1768 BEACH AVE - RES. ALTERATION # "; „.
ITY OF ATLANTIC BEACH
A Vs
800 SEMINOLE ROAD
±� ;r 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: 17-RAAR-2977
Job Type: RESIDENTIAL ALTERATION
Description: repairs following mold remediation; mostly drywall and
insulation work
Estimated Value: $5,000.00
Issue Date: 1/17/2017
Expiration Date: 7/16/2017
PROPERTY ADDRESS:
Address: 1768 BEACH AVE
RE Number: 169602-0000
PROPERTY OWNER:
Name: HICKS, ANTHONY J
Address: 2291 OCEANSIDE CT
GENERAL CONTRACTOR INFORMATION:
Name: BOSCO BUILDING CONTRACTORS
, CBC1250212
Address: 2158 MAYPORT RD QA TODD ALBERT BOSCO
Phone: - -
PERMIT INFORMATION:
I
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
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
Permit No. /7 /Z,J9R-a977 COPY Folio No.
State of Florida, County of Duval OFFICE COPY
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of property(legal description of property and address if available):
1768 Beach Ave,Atlantic Beach, FL 32233 20-20 09-2S-29E.115 Ocean Grove Unit 2 E 41.65FT LOT 6,PT GOVT LOT 4 RECD O/R 11091-42
2. General Description of improvements:
3. Owner Information:
a)Name and Address: Anthony Hicks-2291 Oceanside Ct, Atlantic Beach, FL 32233
b) Interest in property:General
c)Name and address of simple titleholder (if other than owner):
4. Contractor Information:
a)Name and Address: Bosco Building Contractors, Inc. 2158 Mayport Rd, Atlantic Beach, FL 32233
b) Phone Number:(904) 241-0320
5. Surety Information: Doc#2017007257,OR BK 17839 Page 1716,
a)Name and Address: Number Pages:1
b) Phone Number: Recorded 01/10/2017 at 03:14 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
c) Amount of Bond: $ COUNTY
RECORDING$10.00
6. Lender Information:
a)Name and Address:
b) Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a) 7, Florida Statutes:
a)Name and Address:
b) Phone Numbers of Designated Person:
8. In addition to himself/herself, Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
a)Name and Address:
b) Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor, but will be one (1) year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true to the best of my knowledge and belief.
Anthony Hicks, Owner
Signature of Owner or Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The foregoing instrument was acknowledged before me this I p day of da o_, , 201,
b - on (lcs Q‘...)c -e-r" for .
(Name of Person) • (Type of Authority, i.e.Officer/Attorney) (Name of Party Instrument was Executed for)
Joj1
Denise A.Ennis N Y PUBLIC, TATE OF FLORIDA
•. NOTARY PUBUC
""ii NOTARY
STATE OF FLORIDA Print Name: I( )er tc€- �• �1' �S
'• Cann*FF966426
Expires 3/1/2020 Nal Personally Known
❑ IdentificationType:
(Affix Notary Seal Above)
Revised 3/15/12
�i,a -, City of Atlantic Beach APPLICATION NUMBER
Js ABuilding Department (To be assigned by the Building Department.)
4 � 800 Seminole Road pp /�
ti....,r -0 Atlantic Beach, Florida 32233-5445 I 1 -V-Alt-a1
Phone(904)247-5826 • Fax(904)247-5845
j; j E-mail: building-dept@coab.us Date routed: 0( t. Di c .0(�
City web-site: http://www.coab.us
•
APPLICATION REVIEW AND TRACKING FORM
Property Address: (1 (0 t -&LV\ AvQ . ,—De nt review required Yes No
Q ,q wBuildin
Applicant: ODBC 0 �l�ll'�j . Planning &Zoning
Tree Administrator
Project: (4Ct\ C,t_- \-t. 01,6qd ( Q��1tt1
( S, di,v) Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
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: r pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: n116\4 - Date: / /2`/7
TREE ADMIN.
Second Review: ['Approved as revised. nDenied.
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
1
I
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OFFICE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1768 Beach Ave, Atlantic Beach, FL 32233 Permit Number: i 1- c-A AV_'aG-ii-
Legal Description 20-20 09-2S-29E .115 Ocean Grove Unit 2 O/R 11091-4garcel# E 41.65FT LOT 6,PT GOVT LOT 4 RE
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 5Ova — Proposed Work heated/cooled 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 Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): • - 10
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Repairs following mold remediati`I t I SIIroV,9 sctlatiwork
Property Owner Information: JAN 1 0 2017
Name: Anthony Hicks Address: 2291 Oceanside Ct - .. J
City Atlantic Beach State FLZip 32233 Phone
E-Mail or Fax#(Optional) -.
Contractor Information:
Company Name: Bosco Building Contractors, Inc. Qualifying Agent: Todd A. Bosco
Address: 2158 Mayport Rd City Atlantic Beach State FL Zip 32233
Office Phone 904-241-0320 Job Site/Contact Number 904-241-0320 Fax# 904-241-0326
State Certification/Registration# CBC 1250212
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. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, urnaces, 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 herebycertify that I have read and examined this a plication and know the same to he true and correct. All provisions of laws and ordinances governing this
type ofworkwill be complied with whether spec ted 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 or the performance of construction.
Signature of Owner K;(--- JZi - Signature of Contractor
Print Name Anthony Hicks Print Name Todd A. Bosco
Sworn to and subscribed beforee Sworn to and subscribed before me
this to Day of o.nust_c, , 20 t`l this In Day of ' ` ,201-i
Denise A.Ennis . _ , De A.Emit
16 NOTARY PUBLIC
Notary Public _ STATE OF FLORIDA • 'u• is •_
- STATE OF FLORIDA
s.:• ='. Cann*FF966426 '•,7--of '''• -�%��f ff26
- Expires 3/1/2020 Expires 3/1/2020