327 5TH ST - SOFFIT REPAIR .r3 ~ ^v�`n� CITY OF ATLANTIC BEACH
rr+ -
�,. 800 SEMINOE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0123
Description: REPAIR SOFFIT- NEW T& G
Estimated Value: 1500
Issue Date: 8/14/2017
Expiration Date: 2/10/2018
PROPERTY ADDRESS:
Address: 327 5TH ST
RE Number: 169860 0100
PROPERTY OWNER:
Name: BUCKLAND JAMIE
Address: 327 5TH ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ELITE CUSTOM HOMES & RENOVATIONS INC
Address: 2304 Peach DR
JACKSONVILLE, FL 32246
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.
SCity of Atlantic Beach APPLICATION NUMBER
jt rr�,yf Building Department (To be assigned by the Building Department.)
r 800 Seminole Road RE-St ESl -f z r� Atlantic Beach, Florida 32233 5445 -,
Phone (904)247-5826 - Fax(904)247-5845
\N.,__________-':/_,01119:- E-mail: building-dept@coab.us Date routed: _a_i _ii 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3Z7 Sr Department review required Ye No
4-Crildin_g_j
Applicant: E Lr7e CUS t oM of 1.F-V 1a�i ning &Zoning
Tree Administrator
Project: S o FP( T R -PA(e.___ 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: <proved. I (Denied. I Not applicable
(Circle one.) Comments:
BUILDING 7- / 7
�
PLANNING & ZONING Reviewed by: ` r Date: • / ' l 7
/ ,
TREE ADMIN. Second Review: Approved as revised. ❑Denie . ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. I ]Denied. 1 INot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
OFFICE COPY
rSu' % Building Permit Application Updated5/5/17
140
►�.'� City of Atlantic Beach
\vr 800 Seminole Road,Atlantic Beach, FL 32233
�0r:'.e Phone: (904)247-5826 Fax: (904) 247-5845
s) sig �� 3,; 33I� Csi7 - 0 i z 3
Job Address: t�7/4i+�fr �°aa� Permit Number
, A K,Z orl
si
Legal Description -bg /4 - 2 _5 - g f 4-.---- / 2 a ,4#4141" RE#
Valuation of Work(Replacement Cost)$ /76 '°-° Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residen
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be p rmed:
gp+>T �d �)_ / .9-- /� ,.(��. Cyj cam (
T ! Eel c i_ � >c.is�, nFlorida Product App for multiple products use product app`ro4 form
Property Owner Information �
Name: "Ta oci +ct.�� Address: `�1*' 85 A- PA C' ti€ ` l vh L
City Ai" e-- tar /t State 0 Zip 3233 Phone_ Qi,Oq-. -"763 -t1 I W
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information �1 Q /
Name of Company: �iyj�w r!°'"BS /►E� f4 ' Qualifying Agent: J R 44".6 /4//'may W
Address ,931:;t4 94.h Dr, City 1-cci<6e.ty-IIt State f=/ ., Zig 3Zy,� Nil
O
Office Phone 4' N- 233-- f/ 3 e) Job Site/Contact Number qbv AVL - qhs f% -r -t Z
State Certification/Registration# /.'Rt ld 64142 i E-Mail A'I<(0,4O Iry c.i-'o'. 4 '1 43 Y 9 boa . O
Architect Name&Phone# r
� W � o ti.i
Engineer's Name&Phone# U co 1 Z Q
Workers Compensation U o U p
xempt Insurer/Lease Employees/Expiration Date LII �, Q ,
Application is hereby made to obtain a permit to work and installations as indicated. I certify that no work or insta�ti tgs Z
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws reOli. a I rig N
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,fiG cN„ I""
Z
WELLS, POOLS,FURNACES,BOILERS,HEATERS,TANKS, and AIR CONDITIONERS,etc. O Q 2 +.w
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance vith a Q m
applicable laws regulating construction and zoning. W W 5 0
— w o W
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT t' w ¢ W
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU 110-END
cc
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RE ORDING voyij NOTICE OF COMMENCEMENT.
o _
(Signature of Owner or Agent) • ...e. ' '114.- --- ''''..- f
(Signature of Contractor)
(includin 1 ontractor)
ned and sworn to(or affir .)bef• a me this�ay of •ned and swo �('.(7affir .of Q.�, e is a day of
70 b •A �_ by
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_i1} i ; TONI GINDLESPERuL:RO ` '' TO•t11lSr SPERGER
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�? MY COMMISSION#FF 924951 � .._ MYCO CN#FF924951EXPIRES:October 6,20;9 .:o EXPIRES:October 6,2019
"," ",�aed Thru Notary Public Underwriters °'t°' Bonded Thru Notary Public Underwriters
[ ]Perso .. sonally Known OR
oduced Identification (],_ .2 4 5 ,4 zz_s4...09 ]Produced Identification •
Type of Identification: 'J `"I ytie of Identification:
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NOTICE OF COMMENCEMENT
State of County of Tax Folio No.
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: ...<:- 6 y /4 - as ^ a.9k-__-, /72 f/%4/.. /S, _Zvd—
fi (2 )1< 7
Address of property being improved: 3V-2 fl1' &-I-- Rl9 n A` j3 e4,A fl 322 33
General description of improvements: R¢rp4,if/ � 6o.Qf A'+'
Owner: Ntii.ri 0a tQ.4 Address: 3 a 7 6'4 6/ .d lite k /33.26 it 3273)
Owner's interest in site of the improvement: ?e 4iet, /Dos e
Fee Simple Titleholder(if other than owner): /
Name: J ,/ /
O^ ontractor: Ali ir, Cv a� /iDika, Qv4G /?ei,,£>•Ons i v 34ry e5 A �G/71
1 h r. .,.e� 4/ (/�l fe / 3 2til✓ � Address: e��Dy �Ccv � ��t/if�5�
ti)
Telephone No.: 901/' .4-ca-Uel cl Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone 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:
Telephone 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 Statues. (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 OWN 9i' -...... 414
`
►Pa. Ute: d /ail 7Signe..
Befor; me this -. day of in th< County of Duval,State
Doc#2017189627,OR BK 18087 Page 1881, Of Flo id has personally appeared ��
Number Pages:1 Personally Known: /...,,or
Recorded 08/14/2017 at 11:12 AM, Produced Identification: el S •-4 Z" S 4 -09 5 - v
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Notary Public:
COUNTY My commission expires: •6'Ac .
RECORDING$10.00 �•.. gj•,x''ik., TON!C!NGLESFEP:GCR
'••••;1.:;> :'`_ MY COMMISSION 4 FF 924951
.,-.,p,, EXPIRES:October 6,2019
e Bended Thru Notary Public Underwriters