1820 LIVE OAK LN - SIDING & FLASHING -)" ' �S, CITY OF ATLANTIC BEACH
N,,,. 800 SEMINOLE ROAD
t'-) ./I ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
OlSl yr-
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-RAAR-3362
Job Type: RESIDENTIAL ALTERATION
Description: REPAIR CEDAR SIDING AND FLASHING OVER
SHINGLES REPLACED
Estimated Value: $15,400.00
Issue Date: 3/3/2017
Expiration Date: 8/30/2017
PROPERTY ADDRESS:
Address: 1820 LIVE OAK LN
RE Number: 172020-0742
PROPERTY OWNER:
Name: SCOTT, JOSEPH & MARSHA, *
Address: 1820 LIVE OAK LN
GENERAL CONTRACTOR INFORMATION:
Name: DEGEORGE ENTERPRISES INC
, CGC 023079
Address: P.O.BOX 10044
FLEMING ISLAND, FL 32006
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $63.50
BUILDING PERMIT FEE $127.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $194.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEAC11 ORDINANCES AND THE FLORIDA
BALDING CODES.
01-01/2, City of Atlantic Beach APPLICATION NUMBER
as 14. Building Department (To be assigned by the Building Department.)
i 800 Seminole Road410;
i 7` R IAR R _33 ` a
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904) 247-5845
onisys E-mail: building-dept@coab.us Date routed: Zeit 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 182.0 L Ale- OAi-C LK) De ent review required Yes o
uilding
Applicant: 1 )C G EO p(� Exj-/-Gs p (S elan ning &Zoning
`tree Administrator
Project: S ( ( ��Cp( S t4(,CQ Public Works
(
S Public Utilities
POO D H(cam 3 LE Public Safety
C P A-t C, 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: 14proved. Denied.
(Circle one.) Comments:
CBUILDING
PLANNING &ZONING
Reviewed by: , . Date:114/2_
TREE ADMIN. Second Review: Approved as revised. nDenie
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OFFICE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 17 _ R A A R 33 6, Z
Job Address: (&Z Lve oak Lin, Akhil'-13341h.FT:322% Permit Number:
Legal Description( rrjFt
�1%/41✓lcCe- r (ci���6/c-R5Mb P60 Parcel# (ipOZ°—b74'Z
Floor Area of Sq. . q.Ft
Valuation of Work$ ECJ 4 e' Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration i• -.. ; Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial 1'esidenti.
If an existing structure ,is a fire sprinkler system installed? (Circle one): 'es la N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: 13 rrl of Ce4gr'Stc tr- l -\-z:t. ".7)e,
ale oje• A- TIP i c 14. . : 6 ' o - c ..o./- .1 (-- = - .•
IC of eM-10', et-Information:
Nam-: as 1r s oe. G..0'1-''C Address:( e O€kLt-i
City :14 (C Staten Zip=55Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company me e.� s;"-rt- c-c. Quali ing Agent: D- ec 4 - r
Address: d I� City State Zi. SZdQ/6
Office Phone O4-— 1 Job Site/Contact Numbe '" .• t�ZZ Fax#
State Certification/Registration # UCL C'(Z77 n,, .. c r c ® r 9ct �. corn
Architect Name& Phone# .f�
Engineer's Name& Phone# 1J Pr
Fee Simple Title Holder Name and Address, Jc�/e.
Bonding Company Name and Address 1•1 Pc
Mortgage Lender Name and Address iil 4
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 ElectricalWork, 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 sal • a d orrect. All provisi• s o laws and ordin• --• •overning this
type of work will be complied with whether specr red rein or not. The gra ing a -•• .� does not press to : e authority to folate • cancel the
provisions of any other federal,state, or local law reg ating construction or th• er . loge:' onstruction�. `,
VA 11
Signature of Own ����4ei�f z"` -e"`� ' 1i 1444' of lar, A/i_i`/i..._At.
1---- 6C75 % : 5 di 9 W
Print Name Rol Ma/ s-C it itirfasfR a eA-m t.
7
Sworn to and subscribed before me y aworna and subscri.-. refore e
this a( Day of FGb .20 17 $lus =.t Day of .# 20
` 71> �, i Terry Hendry Z,,.,. .. +,ifff,
Notary 'u et State GI I =a�s.�r lsi 'ubl lc , "
My Commission Expires 1113012017 :. vI -
Revised 01.26.10
Commission No.FF 66026 ��'�%.,;„
OFFICE COPY
NOTICE OF COMMENCEMENT
State of Filo C't4et Tax Folio No. (72b2C)—4.)'742.
County of JCI; 1
To Whom It May Concern:
Pe.r rn 71-. -# 17 —eta 11 R - 36.2
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in thi NOTICE F COMMENCE ENT.
Legal Description of property being improved: Le -� L JQ in r Urj t -I p.A. q34:. Vibes,
Address of property being improved: t$ r,.I,v(e. O q k Lb ArC (oir,4 l4 e,..1.„ frk -5z!;3s
General description of improvements: ' , '.4 �d .a_. 44....-..... • _ - ... 1
Owner: �.E.a s ~, hili Address: - Q . WI: . TIP
Owner's interest in site of the improvement: I;QDs
Fee✓ Simple Titleholder(if other than owner):
1 mog
Name:
.� LL.0 . `�c' 3
/T Contractor:_ •� �t _ • ' V i °23 Z`°a"N
T a-,O
Address:
1552.arc Lt Ave, 47eA( -L f �z1`7-7 z o
o m Nm
Telephone No.: Fax No: o N 01
A o
Surety(if any) 1T o x a
no w
Address: Amount of Bond$ 0"'
Telephone No: Fax No: -C-1 13 C4
Name and address of any person making a loan for the construction of the improvements co �n
- m
Name: A. o
0
Address: c
D
r
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: FER p 7
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 Statugs. (Fill in at Owner's option)
Name: (�
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):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Telly Hendry Signe.4/ / � ._ Date: c( r
NotaryPubfic Before me this day of RAG go(r] in the Cou ty of val,State
I) State of Florida Of Florida,has person:lly appeared (y\ICirS h r4 5Lo}l-
MyCommission Expires 11/30/2017 Notary Public at Large,State of Florid County of Duval.
My commission expires: Iv 0-'11
Commission No.FF 66026 Personally Known:
or 0
Produced Identification: pi_ Lr wets 1....1 G
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