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403 ATLANTIC BLVD - INTERIOR DEMO CITY OF ATLANTIC BEACH � 'j = ,� 800 SEMINOLE ROAD t5v, • Vr ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 COMMERCIAL - ALTERATION COMMERCIAL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: COMM17-0007 Description: INTERIOR DEMO Estimated Value: 39121 Issue Date: 7/27/2017 Expiration Date: 1/23/2018 PROPERTY ADDRESS: Address: 403 ATLANTIC BLVD RE Number: 170703 0000 PROPERTY OWNER: Name: 403 ATLANTIC BLVD INC Address: PO BOX 330108 ATLANTIC BEACH, FL 32233-0108 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: Acon Construction Co., Inc. Address: 3653 Regent BLVD JACKSONVILLE, FL 32224 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. J .i�v.;.� City of Atlantic Beach APPLICATION NUMBER `j'r Building Department (To be assigned by the Building Department.) `2 800 Seminole Road ( / � 0 Atlantic Beach, Florida 32233-5445 \/-� �n1 17 —O OCf 7 \ Phone (904)247-5826 • Fax (904) 247-5845 7 /6._ /� \l'401il9r E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 403 TLf\i 3 T( Ct. De artment review required Yes No (- wilding Applicant: ift ' w r . S C - --r s - anning &Zoni . , Tree Administrator Project: 1 krt6:-R.._(OR—. 1<. __P(\0 DEQ Public Works Public Utilities e___orvviv‘ ,-(A Public Safe 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 :i:iii....1iiiiIIIII:: v Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco GN Other: APPLICATION STATUS Reviewing Department First Review: ViApproved. ❑Denied. Not applicable (Circle one.) Comments: ( ri'1.,4...R-,o2. De,,.ko C,,.t `-r BUILDING ��¢o lyct ��V._bTZ �L.A.a e--rcz '6vi`'o Du"1--- PLANNING & ZONING Reviewed by: `-- A Date: Z`2•(t 1 TREE ADMIN. Second Review: I '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 05/19/2017 BUILDING PERMIT APPLICATION CiTY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach,FL 32233 Office(904)247-5826 Fax(904)247-5845 Job Address: 403 Atlantic Boulevard Permit Number: C-..--01\1\('(\I-7_ 0007 Legal Description 10-16 21-2S-29E SALTAIR SEC 3 LOTS 855 TO 858 Parcel# 31,921 Floor Area of SA.Ft. Sq.Ft 140 Valuation of Work$ Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair ove 'a•molitior pool/spa window/door .1 Use of existing/proposed structure(s)(circle one): Commer • a Residentia If an existing structure,is a fire sprinkler system insta •r. ircle one): Yes No N/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: Interior Demolition. One toilet will be active. Dumpster will be located in parking lot adjacent to building. (Parking Lot is not a shared parking lot.) Property Owner Information: Name: Naval Continuing Care Retirement Fdn,Inc. Addres : 1 Fleet Landing Boulevard City Atlantic Beach State FL ip 32233 Phone 904-246-9900 E-Mail or Fax#(Optional) Gin Atre- v7 "L —sir i j & j.?✓! Contractor Information: Company Name: ACON Construction Co.,Inc. Qualifying Agent: David Sypniewski Address:3653 Regent Boulevard,Suite 401 City Jacksonville State FL Zip 32224 Office Phone 904-565-9060 Job Site/Contact Number 904-813-4065 Fax# 904-565-9080 State Certification/Registration# CGCO22916 Architect Name&Phone# Ebert Norman Brady Architects (904)241-9997 Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address N/A Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations is indicated l certify that no work or installation has commenced prior to the issuance ofa permit and that all work will he per/Mined to meet the standards df all laws regulating canstnntion in this jurisdiction. this permit becomes mill and void if work is not commenced within six(6f months.or if construction or work ix suspended or abandoned few a period r f six(6)months at any lime aster work is cimrmenced. I understand that separate permits must he securedfor'Electrical.Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,healers, Tanks and Air Conditioners,etc. 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 RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that i have read and examined thisplication and know the same to be true and correct. All provisions If laws and ordinances governing this type 9work will he complied with whether specified herein or not. The granting o/•a portal does not presume to give authority to violate or cancel the prowsmns r fany otherjederal,slate,or heal law regulating cm truciion or the performance r f construction. Signature of Owner ..-/ ! Signature of Contracto Print Name 0 L'2--t.' 'a /c/ Print Name David Sypniewski Sworn to_ and subscrib Iefore me Sworn to and subscribed before me this 'i Day of (,k .20 this h Day of Jul ,20 17 S�� 44, Notary Public ^, No a u is o,�Yo4;� CATHERINE R.iATr�6�F01.2G 0 -: MY COMMISSION#GG 078487 _;YRi;;4.,, • •wtiLIA4PAL.E•;:t "'•�^` EXPIRES:April 27,2021 r' My coMMISSIQN ft FF o:EG,roP'. Bow Thru Notary Public Undernnters u\ c' EXPIRES:Fetrruary 18,2020Aers • — a: Jc: NOTICE OF COMMENCEMENT State of Florida Tax Folio No. 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: 10-16 21-2S-29E SALTAIR SEC 3 LOTS 855 TO 858 Address of property being improved: 403 Atlantic Boulevard General description of improvements: Interior Demolition Owner: Naval Continuing Care Retirement Fdn, Inc. Address: 1 Fleet Landing Boulevard,Atlantic Beach, FL 32233 Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: Ae Contractor: AeCON Construction Co., Inc. Address: 3653 Regent Boulevard, Suite 401, Jacksonville FL 32224 Telephone No.: 904-565-9060 Fax No: 904-565-9080 Surety(if any) N/A 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 c___).--- Signed: �� Signed: Date: 7447 Before e this day of -� in the Count of Duv I tate Of F.1 rida,has personally appeared h !1 h P Notary Public at Large,State of Florida,County of Duval. r Doc#2017156819,OR BK 18042 Page 1117, Ny commission expires: W r � ' Number Pages:1 'ersonally Known: Recorded 07/06/2017 at 10:00 AM, or 'roduced Identification: -Jlls .s.COUNTY tT ,. LLILERonnie Fussell CLERK CIRCUIT COURT DUVALRECORDING$1000 '': MYCOMMISSION#FF 960966 ` EXPIRES:February 16,2020 „t" Bonded Thru Notary Public Underwriters ,, 1_:.\,,p,-J.;:„ City of Atlantic Beach APPLICATION NUMBER u' , Building Department to (To be assigned by the Building Department.) ,it--,---, 800 Seminole Road F Atlantic Beach, Florida 32233-5445 e ,0 AA 61 l 7 -0 00'7 \\ Phone(904)247-5826 • Fax(904)247-5845 ,4�;11,,, E-mail: building-dept@coab.us Date routed: -7 /6, (1 7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 40. t .1-.Lfl N`r( C' Department review required Yes No ilding Applicant: AQ.o @OJRDCjoZoni Tree Administrator Project: l k_)`( R...(ore_ i< flr-\,c)DFJL___ Public Works Public Utilities e—CD(A, (V\ 6pj(j Public Safet Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required 1 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 by: Date: gal? 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. I INot applicable Comments: Reviewed by: Date: Revised 05/19/2017