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345 Sailfish Dr CE Case 16-508 • • A. Slgnat ❑Alert, 2antl 3.Alw w'PI me E3 Addressee ■ Complete items 1. Delivery Is desired. X C.Date of pelWery item 4o fteame an tlreas odA - S. R ad by(Printed Nama) ■ Print your name and atl wthat we can return the card a mlteml9 Oy. ■ Attach this card to the back o _ �iflere reu p No 0 '. `y�rese blow: or on the from It space perm 71r II YES. ' t, atieeAaareaseam: ,I DEC 2 2016 ' - 3. Service Typep. ( p ExP�sMal ea a,ldlee E31,14 ed_d E3 Ratum Reeelptfor March 0 Insw area in C.O.D. ❑Insured Dell m FeeYes 4. ResWmad DelWery (Em p, ptllcle Number 7006 01011 0001 0787 4100 maaaozD-15^° (AmnslerimrP ?. Domestic Rehm Recalpl CITY OF ATLANTIC.BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 PHONE(904)247-5855 December 14,2016 CERTIFIED MAIL RETURN RECEIPT REQUESTED 70060100000107874100 LINDSEYM. WHITTINGTON 345 E SAILFISH DR ATLANTIC BEACH,FL 32233-4130 Real Estate No. 171386-0000 CASE NO. 16-508 Location of Violation:345 SAILFISH DR,ATLANTIC BEACH,FLORIDA Dear Property Owner: Please be advised,Atlantic Beach Code Enforcement has found your property referenced above to be in violation of the City of Atlantic Beach,Code of Ordinances,to wit: VIOLATION FBC Section 105 Permit 105.1 Required. Any owner or authorized agent who intends to construct,enlarge, alter, repair,remove,demolish, or change the occupancy of a building or structure, or to erect,install,enlarge, alter,repair,remove,convert or replace any required impact resistant coverings, electrical,gas,mechanical or plumbing system,the installation of which is regulated by this code,or to cause any such work to be done, shall first make application to the Building Official and obtain the required permit.(windows replaced with used windows without the required permits as required) This letter requests that the noted violations be corrected by obtaining the required permits for the window replacement within ten(10)days of the receipt of this notice. To avoid having this case be referred to the Code Enforcement Board, all listed violations on this notice most be in compliance on or before the date established by Atlantic Beach Code Enforcement. The Board may impose fines up to two hundred fifty($250.00)per day for continuing violations.Upon completing the corrective action required,it is your responsibility to contact Atlantic Beach Code Enforcement and arrange for an inspection to verify compliance. It is our goal to keep our neighborhoods looking well maintained while protecting property values and your cooperation in this matter is greatly appreciated. Please contact Atlantic Beach Code Enforcement at 904 247-5855 if you have any questions or need additional information. SinC�� - i Deborah White CODE ENFORCEMENT OFFICER STOP WORK CITY OF ATLANTIC BEACH BUILDING AND ZONING DEPARTMENT (904)247-5826 (�/ \cc NOTICE cQ. This building has been inspected and: General Construction ❑ Mechanical (� ❑ Concrete and Masonry ❑ Electrical ❑ Plumbing ❑ Gas Piping IS NOT ACCEPTED CORRECT AS NOTED BELOW, BEFORE ANY FURTHER WORK / e40C ),ISil� � Ove per Mr � ADDRESS: . ? S SA i L} l J nr- -, AIT DO NOT REMOVE THIS NOTICE Inspector: ��® Date: / 9. Failure to respond to this Notice within 10 days will result in this violation being forwarded to the I CODE ENFORCEMENT BOARD. I �LJ~ The posting of this Placard by its contents shall sen:u as dp:o Property Appraiser-Property Details Page 1 of 2 WHLTTINGTON LINDSEY M Primary Site Address Official Record Book/Page nle x 345 SAILFISH DR E 345 SAILFISH DR 17260-01916 9417 ATLANTIC BEACH,FL 32233-4130 Atlantic Beach FL 32.233 345 SAILFISH DR Pro Detail Value Summa RE# IJ13H6�W W Ta DlWict IISD3 Value Metlmd CgMA CPM. vnmerix Use al Ire Ingle Family Tobi BWMIMValue $71,021.00 j7p1510 #aBul ll". 1 extra Feabre Value $D.m j0,00 Laud Ue m. Por full legal descdpuon see Land Value(Mnedisa) $85,000.00 j85'mom IoM B legal section bebw 91n=MV m! —rYl $0100 50.00 EwNtLwm min RDVPL PPIMSaw 0210 Just(Market)Vanni $1561021.00 5155,453,00 Total Ates )369 Assumed Value $156,021.0 $151 The sale a Nis soPeM may result in higher property mess.For mere information an CWDW/Pm bilnyamt j0,00/$0.0 gImj 0.00 to Satre Our Hames and our Plpcem Tax 13tlmatm.-in Progress'property values, ammptbns and ober suppartlng Information on Nis page am pan aNe sock rg nix 19( d $5D,000.00 See bebw roll and am subject to Cause.Cembed slues listed In Ne Value summary am Nose Taable Value $105,021.00 See b¢bw muffled In October,but may Include any alfidal charges made aver cemFlcation t.eam III the Promon,munisors Taxable Values and Exemptions—In Progress{ It there are no exemptions applicable to a taxing authority,be Taxable Value Is be same as the seemed Value I ,ad abbe W the Value Summary tam. County/Munidpal Taxable Value 5)RWMD/FIND Taxable Value School Taxable Value Assessed Value $155,453.00 Asoewd Value $155453.00 Assessed Value ......._...___._............._...._._.._...... _.__.._... j155,453.00 ......................._.....__......_............._._._.1............. Homestred OOQ -$25,000.00 Hwnestead _._...._....._................... ........ adBa._...._......_..._._._...._..._......._..._ ..._......_...adnan ...........__$ , . HomeAead(HX) -j25,00D.00 Homes[eatl BaMIn9196.031(gro)(xl>) Hemesmad Balkln9196.031(I)(b)(HB) ._....._....._.............................___.._................ ..._._... ={zs`ogD.m Taxable Value ;130,053.00 ..........__......._......_..____.._. . ___...... ... =S25�ggo;DD Taxable Value $105,453.00 Taxable Value $105,453.00 Sales Hisro +.J Book/Page Sale Dab Sale Prifa used[ Case D Imetl/ aim VabM/Improved 17260-01915 7131/2015 $1a 'Wo.0 IWD-Warranty Deed Qwliflad lmproveE 09325-01615 6/!/1999 $6y000.m WD-Wall reed! QUaliflad Improved l%07B410416 4/12/1993 $42A W.W QC-Quit Calm Undesired Impoved 0727P01461 2/4/1992 $44,500.0 WD-Warranty Dead Unquxlifind unproved 03716-00142 5/6/1974 $22,fi0n00 WD-Warrant,Dem Unqualified Impoved MP-00521 7/13/1972 $15,W0.0a IWD-Warranty Deed Unguaffed Improved 0318-01131 1/18/1971 $10,800.0 MS-Miscellaneous WqualitiM Improvetl Extra Features+1 No data found for Na scolon Land&Legal Lantl Legal LN f909 Ux Deealptbn ZarVIg Front Depth Cabyory unit y gel LN.. legal Description. N_......>__ _.....�_._ 1 31-117-2429E ..._ 1 0000}J UNITS PER NLSI 75.00 Im100 Cpnnea Ino int AC $a5maW 2 ROYAL PAIRS UNIT 2A 3 LOT 13 B11(27 ♦� Buildings l .d Building 1 auilding l Site Andras element cede Deb 345 SAILFISH DR Unit ll AMII Beads FL 31233 Exmoor Wall tS -W 15 fnriaem Bk� Raaf 9mxt 3 3 Gable or Hip Wiltlinp Type 0101-SFR I STptY Real Ower 3 3 Asph/Comp Shrg rearealn 1961 manor van s s o�ymn BulMlrp Value $70,953.00 IMaoaing 10 IO Toms,learn Heaang 1 4 4 EIaMe Tran Herren Type 4 4Foroedpunetl http://apps.coj.net/pao_propertySearch/Basic/Detail.aSPX?RE=1713860000 A DBPR 0070—Uniform Complaint Form—Construction Page 1 of 3 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND `! PROFESSIONAL REGULATION Please submit to the appropriate address on Page 9. Any investigation or administrative proceeding brought by the Department against the subject of your complaint will rely upon the information you provide to the Department. All allegations and supporting documentation MUST be provided to the Department at this time. COMPLAINANT INFORMATION Last Name 1 FirN�ck Middle Title Suffix nc5 Your Company/Occupaticn� In P/AAI lV I MAILING:ADDRESS Street Addressor P.O. Box 0,0 C City n,otfnC � ���7J OUiu � State_ Zip Code(+4 optional) 3 County(if Florida address) �U� Country CONTACT INFORMAT Primary Phone Numberpd� � It Phone Number - - 7 o Gsa3o Primary E-Mail Address t9� Coa Unlicensed Activity Complnal at h Yes LJ No No ? Unknown ❑ 'COMPLAINT DEl/SCRIPTION a f jp c . ulna s0 hei?eknee/ e/ x / Jy,�reJyr�! r u/ia�fa� r 4 on f , \r QcCiC; a/l IV, ewlo&U3 =, t au.1 Attach additional sheets as necessa Rev OU2014 2 of 9 Construction: Cmplaw DBPR 0070-Uniform Complaint Form-Construction Page 2 of 3 PRIVATE ATTORNEY FOR COMPLAINANT IF APPLICABLE _ Last Name First Middle Title suffix ADDRESS Street Address or P.O. Box City state Zip Code(+4 optional) County(if Florida address) Country CONTACT INFORMATION Primary Phone Number Alternate Phone Number SUBJECT OF COMPLAINT Last Name /Y1rN Fir 1„ e j Middle Title Suffix License Number(if known) /t do Company/Occupation 1•�� ILING ADDREs Street Address or P.O. Box 1.24 City ✓�GieSo uGpGGE State yC L ZiPode(+4 opt z toional) County(if Florida address) t1w Country �sf� CONTACT INFORMATION Primary Phone Number Primary E-,MMail Adc{r ss /tC.� d 3flS(Z C'I �t RES,ItDENCEADDRESS IFDIFFERENT THA AILINGADDRESS Street Address 371C 134; ! � ty .7,r. Ci �;t/nG *' " ! U State qe:�L Zip (+4opfional) County(if Florida addres u r� Country 273 P VATE ATTORNEY FOR SUBJECT OF COMP+. APPLICABLE Last Name 4 First Middle Title Suffix _ ADDRESS Street Address or P . Box City State Zip Code(+4 optional) County('rf Florida address) Country TACT INFORMATION Primary Phone Number Alternate Phone Number Rev 0512014 3 of 9 Construction: CanlxeinR DBPR 0070—Uniform Complaint Form—Construction Page 3 of 3 ,/n WITNESS WAPPLICABLE Last Name hr7`�— Firgp_7__ Middle Title uffix L ADDRESS Street Address or P.O. Box ('� 6c'W ,we — Jf�LiklL - Gam{ CitGart�Mcn� Cny Czt Q-F StZip Codje(+optionaq County(if Florida address) Country 3 Sg CONTACT INFORMATION Primary Phone Numke� Z S$SS Alternate PhoneFGSNumber _ 77 4e� 3o6.�' WITNESS(IF APPLICABLE) [La7NameFirst Middle Title - Suffix _ADDRESS ox SttZip Code(+4 optional) s) Country—Im __ _ CON_TACT INFORMATION TAlternate Phone Number —� I affirm that I have provided the above information completely and truthfully to the best of my knowledge. Complainant Sign Here Dale: 2 Rev 0512014 4 of 9 Construction: Complaint DBPR CILB 4355—Construction-Related Complaint Addendum Page 1 of 3 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Division of Regulation/Compliance Consumer Services 1940 North Monroe Street Tallahassee,FL 32399-0782 NOTE—This form must be submitted as part of an entire packet. if you have any questions or need assistance in completing this application, please contact the Department of Business and Professional Regulation, Customer Contact Center, at 850.487.1395. W KSITE STREET ADDRESS Street Address ;b`*S-A" City L Staiw_ Zip(+4 optional) COu0ty 11 iiiiiiiiiiiiin CONTRACTOR COf MPPLAINT QUESTIONS ddrR� I am complaining in my capacity as a: ❑ Homeowner Building Department ❑ Subcontractor /❑, Contractor ❑ Supplier ❑ Owner of C4mmerc' I Stmcttire ❑ Other. TNS Select the category that best summarizes the work the contractor did for you or that you were involved in: ❑ Built house ❑ Built addition to house ❑ Remodeled house ❑ Built commercial structure ❑ Air-conditioning or heating work at ❑ Remodeled or built addition to commercial house structure L3Re-roofed or repaired part of the ❑ Commercial roof work roof of a house ❑ Electrical work ❑ Built residential pool ❑ Other: &Z4Ja6al S ❑ Plumbing work Please select the categories below that best describe your basic complaint: ❑ Poor workmanship by contractor ❑ Job finished, but contractor will not correct problems ❑ Roof leaks;contractor will not repair ❑ Contractor failedto pay subcontractors/suppliers ❑ Contractor taking unreasonably long time to do the job ❑ Contractor abandoned job ❑ Financial dishonesty/misconduct by contractor /vO Rev 06/2614 60/9 Construction. Complaint DBPR CILB 4355—Construction-Related Complaint Addendum Page 2 of 3 FINANCIAL QUESTIONS 1. Was your contract in writing? Yes ❑ No ❑ 2. What was your contract price? 3. What was the contract execution ate? 4. What was the work begin date? What was the work end date? 5. What was the total amount paid to the ntractord 6. Have you had to pay subcontractors or ppliers directly? Yes 13 No ❑ 7. If you have paid subcontractors or supplie directly, how much and why? 8. Are there now unpaid bills owed to subcontr tors or suppliers Zcontnactor should have aid? Yes ❑ No ❑ 9. What is the total of such unpaid bills? 10. Have you filed civil suit against a contractor?Yes ❑ No L3 .H.ate you obtained a judgment? Yes O N0 ❑ 11. Have any liens been filed?Yes ❑ No ❑ 12. Did contractor sign any statements to the effect that at ills have been paid? Yes O No ❑ 13. Have you fired the contractor! Yes ❑ No Ll 14. Has the job now been completed by you or a new oontrack, as O No LlL15. Whistle the actual or estimated cost to finish the it you hire an er contractor? BUILDING CODE COMPLIANCE BY CONTRACTOR 16. Was a permit required for the work that was to be completed by the contractor?Yes No O 17. If required, was a building permit obtained from the building department? Yes O No If yes,what is the name of the building department? Permit Number Date Issued 18. Who pulled the permit? /O 19. Was the permit obtained on time? Yes ❑ No ❑ �LC� Mv+x 20. Were any inspections missed or pedortned late? Yes O No ❑ 21. Did the site pass final inspection by the building department? Yes ❑ No ❑ 22. If the site did not pass final inspection by the building department,explain why. 23. Was a Certificate of Occupancy issued? Yes Ll No ❑ Rev 0512014 7of9 Coretmction: Complaint DBPR CILB 4355—Construction-Related Complaint Addendum Page 3 of 3 WORKMANSHIP QUESTIONS 24. Has the contractor offered to make repairs? Yes O No ❑ 25. Has the contractor made attempts to make repairs? Yes O No ❑ If yes, how many times? 26. Have you had any other licensed contractor,architect or engineer inspect the work? Yes ❑ No ❑ ATTESTATION STATEMENT REQUIRES SIGNATURE OF APPLICANT , [knowledge. that I have provided the above information completely and truthfully to the best of my Whoever knowingly makes a false statement in writing with the intent to misle d aervant in the performance of his official duty shall be guilty of a mistlemeanor fdegree(Flor" Sta to 8 .06). 2 ( ,nre: Dale: y' Rev 052014 8 Of 9 construction: Complaint BUILDING PERMIT APPLICATION FILE COPY]' CITY OF ATLANTIC BEACH 1 800 Seminole Road,Atlantic Beach, FL 32233 r± Office (904)247-5826 Fax(904)247-5845 n'�1�- — Job Address: �y S SR•�tt� bdl. 1 1Polmit Number: 15--R y DD Legal Description 31-1 \�1-2S-Z9e +.,o �rtU++ 0r* 1k l..t\) 6Parcel# Floor,thea o +r'. Sq.Ft Valuation of Work$7000." Proposed Work heated/cooled non-heated/cooledZ Class of Work(circle one): New Addition Alteration Repair Move Demolition ool/spa window/door Use of existing/propused structum(s)!circle one): Commercial esi 6 D If so existing structure,is a fire sprmkler system installed?(Circle one): es F7r Florida ProductApproval# For multiple products use pro uct approve urm Describe in detail the type of work to be performed: FEBP - b 21716 Property Owner Information• Name: LA+AS�A lt)_ � prr Address: 3yS StI�Z� pa yt,• City�w.- ttf144[. —° State�Zip t'+_33 Phone TO.n7.7t-Lk E-Mail or Fax#(Optional) Contractor Information: CONTRA O EMAIL ADDRESS: '$12 ® Re/wee rg 'n Company Name: mat In Sg gent: ...b 1Lo Jhn„r.p Address: i rat CiTy, se.�.•4c State Zip Office Phone u Job Site/Contact Number i'4.7L21 Fax# State Cei tification/Registration# e- 1 1 ; $' Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address�y., Bonding Company Name and Address MN- � Mortgage Lender Name and Address _ pqk- Application is hereby made to obtain a permit to do the work and Installations as indicated I cert that no work or installation has commenced prior to the issuance ofa permit and that all work will be per armed to meet the standards ofali laws regulattagconstruction to this jurisdiction. This permit becomes null andvoid*(work it not commenced within s&(5 month,,, or**(construction or work is sni,nded or abandoned for netted ofsix/6)months at any time ager work is commenced I understand that separate permits must be secured for ElectricN Work,Plumbing,slim, ls,Poole,FYtrnrtces,Boilers,Hen(ers, Trtnks andAfr Conditioners,ate AEEREG TO UTINPIEFNOTICE COMMENCMNT MAY SI YOUR FAILURE TWICE OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. /he onart tll be cove readaM examined this?plication andknow the same to be true and correct. Allprovisionsoftawsandordiwmesgoverningthis type of work will be compiled with whether specd herein or not. The granting ofa permit does not presume to give authortry to violate or cancel the orovistow ofary other federal,state, or local law regulating construction or the performance ofcam"chem. Signature of Owned_ �1tW11""l Signature of Contractor ?tint Name yvrl t7 fl." V1 Print Name 3efo his ay of 0 o e s y 20 8 0120•�� x3 4otary Ic C imkslon AFF 192145 ubhc n m ti ru f iXphes February 14.2019 exit 0126.10 CITY OF ATLANTIC BEACH Building Department 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 f`v PLAN REVIEW COMMENTS Permit Application # ° /6 - R110p-297 Property Addresses: /.3r/S Sct'r��Jl3 ,�i•.. �1 Applicant: ycnnerA �'y1p YY Horl9�S Project: AweV, 40/1 This permit application has been: F-1 Approved Cg/Reviewed and the following items need attention: i h� vy/C7i)17 �e pr�mrn /— r uc !o al ar C00i es v c ,o N rr1i- nae roy-N 2 - Res Fn s 1 - al Sfh Ep/: inn , .r �v:lal, n t Mei o I Ca.> Level, qca arrn )iiop fAe Co VP. o / n a c e F C - e- - 30/ Cren r �(/ Eal ' GAa �' (3, tgrm ,ys e s rb �'or men ha/I 6e r ief m Vxlff r bhoo ei S b M, o R CinV Jh c/ o% r)2p44Rebar ize b vo Th-, r 3Aa 6t loc•c c3n s/ree'/' /V/, `� 'R C 0,0)-e S e--p4d FII A %n acopies- vf a-he. 1=1oria/a tsv:( I Please re-submit your application when these items have been completed. Reviewed By: / r ''L Date: CITY OF ATLANTIC BEACH Building Department 800 Seminole Road Atlantic Beach,Florida 32233 (904)747-5800 PLAN REVIEW COMMENTS Permit Application # /6 -RAQ0-'2 97 Property Address: 3'/S Sa i/ AS"� Applicant: Project: This permit application has been: ❑ Approved M Reviewed and the following items need attention: G0de, E Pr t!nnSefva i m RYPa --)O/q4 rrh 1-e V Pw 2 b /7l 1e7 Please re-submit yoouyr�application when these items have been completed. Reviewed By: / i • :!- Date: 0�//916 ZONING REVIEW COMMENTS r City of Atlantic Beach rJ Building and Zoning Department 800 Seminole Road Atlantic Beach,Florida 32233-5445 Phone: (904)270-1605 Fax: (904)247-5845 Email: dreeves@coab.us Date: 2/17/16 Permit: 16-RADD-297 Applicant: Redmarq Homes Review: 1st Address: 13245 Atlantic Blvd#4, Jacksonville, FL 32225 Site Address: 345 Sailfish Dr Phone: (904) 859-7221 RE#: 171386-0000 Email: N/A Correction Comments 1. Setbacks: The required rear yard setback is 20 feet. The proposed plan exceeds that. Please revise plans accordingly. 2. 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. Also please be aware that codes have recently changed. If you are unsure about how the new codes effect your project, please submit a Tree Removal Permit and staff can then determine if it is necessary. Derek W. Reeves Planner dreeves@coab.us STOP WORK CITY OF ATLANTIC BEACH BUILDING AND ZONING DEPARTMENT (904/))247-5826 \cc nj\14 O,� NOTICE N s a This building has been inspected and: �A 4Q`�q\Q�� ArGeneral Construction ❑ Mechanical ❑ Concrete and Masonry ❑ Electrical ❑ Plumbing ❑ Gas Piping IS NOT ACCEPTED CORRECT AS NOTED BELOW, BEFORE ANY/FURTHER WORK ' ' 1DDRESS: .? 7 S SQ f •i~"; n I J r � DO NOT REMOVE THIS NOTICE spector• / Date: / /•' iilure to respond to this Notice within 10 days will result in this violation being forwarded to the CODE ENFORCEMENT BOARD. J'j The posting of this Pln,c,A k_;.- ___._... .. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD y ATLANTIC BEACH,FL 32233 PHONE(904)247-5855 December 14,2016 CERTIFIED MAH,RETURN RECEIPT REQUESTED 70060100000107874100 LINDSEYM. WHITTINGTON 345 E SAILFISH DR ATLANTIC BEACH,FL 322334130 Real Estate No. 171386-0000 CASE NO. 16-508 Location of Violation: 345 SAILFISH DR,ATLANTIC BEACH,FLORIDA Dear Property Owner: Please be advised,Atlantic Beach Code Enforcement has found your property referenced above to be in violation of the City of Atlantic Beach, Code of Ordinances,to wit: VIOLATION FBC Section 105 Permit 105.1 Required. Any owner or authorized agent who intends to construct, enlarge,alter,repair,remove, demolish,or change the occupancy of a building or structure,or to erect,install,enlarge,alter,repair,remove,convert or replace any required impact resistant coverings,electrical,gas, mechanical or plumbing system,the installation of which is regulated by this code,or to cause any such work to be done, shall first make application to the Building Official and obtain the required permit. (windows replaced with used windows without the required permits as required) This letter requests that the noted violations be corrected by obtaining the required permits for the window replacement within ten(10) days of the receipt of this notice. To avoid having this case be referred to the Code Enforcement Board,all listed violations on this notice most be in compliance on or before the date established by Atlantic Beach Code Enforcement. The Board may impose fines up to two hundred fifty($250.00)per day for continuing violations. Upon completing the corrective action required, it is your responsibility to contact Atlantic Beach Code Enforcement and arrange for an inspection to verify compliance. It is our goal to keep our neighborhoods looking well maintained while protecting property values and your cooperation in this matter is greatly appreciated. Please contact Atlantic Beach Code Enforcement at 904 247-5855 if you have any questions or need additional information. Sincerely, Cw */& Deborah White CODE ENFORCEMENT OFFICER 1 ir Compliance Investigation Form Investigation# Date of Request: Time of Request: Location(Address)of Violation: 3 Property Owner/Manager: VIOLATIONS: Action Taken: Co cont r 2 o W SyZ 97C o v.d,n S 4P Compliance: Name of Person Malang Request/Complaint: Address: Phone# Investigation Type F:\Code Enfomemmecomplience Investigation Form.doc April 25 2013 Please mall the completed Uniform Complaint Form to the appropriate address below: Board of Accountancy Division of Real Estate 240 N.W. 76m Drive, Suite A 400 Robinson Street Gainesville, Florida 32607 Orlando, Florida 32801 For the following professions: Please mall the completed Uniform Complaint form Architecture & Interior Design to: Department of Business and Professional Asbestos Contractors and Consultants Regulation Athlete Agent Division of RegulationlCompliance-Consumer Auctioneers Services Barbers 1940 North Monroe Street Boxing, Kick Boxing and Mixed Martial Arts Tallahassee, Florida 32399-0782 Building Code Administrators&Inspectors Child Labor Community Association Managers and Firms Construction Industry Cosmetology Electrical Contractors Employee Leasing Companies Farm Labor Geologists Harbor Pilots Home Inspectors Labor Organizations Landscape Architecture Mold-Related Services Talent Agencies Veterinary Medicine Rev 0512014 9 of 9 Conslrodion: Complaint 101A1- ri 5,', -•1* 9' CASE ACTION FORM Investigation # DATE: ii// r/Z6 NAME: . / . ADDRESS OF VIOLATION 55 / Action Taken: Compliance: