1805 SEVILLA BLVD - BATH REMODEL f� CITY OF ATLANTIC BEACH
ss1
��; � 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: RES17-0168
Description: BATH REMODEL
Estimated Value: 10000
Issue Date: 9/19/2017
Expiration Date: 3/18/2018
PROPERTY ADDRESS:
Address: 1805 SEVILLA BLVD
RE Number: 169462 0470
PROPERTY OWNER:
Name: SNYDER JAMES L
Address: 1805 SEVILLA BLVD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: PRO-BUILDERS OF FLORIDA LLC
Address: 1115 S OAKS RIDGE DR
JACKSONVILLE, FL 32225
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.
�S.a,�.i; City of Atlantic Beach APPLICATION NUMBER
Js, ift, „ Building Department (To be assigned by the Building Department.)
800 Seminole Road R E,S 17 - o ` GS
u._ E Atlantic Beach, Florida 32233-5445 E
Phone(904)247-5826 • Fax(904)247-5845
"e;; 0 E-mail: building-dept@coab.us Date routed: 9 /7 '(7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: !SOS EV i C-LA E.LV De artment review required Yiey No
uilding�
Applicant: PRO '—amu 1(,()E-(Z_S Planning &Zoning
Tree Administrator
11
Project: 4� FIT N IR ENO 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 -.&L--
Florida Dept.of Environmental Protection .6'—(C -Ir
Florida Dept.of Transportation �`'�
St. Johns River Water Management District :.� • if
Army Corps of Engineers
Division of Hotels and Restaurants - •�:�
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: E pproved. ❑Denied. ❑Not applicable
(Circle one.) Comments: po
BUILDING
PLANNING &ZONING Reviewed by: /1't'r Date: 9'i`/'/7
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 05119/2017
(-----
,,,
Building Permit Application updated 5/5/17
` OFFICE COP'l
City of Atlantic Beach
V� 800 Seminole Road, Atlantic Beach, FL 32233
';.;�- Phone: (904)247-5826 Fax: (904)247-5845
�� -s�z> RES i 7-6iC�a
Job Address: /SOS- v �/ .9/t/z,4- 3QQ./�•5ZZ$3 mit Number:
Legal Description � 2-Z407'143
� �d-zs �G, /�-��Y,e,-5� 1,RE# / 'f4
Valuation of Work(Replacement Cost)$ /0/ GYD Heated/Cooled SF /If8 Non-Heated/Cooled
• Class of Work(Circle one): New Addition CAlteratio3 Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residenti.
• 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 performed:
Ci(X:f !z)-M- 12-1-$'2,!`✓a n
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: 4 5 G . Cite"r Address:/c���
City 4/2.1. ! - $ 74 State p/� Zip iane go ' p8/`S�
E-Mail)(L YLzi Clriy- e Q7'I4-14-,L 1I
Owner or Agent(If/Agent,Power of Attorney or Agency Letter Required)
Contractor Information /�Name of Company a.-c . l� G�o —�d0-ART, �i! ualifying Agent: _
Address /1/ --- (1D�G/2ld�� Pu , City, 1�7C State rte/ Zip 3ZZZ�r
Office Phone /bill' 353, 0 �f� Job Site/Contact Number
State Certification/Registration# .0=1 C5 l 9( (-- E-Mail IAA 5-- b5 `t-v la foQ_ ( I L- c_c_) /1 ,
Architect Name& Phone# `jdn ..
Engineer's Name& Phone# MoyL�
Workers Compensation
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 regulating
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 4 TORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
r -- -AN .,„.....4-.
(• :nature of•• ser or Agent) (Si nature of `•nt actor)
(Inclu.I•:contractor)
ned an sworn to(or affir • •efore me this day of ted ad s ors to(orJJa ••)b e this day of
?C17by . a 2 t, j e n �` ` 1, ?01 ,b u�Sv` r-0
-'' ' QD CA -46.. . .-9 Min 1111111.111.-
(Signature of Nota (Signature of Notary)
•° 2-!..';::,.t__ MY COMMISSION it tt 2�+n51 101::...,
iONG7NDLE5PER6EnEXPIBPS October 6 2019MY COMMiSSIgV#rr 92585 i[ ] Personally Known ORa01°'Tn"' 'aryPub�ul ersonally Known OREXPIRES:October6,20791
ers
•, . .: Gcndetl Tnru vaay Pub:c Unoerwrters
[ I Produced Identification ' �� z Q 3 S I ]Produced Identification
Type of Identification: ype of Identification:
NOTICE OF COMMENCEMENT
( (PREPARE IN DUPLICATE)
Permit No. e-- Sri---- D 16 Tax Folio No.
State of County of
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: /7/5-----1e ( 5 - 6
Address of property being improved: iG •.�
G07:47) _ . —� ..72 3
General description of improvements:
iGLAE�q��7••v/ ..? - ��n4,(i2.5".F:;)
Owner 4/f�Yr3CS i•-• • S3t-�j r-
Address Sdm C--
` _
Owner's interest in site of the improvement t L—S-t .,hCr.,"ZG
Fee SImple Titleholder(if other than owner)
Name J i r4 5)J yp>=- q -
Address OCA S-CX IL. 6 V tD--
/ Contractor A44- 5 �5e ' Dx 1
/„vp,N —bra � G
Address ll('�$.,40 zez.�L. .P1 ..f?V .5 J 4X / 3 Z.z 6
Phone No. 90 '— ,.. .,‘":"5"9.'9" Fax No.
Surety(if any) Aoli i7e,
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements. .__... _ _
Name Vo --_,
lY�lZPi Nr\1 �, it ^` �:/ 1 :�,9
Address J - - '
Phone No. Fax No. y i
Sip t 1
Name of person within the State of Florida,other than himself,designated by owner upon whom notic) oti r 7 ?017
documents may served: /� � /'
Name ,4-rxtG O;eiyo — .�)�
Address t'
Phone No. e• 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 Statutes.(Fill in at Owner's option).
Name
Address
Phone 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 ONLYI O r R /I
Signed: . /�/I// DATE C /
Co auvel, tale of Florida,has p.' 1 7
8efor• 'da'of '? " in the 111
.natty appeared
Doc#2017220776,OR BK 18130 Page 1323, hi self/•••���•elf end affirms that all tatements 8 d declarations heherein by
rein
Number Pages: 1 are true: d accurate
Recorded 09.2712017 at 12:19 PM, $
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY (y, • 40 ,//
RECORDING$10.00 Nota (
e-aTLarge,s'teof {— County of !�>c')V h
My commission expires:
Personally Known
Produced Identification --?- ' a`: e> 0- D
.. l:.,iti,,:,1 i C�- r
{�. ' Y,o,I, t FF 824951
airy j:.
7:}_.o: E}:?:RES:October 6,CO 9
11 {; . •.sr' F•',nticG Pau Nctay Public Underwriters
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