1833 Tierra Verde Drive RES17-0122 ri r,'yr✓,,
�'� ' ss1 CITY OF ATLANTIC BEACH
`'` '"' ° s� 800 SEMINOLE ROAD
7.5v., zATLANTIC BEACH, FL 32233
'.ri;t TY? INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0122
Description: HARDIE BOARD SIDING
Estimated Value: 16000
Issue Date: 8/7/2017
Expiration Date: 2/3/2018
PROPERTY ADDRESS:
Address: 1833 TIERRA VERDE DR
RE Number: 169542 5086
PROPERTY OWNER:
Name: MCCLURE JAMES W
Address: 1833 TIERRA VERDE DR
ATLANTIC BEACH, FL 32233-4527
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Golas Construction LLC
Address: 6318 Autlan DR
JACKSONVILLE, FL 32210
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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 RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
.r�,1w;:,, City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
`} 800 Seminole Road r
j - •--- �r Atlantic Beach, Florida 32233-5445 1 \ J l 7" 0 ( z Z
Phone (904)247-5826 • Fax(904) 247-5845 / /
F�o;ttgr E-mail: building-dept@coab.us Date routed: ! i/
1 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 633 ► T EKkA V -RDe, ment review required Yes No
Building
Applicant: 0 LAS e. .,_„ T Planning &Zoning
Tree Administrator
Project: J i L 1 j\_ �" 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: Approved. ❑Denied. I INot applicable
(Circle one.) Comments:
BUIL-DIN
PLANNING & ZONING Reviewed by: ill/ Dater' 7 . / 7
TREE ADMIN.
Second Review: ❑Approved as revised. rilDenieoV ENot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I 'Approved as revised. ❑Denied. Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
7r>> Building Permit Application
Qty of Atlantic Beach OFFICE COPY
7
41(
I800 Seminole i�ad,Atlantic Beach,FL 32233
Phone: (904)247-5826 Fax (904)247-5845
-- (2,12A '/ R �5t7 o i z�
,bb Address: 1g t E U E 121)E- D l�- Fir/milt VA
I > 2
Legal Description 3,5-2s 03-25- ,95 .CE1 (/ t � / e Lc27-
l `7.J
Valuation of Work(Fplacement Cod)$ /[� 000 Heated/Cooled g (�7 6 Non-Heated/Cooled /8
W aassofWork(ardeone): New Addition Alteration�l Move Demo Fool Window/Door
O Use of existingrproposed structure(s)(Circle one): Commercialdent
0 If an existing structure,is a fire sprinkler system installed?(arde one): Yes No N/
CD SJbmit a Tree I'moval Permit Applicat ion if any trees are t o be removed or Affidavit f No Tree Rtarnov
Describe in detail the type of work to be performed. i_ DIE� �
D 5/9/A/6- /N74-1 L/rj(�f✓
ki !/
Ronda Rodud Approval# for multiple products use product approval form
Property Owner Information
Name: n r OLP 7()1tP II Address: • r E'_._ i 2 )Z
City (17/..,Iffy 1 lC -13 f�-tr i aate F4. Zip • Phone t`r �i
E•Mai( .`'je)F. 57QL,f r3G r35FZ.- 674,2 i(-1
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: it $ /Z{/" qualifying Agent: 2- i/z4 //L U 2-
Address
Address 6 31 ! ,i r;< ID rV City g, ; 0 ', ^late /1--(,, Zip 2 Z/e9
Office Phone 9Q - Zt -R1v� ,bbSteJCont.• Number "0/7 - 4 - /oma
aate Certification/Ragidrat ion# rt3e/35E-Mail C2,54/+�$6,)�h/s),f7.5e Nj,/L . Up?/y
Architect Name&Phone# N//i
Engineer's Name&Fhone# it//4
Workers Compensation
empt/ usurer/Lease Employees/Epiration Cate
Application is hereby made to obtain a permit to dot ework and installat ions as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulat iong
construction in thisjurisdiction. I understand that a separate permit must be severed for laECTRCALWCPK PLUMBING,SGNS
WELLS POOLS FURNACES BOILERS HEATERS TANKS and AR CONDITIONERS etc
ONNBR S AFR DAVIT: I certify that all the foregoing information is accurst a and that all work will be done in m pl i anoe with all
applicable laws regulating construction and zoning.
WARNING TO OWNER YOUR FAI LURE TO FECORD A NOTICE OF OOM M ENCBVI ENT MAY
RIL9JLT IM YOUR PAYING TWICE FOR I M PROVBVI HVTSTO YOUR PROPERTY. IF YOU I MIND
TO OBTAI N R NANQ NG, OONSJLT W TH YOUR LENDER OR AN ATTOI'IEY BEFORE
RECORDI NG YOUR NOTICE OF COM M BdCBVI ENT.
____,---.-7----- _= r!, OK CA-- -e K LU ,
('gnattire of Owner or Agent including Contractor) (Sgrature of Contractor)
S. •:• - .sworn to(or affirmed'�before me this3/ day of ed and sworn to(affirmed)before me this 2_day•f
7)
(,Jy ,2e/7 ,by � eyit 5 (f) u i �G[,6l,by
�1 „t
ure of Notary) (:• - ure of Notary) 7
e/27(
,=off. �o.. JACQUELINE L. PAYNE
[i} rsonally/11041./n's. MY COMMISSION#FF161659 [ I Personally Known OR
[ ]Produced I.: '••',:••i7: [ I Produced Identification
Type of Identif`atibY.'.`` ' EXPIRES September 21,2018 Type of Identification:
(407)39$-0153 FlofidallotaryService.com
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° °�:. �L�Sf'EnGEft
�' �':•_ MY CC�1iViS51CV'rF924951
I`;; opo; EXPIRES:October 6,2019
—.;t, 6�r,?e;t Thru NotaryPublic Urcervri[ers
JiV L.rLL VL' O/0,I4I6JRLAIAi1/000100.wfJ41 L(PREPAREOFFICE COPY
Permit No.RE E /7-- Tax Folio £?
iNo.
State of FLORIDA County of 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: 38-28 09-2S29E SELVA TIERRA LOT 43
Address of property being improved: 1833 TIERRA VERDE DR Atlantic Beach FL 32233
General description of improvements: SIDING INSTALLATION
Owner STOLP JOSEPH R
Address 1833 TIERRA VERDE DR Atlantic Beach FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
'4 Contractor GOLAS CONSTRUCTION LLC
� Address 6318 AUTLAN DR JACKSONVILLE,FL 32210
767 ! Phone No.904-487-8103
Fax No.
Surety(if any)N/A
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 he 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.
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 1 /
OWNER
DATE - ��
Be melhis ��_day of in the
;totyof Duv:i.Stare of Florida,has pprsonalty appeared
ht415;3' he:'if and a I. that all statements and declarations herein b'
are true end accurate
Doc#2017179685,OR BK 18073 Page 341,
Number Pages: 1
Recorded 08'022017 at 11:01 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL ,y •iicatLarge,State of MEM County of /ms's
COUNTY /" con •- on expires: „ 1;, 2
Personally Kneen C or
RECORDING$10.00 Producedldent5cayyj+flon —
, JACQUELINE L. PAYNE
(.. ' `o MY COMMISSION#FF161659
:fo^. :,•r EXPIRES September 21,2018
(4071398.0163 Florldallotaryservice.com