1810 SELVA GRANDE DR - POOL CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
11N ATLANTIC BEACH, FL 32233
'.-t J;3 �' INSPECTION PHONE LINE 247-5814
SWIMMING POOL - SWIMMING POOL RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: POOL17-0011
Description: MODIFY EXISTING SPA TO A SUNSHELF
Estimated Value: 33000
Issue Date: 7/14/2017
Expiration Date: 1/10/2018
PROPERTY ADDRESS:
Address: 1810 SELVA GRANDE DR
RE Number: 169542 5004
PROPERTY OWNER:
Name: CARPER RICKY L
Address: 1810 SELVA GRANDE DR
ATLANTIC BEACH, FL 32233-4526
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: POOLSIDE DESIGNS INC
Address: 836 Lake Asbury Dr Gm COVE
GREEN COVE SPRINGS, FL 32043
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.
1
S"''�j' �� City of Atlantic Beach APPLICATION NUMBER
41 4 Building Department (To be assigned by the Building Department.)
•
A •
'i`• 800 Seminole Road
j: r Atlantic Beach, Florida 32233-5445 t 00L. (7—n O 1
Phone(904)247-5826 • Fax(904)247-5845
x awl* E-mail: building-dept@coab.us Date routed: 7/G, / r 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
ra
Property Address: iE10 SE.t_'A (Q.ANDe Department review required Yes o
(( rguildin)
Applicant: ?DOLS t oe �E-S(G(� I1\D Planning &Zoning
i� Tree Administrator
Project: I v \C7 01F Lf S PA l Nj P00 L 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: pproved. ['Denied. ['Not applicable
(Circle one.) Comments:
BUILDING �/y�
PLANNING &ZONING Reviewed by: / / l Date: 7' /2'/ 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. ['Denied. ['Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
.r` ''' '. Building Permit Application Updated5/5/17
JS
til
i
;=.�'1 r City of Atlantic Beach
OFFICE COPY
800 Seminole Road,Atlantic Beach, FL 32233
-D.r:91 Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: d/O S2/✓a Gra Ade br Permit Number: P 17 -001 l
Legal Description ko+- a Se/vim, —re rrA RE# lacy -5-0041
Valuation of Work(Replacement Cost)$ 33000 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition dteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No an
• 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'erformed: Mod,C _r1$4., S ✓P�, 1-0 '
it 9cr yl,c kr-i,t;43 Pool dec.K. 6 e, q Sc4 A 5�1 i♦C, Rett" 's1,
iteilo cd. pool I; J+. /(c (cce 04-e,,,,_ pool ' +•►-}er;ur 2-nsi-a// kto 8,.64ler ,-, rti45-(e!4'.
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: 2,� ( C.r1t-r Address: Ivo setra Cra:►Cle
City A/IA".4-I G Bea cL State cl Zip ?2. 3.3 Phone 9Q'-/ IV/-31 25"
E-Mail 6o.,f'Sc4 l ?6 m,/J, rr '
Owner or Agent(If Agent, Powef of Attorney or Agency Letter Required)
Contractor Information /
Name of Company: /oo(s,de es;w1S c_ Qualifying Agent: A,.dre._' Wes'I-berr
Address S 34 1..4ke Asi,ory a C. CityCew Cove Spriiss State 11 Zip /320 Y3
Office Phone 10" ??is- ' 'it20 Job Site/Contact Number Toll 913— .405'5'
State Certification/Registration# CPC /tiSGS ) ? E-Mail 4nor�,.✓ii pm/s3 edes.5.7s . CLr.,
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation r_.ac e n,p}
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
RECORDIN.,,,,,,G YOUR OTICE OF COMMENCEMENT.
(Signature of 0 • or Agent) ignature of Contractor)
(includin: • Factor
S ned and sworn to(•r .ffir •• •efo :t 's l� •ay of Signed and sworn to(or affirmed)before me this day of
0. 0 by �� 7H k a6+� by A.dre�✓ 4�✓es-�herr y
MivAtim ►fiat_
(Signature o otary) a
• '
Ntir. KENNETH H SAITTA
i;'"• a MY COMMISSION#FF247157
'il ..:;1.4.14•., TONI GINDi.ESPERGER EXPIRE8 July 013,2019" "
MYCOMMISSICNitFF924951 ersonall Known OR
[ ]Personally .0 o�nEl�O�i [A-� y Moyr7a:a•s3 :..___
[ ]Produced I *tow EXPIRES:Oetober 6,2019 [ ] Produced Identificatio —.. -
.. _
., �;,. Landed Thru Notary Pubic Undorwriters
Type of Identi`.,•,,, Type of Identification:
Perl.,.,.t )- --f-P- Poo//7 -- d6 /l
NOTICE OF COMMENCEMENT OFFICE COPY
State of FI County of (f trva I Tax Folio No. IC Q,7y 2 - .4 0
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 statedin this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: g&p-t 2 Se.it,a Te r t A
Address of property being improved: 1T/0 Se Iv A C ra n d e Af/arrc- Rea c 4 A 82273
General description of improvements: /n odi ti ,q,4 4,1 Of e x%s 4r;1 S st a %^4o 5-6r4 S'4 E If
Owner: Rick Care er Address: 1910 SAV cr 1.a.4 c
e 4 r. Ai6. l"_l_3zz3.;
Owner's interest in site of the improvement: re c.. 5;,14 It
Fee Simple Titleholder(if other than owner):
Name: Q
.T / /
Contractor: �p01/S✓ e e S e 5-P Zi e ., �1 vi reA,.l L/e.s..6e ec`/
�",/ Address: V.% A a 1(c A s 6� �! �PCe+�i Cove 4 i .S S ` fl 3�0 Y
JF"` Telephone No.: a ?99-11J0 Fax No: g .7)1— ryUU
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 OWNER r
Signed: 6,— Date: )ls'l!
Before me i $ day of 3. I/ 26I) in the County of Duval,State
Of Florida,has personally appeared Ire Lt' C #voter
Doc#2017156904,OR BK 18042 Page 1336, personally Known: ✓ or
Number Pages: 1 ?roduced Identification: /�
Recorded 07/06/2017 at 10:49 AM, votary Public: I(e•,n c-f4 .5;1IN
Ronnie Fussell CLERK CIRCUIT COURT DUVAL vly commission expires: ?/ t.,
COUNTYRECORDING$10.00KENNETH H
' 8AITTA
MY COMMISSION.I FF247157
, a EXPIRES Jury 06,2019
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