623 SELVA LAKES CIR - ALTERATION 1k �S, CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
y 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-2010
Job Type: RESIDENTIAL ALTERATION
Description: remove & replace kitchen cabinets, upstairs bath vanity, &
commode, add closet, elec. & plbg. by others, paint interior & exterior, retexture
ceilings
Estimated Value: $9,000.00
Issue Date: 9/13/2016
Expiration Date: 3/12/2017
PROPERTY ADDRESS:
Address: 623 SELVA LAKES CIR
RE Number: 172027-5554
PROPERTY OWNER:
Name: CORBITT, TERESA BOYKO
Address: 623 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: NORTHEAST FLORIDA BUILDERS, LLC.
Scott L. Peterson, CGC013267
Address: 6755 Laurina PL
Phone: 904-304-3808 — -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $47.50
BUILDING PERMIT FEE $95.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $146.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
rS''`',�? City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
\'',' 800 Seminole Road ��— AA
Iry —� ' Atlantic Beach, Florida 32233-5445 q
\ Phone(904)247-5826 • Fax(904) 247-5845 Date routed: /
:.,../..6-,t1 • E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: kP-1 StINAI, Li, C ILV2._ Department review required Yes o
,, / 1ilding
Applicant: (J 6 FL Lith' t S L/� Planning &Zoning
Tree Administrator
Project: 1( W-LLLtbk(uQAi CU\l 1� Ol(��L11ek. _Public Works
`1 i Public Utilities
Qom' \* 'Rte( ED(ck Ocki- \J( Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required 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
I Other:
APPLICATION STATUS
Reviewing Department First Review: (t✓lApproved. I (Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING ` Date:q ?- O
Reviewed by: /�'
TREE ADMIN.
Second Review: ['Approved as revised. I 'Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I 'Approved as revised. ' (Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH F 1 t a. "r 7 t
800 Seminole Road, Atlantic Beach, FL 32233 k -awl •• ,., • t
Office(904)247-5826 Fax(904)247-5845
Job Address: 143 50/,t/t4 La% Cfin-e�. . Permit Number: IIT AAI-- a 010
Legal Description 1/3-11 1 '725 ' 1 i Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 'j O `''' Proposed Work heated/cooled II ! ,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 7identiaL"
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes 4411.0 /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: IA($e, iP.fe_ 4W;te ,..e:44-,,4.c ./
td 1pru4 balk l O t rt( * e4u.w4442.- P2 N 6.,v) C'JCLV fleZt -e-1'* P
iLAA±Ao-tim.AA.,
A.tetta...0-t.%:1; ConAlume-te'vli p - dute"ce-1--
Property Owner Information: 1�A,„rjj ,Z. (1.42._
Name: Pls:Ts .X6.5A ..1ico Address: 1023 Sti,JA L.p-.i as C i itcut,
City A-tto,.trl'd, 6z_ae,+* Stated,Zip 3?„22-3 Phone `i n`t- Z 38- 5944
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: 0c.rru•kRST' t- tomo+ 6 *c l CAC. Qualifying Agent: J eorc tt an,
Address: (0755 LA-u4-)M; ?IJ+CA- City �-,A-64Sds7'd t 1.4-6 State Cc Zip 3 22tC.
Office Phone 9t'e-.3 o L7 -3.W Job Site/Contact Number Perk F. Fax#
State Certification/Registration# C,&C 0 i 3 ,y24o
Architect Name&Phone# iJ/A
Engineer's Name&Phone# N/ft !
Fee Simple Title Holder Name and Address S C�c� N F E ec -c l ,CO
Bonding Company Name and Address /44. A-
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 sus ended 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, anWork,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 hereby car*that I have read and examined this a 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 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 o he performance of construction. 41/Signature of O AOY • ' ��� Signature of Contractor I ./;lit. AW
Print Name ����5,3. 4/ �_14y /' Print Name ....5eitig L..ansocd)
Sworn to and subscribed before me Swom.rtgand subs ibe, before me
this "°1 Day of e p-f-em 1 ✓ ,20 1 tr this Day of �" ' ` ems- ,20��o
Notary Public ' VICKI C HARRIS _ N�
.t„Y P;;., ,„N N,• RIE CHRISTIANSE
:?�`''t sfc'•• Notary Public State o1 Florida
it'• -T Commission#FF 942017 Revised 01.26.10
1 • J� My Comm.ExpIres Nov 4,2018 ' �: it EX December 9,
2019
? Commission, FF 168350 •.,. .,• Banded NViffnFar eo 'ro79
4 '"%,.;t.‘sos Boded through National Notary Assn.
4
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A r niv .)- l6-g4A 11 R --- 20/O
NOTICE OF COMMENCEMENT OFFICE COPY
State of (t 0 MP 11 Tax Folio No.
County of 0av'4L
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 COMMENCEMENT.
Legal Description of property being improved: 1/3-/i /7 2S _Ay g 50 kVA GI?-AS UV/T Zr
Address of property being improved: 6 2.3 Stoat- L,AKie-S C l(2-t U. PTll Ii1-1t, ►43S1-VeI4 'FL, 3 i1-13
•
General description of improvements: e_itit14C 'V*TIL J >L' L .•// 6a_, ) cit. r►T"�G,h-si �e ,i ts
.✓1'�
Misr - b✓A=l4 't.yaw*, DNgc.4 v�rr,iir r M1 NiviZ T iti'Ya',1�._ oz„-1 S 11•-w�.�..•x Ai_ ~
1`- Owner: AS. f 42fiSA t 0 t1 V f __ Address: to23 S g 'j LA( ei id 4,g,
Owner's interest in site of the improvement: ------------
Fee Simple Titleholder(if other than owner):
Name:t /_
Contractor: /v it 71#4 N 57-' It`Lo tL/0 i4 ,./3-y.. /aA 5,t..." /. 44C + -------
Address: l,75,5' L/7 u/2-/,v/tY /6 C h. .`7'04›G j A, 3 22 ,0
Telephone No.: G/D4/3' fe-3eciS Fax No:
Surety(if any) i'1/4' -_-._--
Address: Amount of Bond$
Telephone No: _ Fax No:
Name and address of any person making a loan for the construction Doc#2016206091,OR BK 17699 Page 120,
Name: Ay/1- _-__ Number Pages: 1 •
Recorded 09i0712016 at 10:13 AM,
Address: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
Fax T COUNTY
Phone No: RECORDING$10.00
Name of person within the State of Florida,other than himself,des e
served: Name: A//l- --- —
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: i/ r t' `/�/ Date:
r"`;.;:.r ,,s MARIE CHRISTIANSEN Before me this d.,of _ _ in the Co ty of Duval,State
:r'' -4-'14. commission#FF 942311 Of Florida,has personally appeared_
'':� Expires December 9,2019 Notary Public at Large,State of F�orid ,Cpunty of Duv: .
Bonded nruToyreloinmatesMU'- ° My commission expires: I 7.
Personally Known:--tn Y1-4-me-4-meC)b(Z- i C.—a.tr•- or
Produced Identification ,i
OFFICE COPY
Northeast Florida Builders, LLC
6755 Laurina Place
Jacksonville, Florida 32216
CGC-013267
Project Location: 623 Selva Lakes Circle 9-01-2016
Atlantic Beach, Florida
Dear Ms.
We propose to complete the following miscellaneous renovations oversite and secure the building
permit as required by the City of Atlantic Beach and per my discussion as well Mr. Mike Jones—Building
Official.
The fee for oversite and permitting time to be $800.00 plus permitting fee from the building code
department,
Clean and resurface ceilings throughout areas and re-texture.
Scope as discussed:
Living room:
Remove the mantle from around the fireplace and replace a small bit of deteriorated wood/Install new
sheetrock and facade as discussed.
Kitchen:
Remove all kitchen cabinets and relocate the dishwasher to under existing window and kitchen sink
to pass through area.
Laundry room:
Remove pocket door and sheetrock—removing stud framing and re-sheetrock aa 36"opening
complete- ready for use.
Upstairs:
Master Bathroom to have existing commode and sink removed and replaced with new fixtures
provided and installed
Closet area to have vanity removed and plumbing for such capped and sealed per code by plumber.
Front Bedroom :
Frame in new closet and seal up opening to downstairs living area—asa well as constructing a false
wood framed beam and install electrical line per code for future ceiling fand and light per building code.
623 Selva Lakes Circle Page Two
OFFICE COPY
All Electrical and Plumbing to be completed from removal and re-installation in conjunction with this
Work by licensed and permits independent from oversite fee—contracted independently by Owner per
local code and licensing requirements.
Northeast Florida Builders, LLC will secure the rewired building permit and attend inspection approval
as required by local building official discussions.
This scope will be completed as described herein—permit obtain as expediently as reasonable upon
securing signature from owner on Building permit application and Notice of commencement—both
notarized as per building department regulations.
Northeast Florida builders will expedite this documents to you this day for signature as availed—
weather forbearing and file for permit should be secured as soon a documents are signed and notarized
for permitting.
Signature cce tan;dis pro sal by owner:
Printed:///CSa�U� v � Sig ' '401 / ate
Signature as to Contractor: �411. 7,A....._._.
Scott . Peterson/ ignature as licensed Agent CGC-013267
Dated: //3/X.,-
Payment due upon Acceptance.
Permit to be posted and review of work with officals with follow as required by Building Officials from
Atlantic Beach, Florida per local codes.
Sincerely,
Scott L. Peterson
Northeast Florida Builders, LLC
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