2056 BEACH AVE - STUCCO REPAIR ' �s, CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5814
.-/ JF�lc r=
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RAAR-2868
Job Type: RESIDENTIAL ALTERATION
Description: STUCCO REPAIR
Estimated Value: $5,000.00
Issue Date: 1/9/2017
Expiration Date: 7/8/2017
PROPERTY ADDRESS:
Address: 2056 BEACH AVE
RE Number: 169713-0010
PROPERTY OWNER:
Name: HENDRY, DANIEL P
Address: 2056 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: WEYER CUSTOM RENOVATIONS INC
, CBC 1256903
Address: 10139 Deercreek Club RD
Phone: 904-813-9425
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $37.50
BUILDING PERMIT FEE $75.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $116.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND "f11E FLORIDA
BUILDING CODES.
0.ay- h City of Atlantic Beach APPLICATION NUMBER
Js , - 16 Building Department (To be assigned by the Building Department.)
�~
800 Seminole Road i (6" ��Ai2 —ZZ(%�, 'e Atlantic Beach, Florida 32233-5445
\ -.—�`"•".,y. .. Phone(904)247-5826 • Fax(904)247-5845 il
x r 9• E-mail: building-dept@coab.us Date routed: t -7.Z7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ZOSLo 01-4 I'1 VE' D ment review required Ye No
Building
Applicant: Planning &Zoning
Tree Administrator
Project: TV Cao R E P ( 12- Public Works
Public Utilities
Public Safety
Fire Services
ms`s v :] 1 ;?, ,,*-046;i rl� ids' _ _
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. ['Denied.
(Circle one.) Comments: ft)
U a C....._
BUILDI P.,
PLANNING &ZONINGReviewed by: ,n - Date: / `1-17
TREE ADMIN. Second Review: Approved as revised. ['Denied
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 ll
Office (904) 247-5826 Fax (904)247-5845 1 t0` P A A R -Zgc 3
Job Address: Z654" r3 . -Q A--t'.t Permit Number:
Legal Description 1 S 13 v1-25- 714. r1, 41-L4-;._ J- du.r A-t, 3 Parcel#
.2., Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ -1.0') Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Re..' Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial 'esid• r '
If an existing structure,is a fire sprinkler system installed? (Circle one): 'es N/A
Florida Product Approval #
For multiple products use product approval form
De cribe in detail the type of work to be performed: •�e.7G-4< '.6^<- 1 � "" . -``« t s `'7 LL
tAItSJ4‘ cn l_ .cfly
Property Owner Information:
Name: te_ru4'/ Address: ZUSL b At--)-
City
LCity A-1-k ( g-€rwl,-- StatesLZip 522 33 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: �_l ' �5 � �[l
�-� \'�^•$.,1~Qualifying Agent:-`\taw. 1/\1441
Address: 11 9 �e-e�c rec.-Cc Ll 4. �-
h P A City -4.- a,ksv:t I r State c Zi
Office Phone C(d-()8 l 3 "i'(- Job Site/Contact Number (golf 813-moi(t 24" Fax# ,: _L __ _..2.22..,be ,t
State Certification/Registration# et3c , '�503 J
Architect Name& Phone#
Engineer's Name& Phone#
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 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. l 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 hereby certify that I have read and examined thisplication 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 fe,eral,state, or local taw regulating construction or the performance of construction. '
BM
a� ..I
A /14Signature of Owner � f`� Signature of Contractor •
Print Name K 4 '"yJ it(�i y Print Name T///(/'G ' A e./
Sworri��t,oand subscribed before me Sworn to and subscribed before me
this M"CW\Day of 1 2t`.•C 'OC( ,20 l V this I l-1"Day of 1�-GC 4 Y1 bt,r ,20 L(0
"+P'' NO.:Y'xraeub KAYLEE ROBERTS f
Notary blic ;o. �o;•.," KAYLEE ROBERTSROdERTS
N !" Notary Public-State of Florida '`4,�: ,tary Public-State of FloridAt
• •. ��� iced 01.26.10
a, My Comm.Expires Jun 4,2011 iii`. My Comm Expires Jun 4,20
`"„sot ps Commission•FF 023994 4 -:'F...�,,,,,,, Commission I FF 023954 )
i •
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
I (A 1 t3 -00‘0Permit No. Tax Folio No.
State of tri.- County of
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., j
Legal description of property being improved: /s -413 o 1 -
i� A 4-L 'tic ci, 0,1. ;
i-1.Lr'7 1dr 1z A l.rx ` tel I3`fT')
Address of property being improved: XJ fo Dei%GVl C 3 Z Z-5e3
General description of improvements: 5+ _t -c. v'
Owner fB.,n 14,_4►,y 4.f-afth'
Address f.-056 /�,.j 4 vi- 3 )
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor (A); I t: ,r• tii4py
Address �r !` OK 1,if
9n�
Phone
Fax No.
Surety(if any)
• Address Amount of bond$
Phone 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
Phone 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 Statutes.(Fill in at Owner's option).
Name
Address
Phone No. Fax No.
A A
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a :0 o
different date is specified): •,—amu ,
o c c
THIS SPACE FOR RECORDER'S USE ONLY OWNER w LL
f' N
Signed: �, ice? DATE it K.; ¢ y �' lk
n
c
f�
Before this 1 ay of CG Yl l ver ZD 1%.,9 In the W c, x c
Co n of D val.Sta a of?fide.has peappeared —+ . "' .co
Doc#2017005665,OR BK 17837 Page 1147, ,� �VtU � � co
herein by a a' E
himse/herself and affirms that all statements nd declarations herein r o E
Number Pages: 1 are true and accurate .`o'c) o
Recorded 01/09/2017 at 11:25 AM, z ›.c.)
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY ..so •
111 RECORDING$10.00 Q ••
Notary Public arge.State of -Flew-0Ot. County of (NUL VOLD r =,�
My commission expires: _t .
Personally Known/ or
Produced Identification """"'