1330 Ocean Boulevard kitchen remodel permit CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
x� 9YJ9:.
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RAAR-2385
Job Type: RESIDENTIAL ALTERATION
Description: kitchen remodel - replace counter taps & cabinets, install
wet bar, built-in shelving
Estimated Value: $20,000.00
Issue Date: 10/28/2016
Expiration Date: 4/26/2017
PROPERTY ADDRESS:
Address: 1330 OCEAN BLVD
RE Number: 171847-0000
PROPERTY OWNER:
Name: PALEY, SEAN &ALICIA,
Address: 1330 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: TRI-H CONSTRUCTION LLC
Anton Harasz,CBCO22201
Address: 11215 ST JOHNS INDUSTRIAL PKWY ANTON HARASZ
III
Phone: -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $75.00
BUILDING PERMIT FEE $150.00
STATE DCA SURCHARGE $2.25
STATE DBPR SURCHARGE $2.25
Total Payments: $229.50
PERMrr IS APPROVED ONLY w ACCORDANCE WITR ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
State of_FLORIDA Tax Folio No.171947-0000
Countyof_DUVAL
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: 10-11 16-2s-29e Mandalay lot 2 block 54
Address of property being improved: 1330 Ocean Boulevard,Atlantic beach,FL 32233
General description of improvements:Kitchen renovations,added cabinets,Plumbing,new counter tops.
Owner:Sean&Alicia Paley Address: 1330 Ocean Boulevard,Atlantic beach,FL 32233
Owner's interest in site of the improvement:Owner of Record,Occupant
Fee Simple Titleholder(if other than owner):
Name:
Contractor:Tri-H Construction LLC C/O Anton Haresz IB AKA Tony Harasz
Address:P.O.Box 331118,Atlantic beach,.FL 32233
Telephone No.:TH Cell 904-545-9978 Fax No:904-328-2224
Surety(if any)
Address: Amount of Bond S
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fat 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) /1
Name: U
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):December 31,2016
THIS SPACE FOR RECORDER'S USE ONLY
OWNER
(tF' Signed: Date:
Ox N 2016241461,OR BK 1 T48 Page 2103, Before me this day of 2✓ in Ne Cqunry of Duval,State
Number Pages'.1 Of Florida,haspersonallyappearedS Pun Rl-Ir.M 1��}lEY
Recorded f or20r2mG at 09:37 AM. Notary Public at Large,S loride,Cpyn oflhrval.
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Mycommissionexpires
: d-
COUNTY
RECORDING$10.00 -, ra�wy. NRGINIA fl03ALE5
_ Nolary PUEIic-$tate of Flori7a
'�� MY Comm.Exnirea Jan 27.2017
-'y Commlaaion N EE 862763
City of Atlantic Beach APPLICATION NUMBER
- Building Department (To be assigned by the Building Department.)
800 Seminole Road jb-R.A-A R-a3 8S
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845 1
E-mail: building-dept@wab.us Date routed: tOlayl t b
City web-site: hdp:/lwww.ccab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address- 1330 ocaix (3W� De artmentreviewre uired Yes o
1 COildin
`-O -
Applicant: T1l1 -1-F n S'(kC.A 0A Planning &Zoning
�1
Tree Administrator
Project: rl'f(.�/1 dUh.o�.P.� Public Works
Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: M<P'Proved. ❑Denied.
(Circle one.) Comments: o c
UILDING /�/
PLANNING &ZONING Reviewed by: Date:
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 05114109
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OFFICY L,.. ;
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 1330 Ocean Boulevard,Atlantic Bch.FL 32233 Permit Number: 16—RAAQ— a371
Legal Description 10-1116-2S-29E MANDALAY LOT 2 BLOCK 54 Parcel# 171847-0000
IF oor iuea or zki.rt Nq.ri
Valuation of Work$ 20,000 Proposed Work heated/cooled non-heated/cooled
No added area
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)(circle one): Commercial Residential
If an existing structure,is a f re sprinkler system installed?(Circle one): Yes No NIA
Florida ProductApproval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Replace kitchen counter tops Install new cabinets and wet bar in
Existing kitchen,renovate built in shelving to new wall,Plumbing related to wet;ar by plumbers.
Property Owner Information:
Name:Sean&Alicia Paley Address: 1330 Ocean Boulevard,Atlantic beach,FL 32233
City Atlantic Beach State F1.-Zip 32233Phone 904-477-0197
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Tri-H Construction LLC_Qualifying Agent:Anton Hamsz IB AKA Tony Harasz
Address:P.O.Box 3311 18City Atlantic Beach State FL Zip 32233
Office Phone 904-328-2224 IVR Job Site/Contact Number 904545-9978 Fax#904328-2224
State Certification/Registration# CBCO22201
Architect Name&Phone#N/A6
Engineer's Name&Phone#N/A
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work aM installations as indicated l certify t t no war arr. a ton commence prior to the
issuance of apermit and that all work will be pe armed to meet the standards ofalllaws regulating co traction in this jurisdiction This permit scones null
aM void fwork is not commenced within six(6�momhv,or ifconsnuction or work u$as ed or aba time alter
work is commenced. 7 understand that separate permits must be secured for E![dAcal Work,Phmbing,Signs, ells, Poo/s, umaces, Rollers, Nealers,
Tanks andAyr Con tidonem em
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.
/hereby cert6 that I have read and examined this plicaHonaM blow the same to be true and correct. Allprm'triont oflows and ordinermesg�rningthis
type aJ work well be complied with whether speciid herein or not. The roaming of a permit does nm Presume to gree authority to violate or conceit the
provisions ofarry other federal,state,or local law regulating construction or the Performane,orconstractun,
r—`
Signature of Owner 14 44Signature of Con to _
Print Name S�/1Q.ldzCL...z ... ..al//¢,/.._...___.... Print Name _ kiAh0.✓c,SZ_�lu-___...__....._..
Sworn to and subscri ed bjeficire me .•ll Swom o and subscribed before me
this Day of 20 this Day of 20
Notary tic otary
,�a� mNmLSN1ai7FlpEtg�
,a M'"°'••. VIRGINIA ROSAlES �` ``- MY COMM5310N i1't01Td 1.26.10
• E%PIFEa:May iC'�17_
Notary Public-stateol Florida 1,tiL;n, eowe mry ua,n Paewasmen
MY comm.Expires Jan 27.2017
°•„p s,«,,. Commission#EE 862763
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