1855 BEACHSIDE CT - PAVERS 0 rLy:p r
.�� 'ilk s+ CITY OF ATLANTIC BEACH
tl ? 800 SEMINOLE ROAD
,� ATLANTIC BEACH, FL 32233
"�o; 9INSPECTION PHONE LINE 247-5814
RESIDENTIAL OTHER - SINGLE OR TWO FAMILY RESIDENTIAL OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RESO17-0023
Description: REMOVE CONCRTE, REPLACE WITH PAVERS
Estimated Value: 0
Issue Date: 8/11/2017
Expiration Date: 2/7/2018
PROPERTY ADDRESS:
Address: 1855 BEACHSIDE CT
RE Number: 169542 0558
PROPERTY OWNER:
Name: TEMPLE CHARLES R &JEANNINE M LIFE ESTATE
Address: 1855 BEACHSIDE CT
ATLANTIC BEACH, FL 32233-5954
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: KETTELL INC.
Address: 1860 MAYPORT RD
ATLANTIC BEACH, FL 32233
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.
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- City of Atlantic Beach
Permit Number: RES017-0023 Description: REMOVE CONCRTE,REPLACE WITH PAVERS
Applied:6/19/2017 Approved:6/22/2017 Site Address: 1855 BEACHSIDE CT
Issued:8/11/2017 Finaled: City,State Zip Code:Atlantic Beach, Fl 32233
Status: ISSUED Applicant:<NONE>
Parent Permit: Owner:TEMPLE CHARLES R&JEANNINE M LIFE ESTATE
Parent Project: Contractor:<NONE>
Details:
LIST OF CONDITIONS
SEQ NO ADDED DATE REQUIRED DATE SATISFY DATE TYPE STATUS
DEPARTMENT CONTACT REMARKS
1 6/20/2017 EROSION CONTROL INSTALLATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(247-
5814)to request an Erosion and Sediment Control Inspection prior to start of construction.
2 6/20/2017 ON SITE RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site during construction.
3 6/20/2017 ROLL OFF CONTAINER INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Roll off container company must be on City approved list(Advanced Disposal, Realco Recycling,Shapell's,Inc.,Republic Services). Container cannot
be placed on City right-of-way.
4 6/20/2017 RIGHT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full right-of-way restoration,including sod,is required.
5 6/20/2017 RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
Printed: Friday, 11 August,2017 1 of 1
`
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
i i' 800 Seminole Road 2
Atlantic Beach, Florida 32233-5445 R C E c) 00z3
Phone(904)247-5826 Fax(904)247-5845 /
-:!1119' v E-mail: building-dept@coab.us Date routed: 67 /1 C) / ( 7
City web-site: http://www.coab.us fff
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 BSS I &- a(DF c" Department review required Yes No
l Building
Applicant: 1 < TEl.t_. lC- efar Hing &Zornn
Three rfiinistrator
Project: PR VE-Z- - Public Works
Public Utilities
Re. -AQ_& C6PDO12 GTC 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. . ❑Not applicable
(Circle one.) Comments:
BUILDING /
PLANNING & ZONING Reviewed byf i •ate:6/ i '
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. ❑Denied. . ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
rs.:Lvr,� City of Atlantic Beach '
APPLICATION NUMBER
} ift Building Department ' JUN 9 2017 (To be assigned by the Building Department.)
800 Seminole Road r-,,
r� Atlantic Beach, Florida 32233-5445 ESO - V d0 3
J V r
Phone(904)247-5826 • Fax(904)247-5846 —
�J,11jir E-mail: building-dept@coab.us Date routed: t� 9 + 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 B CJs EA{?t•�S F Cr Department review required Yes No
/ Building
Applicant: I E-I-rCLL C ning &Zonin
ree anis rator
Project: PR V — Public Works
-
Public Utilities
RC-Qt-Ae-& ae,p.. 0 ._G-1- 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. . ❑Not applicable
(Circle one.) Comments:
/0116/1411/1414
BUILDING
PLANNING &ZONING J
Reviewed by. eeic,L� Date:
TREE ADMIN. Second Review: A roved as revised. LGLG
❑ Pp ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. . ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
rs--L"r'' Building Permit Application Updated 5/5/17
s_.=.1'
J Itid
c'.'' City of Atlantic Beach
JV 800 Seminole Road, Atlantic Beach, FL 32233
- ;0, Phone: (904) 247-5826 Fax: (904) 247-5845
, e
Job Address: 1� 5 e444'$14€� (h)fl Permit Number: CS 0'7- 0O0
`7
Legal Description 2--/7 d"1 ZS -24 E RE# : q,5 Z '"0153?
Valuation of Work(Replacement Cost)$ 35CV Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Additio It t' Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial -esidential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes N. /A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavi o to ree Removal
Describe in detail the type of work to be performed:
pellot aH e 0+1.45 4- f 1►^c P of t afta fc, 1,0;#1, p✓bei,
8 D,r✓]0../,— 69.4—e74—/.
Florida Product Approval# • for multiple products use product approval form
Property Owner Information ��rr (� ��
Name: �P/YYl Address: I a7S _ il•S'^
P ZZ Phone Z ,../
Z
City 411/4",17"‘„, �j��+ State f� Zip ,� 3� �Dy ��
E-Mail TM7T of & C usf-. nil'
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Informatio
Name of Company: �a ` (.- Qualifying Agent:
Address ISG( l�Ti4L #i /lira City 4 S. State Zip 3ZZ33
Office Phone gal ill_ 7 Vt4 Job Site/Contact Number `l0 77 /Do gr
State Certification/Registration# E-Mail .r14 @ `tG , .'.,L. L#"-.
Architect Name& Phone# U 0 .
Engineer's Name&Phone# 04,E
Workers Compensation t�
Exempt/Insurer/Lease Employees/Expiration Date
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 the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS,FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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
RECO' P ING YOUR NOTICE OF COMMENCEMENT.
i % `-
,€ 4-
(Siture of Own or Agent) t (Si nature of Contractor)
(including •utractor) •
S' ned and sworn to(or affirm•. .efore me this day of Si ned and sw rn to(o fi med befo me this of
by � y
��r I
iday
(Signature of Notary) (Signature of N tary
.
•
;'.f TONI GINDLESPERGER 1 ellnk.,,, TONI GINDLESPERGER
(;(4:-;;;;7; MY COMMISSION#IV 924951 .?:: ia, ;._ MY COMMISSION#FP 924951
[ ]Personally Known OR tea• :'j EXPIRES:October 6,2019 [ j Personally Known OR ;• ..y �'a EXPIRES:October 6,2019
4p F,fP Bended Thin Noiey Public Uneerwriters od'c°N' Bonded Tbru Notary Public Undenxriters
[ J Produced Identification I ]Produced Identification , `ti? ,•
II Type of Identification:
Type of Identification: Yp
NOTICE OF COMMENCEMENT
State of FLZ..- County of .L2 V4.1 Tax Folio No.
1
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. 9 e j
Legal Description of property being improved: �'L"1'i O Q- 7 5 - 'q !: aq,{.!i f1 / 6L�c
/ 4? 14q cen - os5S'
Address of property being improved: /KS &et 46 5,cic C. t 14'
General description of improvements: Alnrette C:oi i e C petal I /p% e.. L,.•41"
lu,rci.12./ pcti,/ ell j
Owner: �Q/y)l pit Address: /j� . zie_ (ate ri
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: I/1/,' 'l •�iy�r
tJ�A� Address: I ./ ,, 32z 3 3
r- Telephone No.: reit 3.71 7.14 Fax No: sW 53y 5-7z
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 OWNE/
Signed ///.,/ , /// Date: . /
Before e this day of '' in the Co ty of D val,State
Doc#2017191768,OR BK 18090 Page 1281, Of Florida,has personally appeared Zt 6 "7 tie45y
Number Pages:1 Personally Known: or
Recorded 08/16/2017 at 08:51 AM, Produced Identification: 14 Cc,— R 38 4-
Rennie Fussell CLERK CIRCUIT COURT DUVAL Notary Public:
COUNTY
RECORDING$10.00 My commission expires: __Q/
1,,i,,,:;0;;;;;;,;;;;;
rye i TONT GiNDLESPERGER
� MY CGS,MISSION#FF 924951
,?,5,
5 ,3 M�5 EXFIFtFS:October 6,2019
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