330 GARDEN LN - STUCCO REPAIR r� ' ,O' CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
15110, v� ATLANTIC BEACH, FL 32233
x;r f3 . INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0178
Description: STUCCO REPAIR
Estimated Value: 8200
Issue Date: 9/26/2017
Expiration Date: 3/25/2018
PROPERTY ADDRESS:
Address: 330 GARDEN LN
RE Number: 172020 5015
PROPERTY OWNER:
Name: Cindy Austen
Address: 330 GARDEN LN
ATLANTIC BEACH, FL 32233-4522
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: On Target Renovations, Inc.
Address:
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
Building Department (To be assigned by the Building Department.)
_ 800 Seminole Road
Atlantic Beach, Florida 32233-5445 I / — ( `� I ! C,
Phone(904)247-5826 • Fax(904)247-5845
,,;%.2--01.115‘
E-mail: building-dept@coab.us Date routed: C%
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3C) A 12.13FN L t.3 D mento review required Yes No
Buildin
Applicant: ON I (LGC-7 R �7(O/Q.S P anni Zoning
Tree Administrator
Project: 3 co CC-v IC P}c2 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: 1 l Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING '/�
Reviewed by: r I , Date: 2'/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 05/19/2017
OFFICE COPY
.4.;5,........,,t,„ Building Permit Application
ti City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
p-Oir'., Phone: (904)247-5826 Fax: (904)247-5845
Job Address::2:2,,O. C a(6e() LA/ A \Cu11 l(-"2,e6.6-,,FL :7,1,,,2S:2) Permit Number: R E_S 17- C) (7 E
Legal Description 3'7- - 0q-as-21G SeIvc.Mcrinct G uc)f1) Wd3.5R- l_(Trcl C i- L0c5 RE#
Valuation of Work(Replacement Cost)$ B,,5?co• 00 Heated/Cooled SF ,2110 Non Heated/Cooled 0.2-1-1U)• Class of Work(Circle one): New Addition Alteration •'e•a Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Cesidentia
• 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 Affidavit of No Tree Removal
Describe in detail the type of work to be performed: fenxj.. c i ry 3CX)5ciCt of 51-t Co, ( I C-ir't ICt+Vt r i frWICAVOr
6 IC`R Sacco CO- -118"
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: C t(Ch., L At.�}ec z Address: , GC.2&�n Ltd.
City `Qt)'ciCLi ?eo cV\ State c--(.._ Zip (Sad 3-6 Phone(GM-()2c.35 -OSIS
E-Mail he(rr,.s..)(c.lcicArS AlYXXIl .cc'n
Owner or Agent(If Agent,Power of`Attorney or Agency Letter Required)
Contractor Information
Name of Company: ( Tc cce4Rl-eeo\fGtk(C Qualifying Agent: Sc( P7 --e- <-
Addressd3(,3 U1)1\L 7-)l\ir{• N City tl�a,f)lft((. State cc Zip Leal)
Office Phone (9'0) 5(.41-(Ist-I Job Site/Contact Number SGtt'_
State Certification/Registration# i ...21--4981 C (r L E-Mail V-xntP, \N.p rcs Co. CAY'"
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Q_ - CY/iNtp (Bo/e
! 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 A ' • • : EY BEFORE
RECORD! YOUR NOTICE OF COMMENCEMENT. mipp
. ___
i,„/ (,,,,, .
(Signature of Owner or Agent i ing Contractor) (Silik ure of Contractor) ,•k
g
Signed and sworn to(or affirmed)be ore me this It,day of Signed and worn ...(6r affirmed)before a this A0 day of i
€P4Q-.nif. .?Dn , by Petal Z(O�� Ftutna-n7C . 5.e,41 (- v[7 ,by e ' �iumk;11 12 ink
I (Signat 1'e of N C.ry) — ature of Notary)
.0', .
.P, ••,• JENNIFER JOHNSTON _ �ot►R�P o JONVNI(iBNTVAN.1 'A
``n '' '.. MY COMMISSION tt GG 042984 # <_ s #MY COMMISSION#GG 468086
'"' ' EXPIRES:October 27,2020 ? ! EXPIRES:Ja
[ ]PersonallyKnown OR •'� ,Pr' 1 25,20 1
,e,,;•t.o,. Bonded Tiro Notary Pubic Underwrite sonally Known OR *4, rto1`�gp
ji)Produced Identification ---II duced Identification /� `,pp Budget
�' !' Sang
Type of Identification: at t 1 t. ' fl i' Type of Identification: 101'✓eri I;SCQi?Sl.
P630-2 '6-bs(0.-a
erm� 71 ���5 1 -7— 6)173FICE COPY
NOT CE OF COMMENCEMENT
OFFICE
State of t-inr o. Tax Folio No.
County of TU\Jct
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: 3/-84 Coq-a S-ad'E S..Iva maci nca GI vol-e4
`u<! 023.5 c Lei 4, E 3.t) (ons
Address of property being improved: 330 ClC -€n L.N. l-1rlcantiC ea.c'1, F(-"r 33
General description of improvements: Cerno .2 nock (4Qtorie c. 3C0'e • (7s 3k)ccD: f)IQCE l Ilmfa(1
QIP)
Owner: AO, CA.0 L. Address: 330 C -€r LA!. /+\(1( t?A h 1 FL c3a5a '
Owner's interest in site of the improvement: G.rt cezk- n P_
Fee Simple Titleholder(if other than owner):
Name:
Contractor: 0(\Pr(Xc .o-c P1 (.1..C__
Ctk-lo0;
Address: (0) U�(h'i\t Pcs1i %k i. N JQ.CV\SOOVi It-e, �L 319621 I
Telephone No. O4)S1-7- 4(p-I Fax No:
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
Signed: , Date: C/ 1 / '+'
Before me this t % day of S.Gpt in the County of Duval,State
Doc#2017213766,OR BK 18121 Page 1710, >f Florida,has personally appeared Pew. -lr a.^K t4 t.(man Z f •
lotary Public at Large,State of Flo:da,County sf Du al.
Number Pages:1 \
4y commission expires:
Recorded 09/20/2017 at 09:33 AM, '
Ronnie Fussell CLERK CIRCUIT COURT DUVAL 'ersonally Known: _ YP JENNIFERJOHNS161N
COUNTY 'roduced Identification: d r i�l 4 i �Gen',14:•`' '•" MY COMMISSION#GG 042984
RECORDING$10.00 ""' EXPIRES:October 27,2020
°••',o o?; Bonded Thru Notary Public Underwriters