI-+I ai t'H t Fit G cL State l . Zip 52,233 Phone RO`l-S 7/-/0-33 E-Mail or Fax#(Optional) Contractor Information: Company Name: 3 Cd prs tv lCt s LCC Qualifying Agent: Curd fYl r6tme Address:WM AJU) 319 (!1/U CityJena'n V State FL Zip 3,2053 Office Phone 386. 201-N c2 I LI Job Site/Contact Number 3 tri,-.;104-d 0 7 t1 Fax# State Certification/Registration# FL C6C 1a57732 Architect Name&Phone# Engineer's Name&Phone# Leas 4 Sc-oil [n3;nc e r ni 404• .240-4410 Fee Simple Title Holder Name and Address 3 it t`V ef5 GS 9 p/0. 1. &eP/4 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 Electrical Work,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. I herebycertify 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 ofworkwill 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 re! lating const ion or the performance of construction. Signature of Owner / Signature of ContractoAle9- r Print Name &9rg 7)1 /t �� Print Name �etpf- ,figT erre,I0( Sworn toand subscribed beforeap Sworn to and subscribed before m this y Day of 4 ct. ! " /, N this (it' Da .ef Po C_ 1 u aphney Jirau, 20 16 ION�� �lotary Public,State of Florida ' .�.1s!im.:,r. ommi ion*/FF 163906 State of Florida N.' • "''11 is - "'I My comm.expires Oct.14,2018 No P,o� MY COMM COMMISSION NO. EE 863152 OF O FYn '•isJiQfrf 1 2017 NOTICE OF COMMENCEMENT I i! 7)04 :5-60M State of 1 10r,d q Tax Folio No. •. . County of btklitk.1 OFFICE COPY 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 8,tated in this NOTICE OF COM '�j NCEMENT. 'l Legal Description of property being improved: . . _ I g-3 t Ii aS 2 C ,ICP 7 P Q $',C4') /j4/ &k. Address of property being improved: Me Roses Si' A•144 n f:C 64 e A,f'L 3aa33 _ r General description of improvements: .ntj .1.1Ld .Jldoaj COLO/41-4.c7 C6it:.teQci &)et lade .1 / qQ, oi e 0It,tl.t�c.i (I(t4 o . a Owner: re)✓ry t�. /Iv1-r (r , Address: I /C?ase Si _A 4bl 12 cl., (L g.).231 Owner's interest in site of the improvement: I = S-,•.(Ile_ Fee Simple Titleholder(if other than owner): Doc#2016128410,OR BK 17589 Page 66, Name: Number Pages:1 Recorded 06/07/2016 at 02:13 PM, /+ Ronnie Fussell CLERK CIRCUIT COURT DUVAL Contr ctor: ed rr 1'l Q1JS�rac' � &(L).ces,�L� COUNTY N,6, Address: ODM 4 A)t.) '9j' t�t rd(e� , jefitaf , FL 320s3 RECORDING$10.00 �°'(J Telephone No.: 1-&•02 qf-;10 7 y Fax No: Surety(if any) Address: Amount of Bond$ 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 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 Signed: , 7/4X;41-11° --- Date: — ,24)/‘ _�� Before me thday /�(c y 2 o I k, in the Coun`y of Duval,State i a MIRIAM GRIFFIN Of Florid. as personally appeared Gih 9.2 i i .1-i v-&? �� ' a% Notary Public,State of Florida Notary Public at Large,State of Florida,County of Duval. a - o Commission#FF 163906 My commission expires: /O--/9'-.z,,,,,/ ''w'' My co .•xprr:.. •M.1',2018 Personally Known: or Produced Identification: xr ea •ye 11:bb CLRPSOII 206 P02 MAP SHOWING BOUNDARY SURVEY OF LOT 1, BLOCK 234, FILE COPY AS SHOWN ON MAP OF SECTION "H" ATLANTIC BEACH. AS RECORDED IN PLAT BOOT( 18, PACE 34 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY. FLORIDA. FOR: PLATE P4014E CORPORATION BEARING REFERENCE: P4 O1'22' W FOR RIGHT-OF-WAY UNE OF MAIN STREET PER ABOV€MENTIONED PLAT. NOTE: ELEVATIONS SNOW THUS (6.e) AND REFER TO NATIONAL GEOOE11C VERTICAL DATUM OF 1929. - CetT!FJED Tor JAMt3 W NI /t&& 'Z. Coe PULTE MQ 'T&A6E CooPORAT/o/ FhPsr AME+P/CAN t/Tt /Nichro4 ' Co. PNC T/rLE COPPO.PA /eit! RE CE!VED ROSE STREET (50' R/W)ee S i 9 1997 �D�♦ , City of Atlantic Beach c� SO1'22'00"E •o i Building and Zoning °�� 70.00' `c� + ,1.• , d al. i,. 1 • (..-1- . 12.1• 41 \p WF/A//.0N /'t oR et.(/4.4 Li p r ei /-sraRY - Li N OO CDMLRer. BLOCK • CV (STuC6o p/foA/T) '' P $ owsfss/N& d 1 (N.11° o CO v.- froAves O co #/390 J Z 1.7.' Z it 17.9 40.0 12.1 F- . 10' ,' U) . R can't. .• ;/PAlio 3X MAIM A/C P,PO are Mwt' BLOCK ; 2 3 4 r -OUY wet i Y►aET•FeDN POMFA POLE-�� 9 + (CAP Lams)0.S 0.r. (1.5 4144)I a—�;•b1• A1i Lux FDCt j 4•x 4'moo PSNCE ci 70.00' x 1.4 Post GN CORNER °'r S01'22'00'EI L 0 T 1 L 0 T 2 BLOCK 2 3 3 i/.VAI $4'R✓PY -9-45-37 WW1":AF44.47 AL COAWEse5 FNUNOAT/ON ..51.441/4.y 7.30.3'7 //ors t..-04/449 ALL CORA/6F5 ^I HEREBY CERTIFY THAT TIRS SURVEY, PERFORMED UNDER MY RESPONSIBLE DIRECTION MEETS LEGEND: THE MMS4LRN TEC/RMCAL STANDAROS FOR LAND SURVEYORS MN ACCORDANCE MIN CHAPTER 61917-4. • FD. CONCRETE NON,NEH1 fLORIOA ADMNISUATVE CODE (PURSUANT TO SECTION 412021, FLORIDA STATUTES). AND FURTHER • 1/2.FOND IRON CERTIFY THAT THERE ARE NO VISIBLE ENCROACHMENTS UPON THE SUBJECT PROPERTY EXCEPT AS SHOWN. 0 t/2'SET IRON-t.7 1704 /yy� �p��/�� 6.R.L. 6UILOwG RESTRICTION LINE FL000 CERTIFICATE:THE LOT SH04NCt CENTRAL ANGLE HEREON IS IN FLOOD 2O11E x' AS SHO4N C1ARSON No ASSOCIATES, 1NC. R RADIUS ON THE 11.000 NSURANCE RATE YAP.COMMUNITY 1643 N/LLDO AVE. JACKSON 32207 L An LENC7N PANEL NO.120075-0001 D DATED 4-17-60. • EN CHORD P.C. PONT Of CURVATURE SURVEYED MAY 7 1997. P.1 PONT Of TANGENCY ARC, PONT OF RE'.4RSE CURVE SCALE: 1" >• 20' FD. FOVNO FIELD BOOK J06 PAGES t7, B REPSTEAED °RIGA SURT.EYOR A NAPPER Na u67 R/W RGHT-Cf / O.R.V. OFFTdAL RECORDS Vaw':: JOSE A. HILL JR. —x-6 FT.4000 FENCE —_ (44TH TIES TO FACE OF FENCE) SL,�;..� TREE & VEGETATION AFFIDAVIT 64 ; �, City of Atlantic Beach -_ oDepartment of Community Development 0,. =" Planning&Zoning Division 800 Seminole Road Atlantic Beach,FL 32233 rt J'3 9V (P)904 247-5800 (F)904 247-5845 PERMIT# SECTION I-APPLICANT INFORMATION E Owner(s) r Legal Authorized Agent* NAME OF APPLICANT Curt McDonald NAME OF COMPANY 3 Rivers Construction Services LLC ADDRESS OF COMPANY 4215 Snowy Egret Trail Orange Park,FL 32073 PHONE (386)249-2074 CELL (386)249-2074 EMAIL 3riverscs@gmail.com CONTRACTOR CERTIFICATION NUMBER CBC1257732 ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION II-SITE INFORMATION STREET ADDRESS OF PROPERTY 1390 Rose Street Atlantic Beach,FL 32233 It an address has not been assigned to this property,contact the AB Building Deportment at(904)247 5826 to request on address. LEGAL DESCRIPTION 18-3417-2S-29E.164 ATLANTIC BEACH SEC H LOT 1 BLK 234 LOT 1 BLOCK 234 SUBDIVISION 03119 AB SEC H REAL ESTATE NUMBER 171063-0000 LOT OR PARCEL SIZE: 7123 SQ FT AC RESIDENTIAL X 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 vegetati. will be damaged,destro,ed and/or removed from the above-described• •djacent•r••• ies in conjunction with this project. Aelfii / - ii- - -<<1 h-- SIGNA 5' •F O T ER SIGNA 1 E OF OWNER Signed and sworn before me on this 7 day of (O , , U (o ,by State of r County of Identification verified: r! VI e.j-- i Oath sworn: ? ' r Yes r No R•"'^ THERESA L RIHEL ?/ ,r —4..)0' ' ; MY COMMISSION#FF987063 Notary Signature ti _ 'z.a6"'�Z EXPIRES April 27,2020 o,: 19d,;153 canAaNa .aom My Commission expires: REV-7VA-v)0.11 P . 0 2 A P R - 2 9 - 9 7 M O N S : 1 1 0 MAP SHOWING PLOT PLAN OF - LOTI___ BLOCK Z34 AS SHOWN ON MAP OF 5 E crION "H" - ,ar�t.ANTt c BEAcN *a RECORDED Di MDT BOOK_A PACE$ 34- . Of THE cupperr PUBLIC RECORDS 2IV4L COUNTY. FLORIDA. FOR: NORTH PLORIDA CLASSIC HOMES • -!,- Y HTR J Is E SAMEN A AS IO* OE ME PIAT_ MINOR L-OT GRAD I1't TREE LEGEIJD : IS ANTIC,PArEO . L.e.q e nod: p tAYRTLe' Deit04 es 5' 5,4- k P 'TRIPLE µYRTL -- t aC. d r Up4.4 �'4cLeI S-i'r'c4",.i,t5 , PINE I.AA:�.+//".., .-5,1-,nce_ befween Gov«< :O of P..- iPis�' Fee_ QAd V'4Z ebp 1 ,54- r4ee -1-4, se_ 51 0'' t. 0T 2 LOT I B L 0 c K 233 70. 0, T - ^ - Z.- _ 1V___. _ _ 0 G42eb0 I I`. � l I-- u G0vee_01 P4.1"Q I al di 40' tY N 0 I w w L I • ln PL�� !4'74 Q = Q r .NS 6 (si .4.4 ii Ili I 12 l•.94.59' 18 I tn l ,4' ..,g. ID 111 I — I 3 2(.�"1' I1 1 0`% iv , ( QUO o����es , i '' • [ N 0 PQo�P•�,ti �0 ' 0 c/ � NOTICE OF COMMENCEMENT + 7Jtt.j-b0aS State of t I(?Y•:(1A Tax Folio No. . . _ County of buk,Utd 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: _ ._ . 11 5��C .I(a'q Q �PC� Psf Address of property being improved: 13W A1-14 n to 64 e A,:1 3.733 General description of improvements: 4tutd i.1,t, oxi .,Adolf CO7t,o&a.ci Cd rei &;kL/a {Jq"n -_,�,(jp1 4i Cond a. o. � Owner: 6ref,;.ry Address: IV gale c��. 11-141/ i a c L, (e , 223.1 Owner's interest in site of the improvement: f C.`,h.( e_ Fee Simple Titleholder(if other than owner): Doc#2016128410,OR BK 17589 Page 66, Name: Number Pages:1 Recorded 06/07/2016 at 02:13 PM, r Ronnie Fussell CLERK CIRCUIT COURT DUVAL tr Conctor: • rlfer's Cpt15ir td-1 , �lt.rtJiCzs ,��` COUNTY Address: 1109 4- A.ii '3151 Ufa" , Jennix , FC 32053 RECORDING$10.00 Telephone No.: 3*-o2qrf - 07f Fax No: Surety(if any) • Address: Amount of Bond$ 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 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 Signed: !✓ //moi --- Date: 7 VK- Before me th•: da — y•. f Q y 20I !-, in the Coun y of Duval,State MIRIAM GRIFFIN Of Florid. as personally appeared C.,-‘/4_ o t t.4 i1- % Notary Public,State of Florida Notary Public at Large,State of Florida,County of uv Commission#FF 163906 My commission expires: /f> / .2,,/ �o '"." M co,. .•xpi 4. • t.1•,2018 Personally Known: or Produced Identification: £defke 1, �'/4/2 Zai- /02 g. 20 e 17/ 0 mos zoz a-4; a.ok3 ri 14 , 117 iarirpeitr )27`f'7 sta, p ; k ,� = 4. 000 attzeho D � f