289 Magnolia St alteration permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALVOTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-SS14
30B INFORMATION:
Job ID: 16-RAAR-1894
Job Type: RESI DENTIAL ALTERATION
Description: re-side exterior with hardie-lap siding, window replacement
Estimated Value: $10,500.00
Issue Date: 8/23/2016
Expiration Date: 2/19/2017
PROPERTY ADDRESS:
Address: 289 MAGNOLIA ST
RE Number: 170542-0000
PROPERTYOWNER:
Name: TRUSROTT, ROBIN W&THEODORE,
Address: 289 MAGNOLIA ST
GENERAL CONTRACTOR INFORMATION:
Name: JUSTIN LARSEN CONSTRUCTION INC
Address: POBOX1942 LIC # BELOW 4 GERALD GOLLOBIT
Phone: 904-327-4311
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $51.25
BUILDING PERMIT FEE $102.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2,00
Total Payments: $157.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDWANCTS AND THE FLORIDA
BUILDING CODES,
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 1 W-9-A A Q_- 1194
Phone(904)247-51326 Fax(904)247-5845
E-mail: building-dept@coab.us Daterourted: DILLq-1110—
City welb-ste: thttpJA�.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: a,'%Ct " AOUC4 St. _D_ 2��em review required Y 'No
gL
1� uld,
Applicant: Uutti�bt`\ L-&ALA tDAS-V"z-f) Planning&Zoning
Tree Administrator
Project: I L-SAL VA `lf)tkt�t L46t S Ji 11.5 Public Works
Public Utilities
Public Safety
Fire Services
Review
Other Agency Review or Permit Required 0 innitoVre"'Oell
f Pe rffad By Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
StJohns 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: PApprved. E]Denied.
(Circle one.) Comments:
CE��
PLANNING&ZONING Reviewed by: Date:
TREEADMIN. Second Review: DApproved as revised. [JDenkV
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: —Date:
FIRE SERVICES Third Review: DApproved as revised. [:]Denied.
Comments:
ReAsed OWW09 Reviewed by: —Date
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
Office:(904)247-5826 - Fax:(904)247-5845 COPY
800 Seminole Road,Atlantic Beach FL 32233
Fi"
JobAddress: Permit Number: 10—QA?_— 11'71/
LegadDescription
,t_
Valuation of Work(RcItlacernent Cost)
..,_�Heated/Cooled SF_Non-Heated/Cooled
• Class of Work(Circle one): New Addition teradion Repair do Moor
• Use of existing/proposed structure(s)(Circle on - 6ep,
'(Snerciall Rcsidentia Poo,
• If an existing structure,is a fire sprinkler system installed?(Circle one): N
• Submit aTrec:Rentoval Permt Application if my trees are to be retnoved or Affidavit of No Trce,Removal
Describe in detail the type of work to be V_-S ,0� ex--%�egxoe q 14 A"-t-
wtod)ow
Florida Product Approval h!
_for Multiple products use product approval fam
Property Owner information
Narne,,,I_�Z_�_,. ______Address,9,2Tq W
city StateCL Zipa.,_�I Phone q0q I
E- 'I :]-Lf\� r e cap 0 o k- e �
OwnerorAgent (WAgen�ftwaofAum,,orAg=y�
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 NOTR!E OF COMMENCEMENT.
Contractor Information:
Name of Company��� � =Ay, QuafifyigA$eV,:7T2jS,,j L.US4.-)
Address:$R0 Be"A., cl,- -City OAODDIftlo,15 State Zip 1-1.
Office Phone Job Site/Contact Number Ciout-) 4157- zaa:]�.
State Certification/Regis ration# eg'_tZYjjBU_E-MaiI
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation Esempt / Insurer Lzase Emptoyees I on ate
o.e,�d
,isdteft.�.
o�rd v,.
1. ing,
........... ...................
v n27 2 7
.................
1hereby certify that 1hal an y Doun.myt. .............. ow the am to ee s and
ordinances governing th c rk wil be er Spec c be , 4 ", I
resume to ive authori t r a e I . an
Pe mance a construction. P v to 8 other era, 1W or the
EXPNW8Nwsn*,o8.20jq
Wn... 4A116
Pertny �- g 16-10AAe—la'791
- NOTICE-OFCOMMENCEmENT _ _ FLE Copy
State of Counlyof DV�AL Tax Folio No.
To Whom it May concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF CONEAENCENM
L,egal Description of property being improved 2M, -A, �/�57n3
Address of property being improved:
General description of improvements: AM.,
Owner Address:
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
CqVactor. jrjn:�� '4'fix-ft—)
Address: q(91z V k---
Telephone No..(104 Fax No:
Surety(if my)
Address: Amount of Bond$
Telephone No: Fax:No:
Name and address of my person making a loan for the construction of the�miprovments
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 Counnencement(the expiration date is one(1)yew from the date of recording unless a different date is
specified):
D.#2016193332,OR BK 17679 Page 2429, OWNER
NMW Pages:I I -
R.rdecI08119MI"01:51 PM. I 5igned:
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Pefure e tlas day.of Data
COUNTY m ithe - ty-6 R
A'4�of Duval,State
RECORDING$10.00 Of Florida,has Personally appeared 0 1 0 �a'lrl�
I'mmally Known-
- - - - - - - - - -u ldc�tifi .on: 62 or
fic
b c.
M alw�lm expuesu---`2
""""A Ro"LE'
Mary P.1,1111- State-t Ronda
17T