1969 BRISTA DE MAR CIR - SIDING (---
`i4 CITY OF ATLANTIC BEACH
5 '` _> 800 SEMINOLE ROAD
�� ATLANTIC BEACH, FL 32233
r�01t v INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0301
Description: REPLACE SIDING
Estimated Value: 7000
Issue Date: 12/14/2017
Expiration Date: 6/12/2018
PROPERTY ADDRESS:
Address: 1969 BRISTA DE MAR CIR
RE Number: 169506 1670
PROPERTY OWNER:
Name: KANE PHILIP B
Address: 1969 BRISTA DE MAR CIR
ATLANTIC BEACH, FL 32233-4525
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: MARTIN HOME EXTERIORS
Address: 5749 HAVEN RD QA KENNETH BRIAN MARTIN
JACKSONVILLE, FL 32216
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.
51.J.v.r��. City of Atlantic Beach APPLICATION NUMBER
Jj - •�A Building Department (To be assigned by the Building Department.)
Atlantic
SeminoleRoad 1 L 5, 7 ` 0 C)
� AtlanticticBeach, Florida 32233-5445 t
Phone(904)247-5826 • Fax(904)247-5845 /
1
P•t E-mail: building-dept@coab.us Date routed: I Z // 7 I/t
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 G-q S7fl ( p_D rtment review required Ye/ No_
n I (3m(-- Buildinq� t/
Applicant: b' �/ \ A (`-F
L A-) �'C=1Z�C�(`_S Planning &Zoning
Tree Administrator
Project: 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 proved. nDenied. f Not applicable
(Circle one.) Comments: , /
12-� u Y P r 0 S Y4.S S )Of�hS , n $ pec i,ori
�0�.
BUILDING SAa` Q
PLANNING & ZONING Reviewed by: / i �//� Date: 12'/ 2-1.2
TREE ADMIN. Second Review: nApproved as revised. nDenied. fNot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. nDenied. fNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
OFFICE COPY
j Building Permit Application
`" - City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
qin r Phone:(904)247-5826 Fax:(904)247-5845
Job Address: t`1 tool Bristo ck Mar ar CA 1?A 6 c•Q 3;3. Permit Number: 1 ` ESI ( C.30
Legal Description 4C.3}.pal.2-5.2-U SEVIA NORM UN•-r-2 VCT 'TO RE# 10 SOto- l la t
Valuation of Work(Replacement Cost)$ 1-, Ob U Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial •esidentia
• 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:
R.,81)R.,81)1.0.ce cu(r�c o t s if wrklA 3 cm (a.v LQ i
Florida Product Appro al# r;r 9 a for multiple products use product approval form
Property Owner Infor on
Name: t71,-iILAQ iK.,aritt,C N K"J‘r Address: laV\ ReisiV c(6 11/lav G
City ,c-k-1 a Vt,4 C. GE/A.-an State pts Zip 3 1-.3 3 Phone "Cit • `CI'l, -2 2--
E-Mail lc-MN G Illb(Oro,(tn et,i 1-• UOYVt
Owner or Agent(If Agent,Po'er of Attorney or Agency Letter Required)
Contractor Information t'
Name of Company: MA441 ( 'J ti tdi/16 G4A►te 1OC,5,INt.Qualifying Agent: iN 41V- ,TIN
Address t i"5 i-t!V si✓N City\A-acoNvI VlState P1— Zip --42,-/A Le
Office Phone C\lM• k2, \ •4O Job Site/Contact Num er AON t
. l--1 • 3n-1-p
State Certification/Registration# 4-C O 030 E-Mail K41VA (ViNt2rJA-O• GO(V'
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation ll4 Rat✓'(\1 t; A<<OC1PII-Kt 0/12-1itO1 ,
Exempt/Insurer/Lease E ployee /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
RECORDING YOUR NOTICE OF COMMENCEMENT.
/ / I (1-4(Q---- Ix f
(Signature of Owne or Agent including Con, _ (Sig re of Contractor) f t , JIi "2 `��'
Signediaand sworn to(or affirmed)beforf me Si4gned and sworn to(or affirme •efore a this I da 1
t d+fitr 2617 by Gs'y1'��+ c3 ` ,'N 2" 7 by 6 6+ti e 7 .
i i it
i nate re o Nota II w / (Signat .f Notary) r— i
g
[ 1 Personally Known OR "�r ( ]Personally Known OR 4 $1.
[ roduced Identification :; .!,\ (.Produced Identification ;`�r•i i'''?
Tp of Identification: �' L 2 ' Type of Identification: f�/) Ali
NOTICE OF COMMENCEMENT
i PREPARE IN DUPLICATE, I
Permit No. r4- ti--/-
) US L',
Tax Folio No. 169506-1670
State of Florida County of Duval
I
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: 40-37 09-2S-29E SELVA NOTE UNIT TWO LOT 90
Address of property being improved: 1969 BRISTA DE MAR OR,ATLANTIC BEACH, FL 32233
General description of improvements: siding, windows or screen room
Owner Philip/Kathleen Kane
Address 1969 BRISTA DE MAR CIR,ATLANTIC BEACH,FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner
Name
Address
Contractor Martin Home Exteriors,Inc.
Address 5715 Haven Road,Jacksonville,FL 32216
Phone No. 904-737.5009 Fax No. 904-594-3064
Surety(if any)
Address Amount of bdnd S
Phone 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.cesignated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
in addition to himself.owner designates the following person to receive a copy of the Lienor s Notice as provided n
Section 713.06(2)(b).Florida Statutes. (-ill in at Owner's option).
Name
Address
Phone No. Fax No.
e-0».rpt,,~
Expiration date of Notice of Commencement(the expiration date is one i 11 year from the date of recording unless a °;��.i; ''
4.
different date is specified) :09� ••
THIS SPACE FOR RECORDER'S USE ONLY 0 NE' Zi c
7-
Signed,,-. Lt�l l - ,� .. a-E21,a;// (5,
' Before me t is q0 day of # 2�:� " ____in the ". O
County S a e of.loris6has Ceerso ally appeared X)
Doc#2017278047,OR BK 16209 Page 88, 'lf wrm N«':— re•ein by a
g himself'herself and affirms hat ail statements- d declarations herein >Yn
Number Pages:1 are true and ac rate/ I 6 z
Recorded 12/06/2017 10:22 AM, , w
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
r
COUNTY 9m
RECORDING $10.00 ro w
! 1„
N.a ubli'at arge.State o' County of QV V/� f'
My commission expires. ,__,,,_7 „'.�-t# "4 t
Personally Kno.,n.,__ _ or
Produced identification 4r?_4_.