133 Beach Ave tile & cabinets permit Ti ,.
CITY OF ATLANTIC BEACH
fl 800 SEMINOLE 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: RES17-0139
Description: Tile, Cabinets(Plumbing and Electric have separate permits)
Estimated Value: 29485
Issue Date: 8/18/2017
Expiration Date: 2/14/2018
PROPERTY ADDRESS:
Address: 133 BEACH AVE
RE Number: 170213 0000
PROPERTY OWNER:
Name: SCROGINS WILLIAM C
Address: 2000 CHEROKEE DR
NEPTUNE BEACH, FL 32266
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: LACOUR CONSTRUCTION (GC)
Address: 2639 S PONTE VEDRA BLVD OA JAMES MICHAEL LACOUR
PONTE VEDRA BEACH, FL 32082
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.
City of Atlantic Beach APPLICATION NUMBER
�p Building Department (to be assigned by the Building Department.)
)
800 Seminole Road �51� —6139
Atlantic Beach, Florida 32233-5445
Phone(904)247-5828- Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: r[J
-- Cityweb-site: hdp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property y Address: 13 be"_bDe ant review re uired Ye No
1f�.TC.
uil ing
Applicant: I Cnc LArC� c'ticv� Planning Zoning
Tree Administrator
Project: --^-kA)r Akici, .lir-1`��r(�-lir roic Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permk VeriFled B
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:
APPLI ATION STATUS
Reviewing Department First Review: Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING � V �/
PLANNING &ZONING Date: 6c -/ 7-1
Reviewed by:
TREE ADMIN. Second Review: [-]Approved as revised. [-]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 05H912017
1="j:r. Building Permit Application OFFICE COPY
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone: (904)247-5826 Fax:(904)247-5845 pp
Job Address: 135 BEA H AVENUE GARAGE APT 133 BEACH AyjrmR Number.&t5� /—I— O[3 1p
LegalDescription 5-64 16-2S-29E .461 ATLANTIC BCH,LOT2,PT LOT 1 BLK 32 RE# 170213.0000
Valuation of Work(Rep[icement Cost)$ 29,485.00 Hsatad/Cooled SF 1599 Non-Heatad/Coolg�02
• Class of Work(( rcle one): New AdditionAlteration Repair Move Demo Pool Window/Door
• Use ofexisting/ roposedstructure(s)(Circle one): Commercial Residential
• If an existing sti jaure,Is a fire sprinkler system Installed?(Circle one): Yes I No I N/A
• Submit a Tree R amoval Permit Application If any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the ty a of work to be performed: TILE, CABINETS, PLUMBING, ELECTRIC
Florida Product Approval# for multiple products use product approval form
Property Owner Infori nation
Name: SCROGINSWIL IAMC Address: 2000CHEROKEEDR
City NEPTUNEBEACH State FL Zip 22214 Phone
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Informatio I -
NameofCompany: Le OUR CONSTRUCTION COMPANY qualifying Agent:JAMES LACOUR
Address 2939 S P NTE VEDRA BLVD Clty!PONTE VEDRA BCH StatfL ZiR2082
Office Phone 01i ZOMIN Job Site/Contact Number 110s-2taagw
State Certification/Regi tion# CGCOa1PW E-Mall JIM®ucquRCCN6TRUCTxM.CCM
Architect Name&Phone# NA
Engineer's Name&Pho # NA
Workers Compensation EXEMPT/EXPIRATION 10/21/2018
Exempt/Insurer/lease Employees/&piratlon Dee
Application Is hereby male to obtain a permit to do the work and Installations as indicated.I certify that no work or Installation has
commenced prior to the ssuance of a permit and that all work will be performed to meet the standards of all the laws regulation&
constructlon In this jurisc Iction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FU RNACE 5,BOILERS,HEATERS,TAN KS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I a rtify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regu latin I construction and zon Ing.
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR AYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINAL ICING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC/ORD/I.N/G/Y'O-U NOTICE FCOMMENCEMENT.
(Signature of O rneror Age t including ntractor) (9...ni a of comret,u) '�t
Signed and sworn to(o afflrmed)beforem his day of Signed and swot
to(or affirmed)before me this j of
Aoil sT . 01 by moo}} by
;?:i:'"r.� (M@♦badT TA Y11 ..
Y OMMISSION#GG tO6J1a .q• '� MRON O. HASTAIN
t•.' a` E%PIRES:May 18,2021 tiFf MY COMMISSION#GG 106318
Nna�lnru Npary puWCWq•'sflan, i•t,... EXPIRES:May 16,2821
�� '+• �'::?.^'- emaea Tnry raun P•escu.we.,awr
Personales Known [.1Pe rwnalN Known OR
[ I Produced Identificatio [ I Produced Identification
Type of Identification: Type of Identification:
NOTICE OF COMMENCEMENT
State of FLORIDA Tax Folio No. 170213-0000
Countyof 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 infmmatim is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: 5-84 16-2S-29E.461 ATLANTIC BCH,LOT2,PT LOT 1 BLK 32
Address of property being improved: 133 BEACH AVE ATLANTIC BEACH, FL
General description of improvements: GARAGE APARTMENT(135 BEACH AVE) INTERIOR ALTERATIONS //
Owner: SCROGINSfWILLIAM C Address: 2000 CHEROKEE OR n Yp hc. ear.A
Owner's interest in site of the improvement: RESIDENCE G 3 Zup
Fee Simple Titleholder(if other than owner): NA
Name:
CmItactor: LACOUR CONSTRUCTION COMPANY
\ 240
Address: POBOX50421 JACKSONVILLE BEACH, FL
Telephme No.: 904-223-1131 Fax No: JIMf&LACOURCONSTRUCTION.COM
.cry(if my) NA
Address: Amount of Bond S
Telephone No: Fax No:
Name and address of my person making a lom for the construction of the improvemtals
Name: NA '
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 Limor's Notice as provided in Section
713.116(2)(6),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 OWNER
Signed: y to
- ---- -'-- -'--�Hefxe me this 14 da of eCarf State
p�g201]192246,OR 8K 18091 Page 360, Of Flaids,has personally appeaw Io
Number Pagan1 Notary Public at large,State of Florida,County of Duval.
Retarded 0811&201]a10100 PM. My commission express
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Personally Known: WLLWa\a or
COUNTY Produced Idenefiamon: N
RECOROING$10.00 f•••., OMMI 8709318
S. 8,20 1
••' 9aaEe9TMa Noury Publk