360 W Dutton Island Rd porch & WDO repair permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Zoll 9' INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-S814
PERMIT INFORMA77ON:
PERMIT NO: RES17-0255
Description: FIRE DAMAGE REPAIR - FRONT PORCH, WINDOWS, DOORS
Estimated Value: 6500
Issue Date: 11/15/2017
Expiration Date: 5/14/2018
PROPERTY ADDRESS:
Address: 360 W DUTTON ISLAND RD
RE Number: 1723390000
PROPERTY OWNER:
Name: KENNELLY BARBARA K
Address: 360 DUTTON ISLAND RD W
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: JEP CONTRACTORS INC
Address: 1416 FOREST AVE QA JOHN EWEL PEARSON, III
NEPTUNE BEACH, FL 32266
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
11 SIN Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 St -7
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us LDate routed: ::��7
uity web-site: http://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
W
P ro pe rty Ad d ress: S L`0 DUT—ob L&),C�_ Department review required Yes No
C 1501cling
_C P
'AC
Applicant: Planning &Zoning
Project: Pn ( J2 Tree Administrator
r— ( jZC Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
Florida Dept. of Environmental Protection of Permit Verified By LU�e_ �e_
Florida Dept. of Transportation TA-ir
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: [eApproved. ElDenied. E]Not applicable
(Circle one.) Comments:
CB:U:l L�D I�)'
PLANNING &ZONING Reviewed by: zv I Date: 17701
TREE ADMIN. Second Review: FlApproved as revised. F]Denied. V []Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by.- Date:
FIRE SERVICES Third Review: F]Approved as revised. F]Denied. F]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit Application P OPY
OFFICE C
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904) 247-5845
JobAddress: P it-N u m e r: __.. r
Aq -q nf_191� -
Legal Description 1-1 -z`� - 2,�A- E . Lq oi S�- Ld-
Valuation of Work(Replacement Cost)$ _SC)n Heated/Cooled SF Non-Heated/Cooled
'-;Door
Class of Work(Circle one): New Addition Alteration Repair Move Demo Pook���indow
Use of existi ng/p ro posed structure(s)(Circle one): Commercial �=esidential
If an existing structure, is a fire sprinkler system installed?(Circle one): Yes (;Eo) N/A
Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Dgscribe in detail the ty e of work to be performed- VJp,d.
V I
C2
for multiple products use product approval form
Florida Produci Ap'proval#
Propp!VI�Pwner Information
Name� f-��YXA_CA C, CtnOeli�4 Address:-3
city PAJ-1CJ1+'C I-'yer_.c_h 'ate �-L_ zip Phone
I
E-Mail C CA_,r)�-ru C4( r
Owner or Agent(if Agent,_0ower oYAttorney or Agency4etter Required)
Contractor Information
Name of Company:'TE F Ca In ty-a4t-n;, A c- -Qualifying Agent: 70
Address 14 16 4N(,_-_i ' City N&,ptVw-_ Reae-k State FL zi�. Sg%L
Office Phone JtJ4-Z47- 19�25 ' JobSite/ContactNu bergolf- 2-?_q -,6,9Y2_ To-IkK
State Certification/Registration#cac-6-5-6643-- E-Mail _T(FC,-"I ia<:
Architect Name& Phone# A
Engineer's Name& Phone# V
Workers Compensation f--r-I-D&= , 5? Zf- 26 1,2
Insurer/Lease Employees piration Dat
al�mpt
Application is hereby made to obtain a permit to do the work and installations as lhdiratpd' 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 LEND, R AN 7ATTORN Y BEFORE
RE=OUR NOTICE OF COMMENCEMENT.
Ict
(Signature of Owner or Agent) /'7 (Signature of Contractor)
(including contractor) 11
Signed and sworn to(or affirmed) before me this I"'day of Signed and sworn to(or affirmed)before me this jD3 day of
0\_-) by eoi b NOiCnY)ff 26�1 by,O)Vi 1��. Pe(A'(5M
Pleatherftn*
ASHLEYWALTERS (Signature of Nofa rw We of Flodda (Signature of�otary)
Commission#GG 025031
Expires August 26,2020 My COMdsslon Expires 02/0112021
C=Won No.GG 68713
B wxW Th ru Tmy Fal n Irm r&w M38 5.70 1,
Personally Known OR Personally Known OR
Produced Identification [k�<roclucecl Identification
Type of Identification: N-')Of I CU3 �-)L_ Type of Identification: k-�[)nckn Do�t(s bc-eac
OFFICE COPY A on 7 �- 4t�- f2& S 1'2
NOTICE OF COMMENCEMENT
-1 Aqsq - 0ox
_t C)r;C
�C
State of County of Tax Folio No.
To Whom It May Concern: V
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 )TIC"F C C
Legal Description: roperty bein S,
.g improved: V
a-1 V I so Lot
Address of property being improved: '3(pa S1-
General description of improvements:7+�e�an�j r raktfr +1 re,
I A P-
Owner: A 1-5
j V VA rn Address: �3G 0
Owner's interest in siteof the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: F CQ-*�C+J OCA y C-,
Address: iq 1 (0 G.L� b&Lt—C
Telephone No.: Fax No:
Surety(if any) A
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person maldng 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. (Fin 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
specifio):
THIS SPACE FOR RECORDER'S USE ONLY OWNER,—�,
Signed: ' Txlv�b rk�*l I I
"Ieforemethis dayof C)0,cne-�--, ',t�,�:) in eCou ofl)uval,State
Doc#2017248263,OR BK 18167 Page 24225, Florida,has personally app�ar
Number Pages:1 Tsonally Known: or
Recorded 10/31/2017 02:02 PM, oduced Identification: li5 A
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL )tary Public: C�� k
COUNTY y commission ex�ires:
RECORDING $10.00
--,,,ASHLEY WALTERS
Cwaftsion#GG 025031
Expirm August 26.2020
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