920 SAILFISH DR - INTERIOR DEMO �d .. ft' CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
'12,011 S) INSPECTION PHONE LINE 247-5814
DEMO - INTERIOR ONLY
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DEMO17-0025
Description: INTERIOR DEMO
Estimated Value: 0
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 920 SAILFISH DR
RE Number: 171164 0000
PROPERTY OWNER:
Name: JODY LYNN SOMMERS
Address: 1648 ATLANTIC BEACH DR
ATLANTIC BEACH, FL 32233-4219
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ULTIMATE CONSTRUCTION
Address: 4054 W ARBOR LAKE DR JAMES VAN ARSDALE
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$7,500.
r1,,,% Building Permit Application Updated 5/5/17
'' City of Atlantic Beach
),':, 800 Seminole Road, Atlantic Beach, FL 32233
N'....-4D1119',' Phone: (904) 247-5826 Fax: (904)
247-5845
Job Address: ti/, DINI Perimit Number: OLAA01-7-00 ZS
Legal Description LA j to tA�� �1 1 % LtA(•* 1 RE# 111160 0000
Valuation of Work(Replacement Cost)$ Heated/Cooled SF CO Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move (Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• 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:
?, dot oc all t aiG✓ _5ti
Florida Product Approval# for multiple products use product approval form
Property Oner Information
Name: Cti v I. - w1��s Address: J I4TZA�(C 66(4 be. .
City /( I GC�II' State f(, Zip --r-,2.-2._3-, Phone 1110 / c4,(7
(
E-Mail vLt�aGS --t-g,^G b1 C.cm( r�/`
Owner or- oGHgent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Com ny: i II (i r 1 ilia j a i 1 , Qualifying Agent:
Address i.k.0 ` ( So PLV , City State ( . Zip 3226
Office Phone Job Site/Contact Number ti) -Lici
State Certification/Registration# cot., IZa6q WailArchitect Name& Phone# /�ik
Engineer's Name& Phone# /
Workers Compensation 14l A
Exempt/Insbrer/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 F NANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
R : 'DING •UR NOTICE OF COMMENCEMENT. ,
. .114........II
(�igwatwe of Ow r or Agent) WO
(Signature of Contractor)
(including contu 1 1461\
tractor)
Si ned and sworn to(or affirmed)before me this30 day of Si ned and sworn to(or affirmed)before me,// thi//s day of
LE25Y 0 01-1 , by -S�y ,�jM
r+lfCS •e�.- ,�O/-7 , by 5 phen /-/c�.i2/
( !g ure , pry .�a v ggna re of rryy tor
1 ,,;Z: JOHN JOS4EF.H-SHAU6HNESSY III sT:o..A <;; JOHN JOSE�H 5'� ESSY III
: '. Notary Public-State ot r!onda 1 z. ; ,A. ? Notary Public -State > iorida
1 str, ,T .o' Commission# FF 973583 1 kos. g Commission# FF 97?rd3
PersonallyKnown
.„,;;:-.:.,..0,p-FMy Comm.Expires Mar 22,2020 ( '••�n4;.n��'` My Comm.Expires Mar 22,2020 0
[ ] 01 [ 1 Personally Known OR'
6(]Produced IdentificakorT — — 7 — [x1[x]Produced Identification
Type of Identification:1d' ,f,rf jinJa2.. Type of Identification:`t Crt7lWieiJa a
Duss, Kenney, Safer, Hampton & Joos, P.A.
Attorneys At Law
John S.Duss,IV
Theresa M.Kenney*+ 4348 Southpoint Boulevard
Eliot J.Safer Suite 101
Wade McK.Hampton** Jacksonville, FL 32216
William J.Joos
Jonathan M.Smith Telephone:(904)543-4300
Facsimile: (9041 543 4301
www.jaxfirm.com
*Florida Bar Board Certified—Real Estate
+Florida Civil Law Notary
**Also admitted in Georgia
We have provided you with copies of your closing documents.
Your deed will be returned to you by the Clerk of the Circuit Court after recording in approximately
thirty (30) days. If you have not received your deed within sixty (60) days, contact the Clerk of the Circuit
Court to inquire about its disposition.
Keep your deed and these closing documents in a safe place since some of the documents are
important for income tax purposes. If this transaction involves the purchase of homestead property, you will
need your deed as proof of ownership when you apply for homestead exemption. You may apply for your
homestead exemption at the Property Appraiser's Office once you receive your original deed through February
28th of the following year.
Also, with respect to purchase transactions occurring after June 1 of each year, it is possible that the
tax assessor will retain the seller's name as the appropriate party to receive notices and bills. It is the buyer's
obligation to obtain the ad valorem tax bill for his own use and to ensure that the lender (if any) receives the
bill in a timely manner so that its payments may be made from funds escrowed for that purpose.
Our closed files are maintained outside of our office. Should you lose or misplace any of the enclosed
documents and need duplicates, please allow for a five (5) business day delivery. There will be a small courier
and copy fee charged for reproductions. We destroy our records after seven (7)years.
We enjoyed being of service to you, and we invite you to call us if you have any questions regarding
this transaction. We would also be honored to assist you in any other legal matters.
Very truly yours,
A. U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT B. TYPE OF LOAN
SETTLEMENT STATEMENT
Duss,Kenney, Safer,Hampton & Joos,P.A. I. ❑FHA 2. ❑FMRA 3. ❑ CONV.UNINS.
4348 Southpoint Boulevard,Suite 101
4. ❑VA 5. CONY.INS.
Jacksonville,Florida 32216
904-543-4300 fax:904-543-4301 6.File Number: 7.Loan Number:
117.113DR
8.Mortgage Ins.Caae No.:
C.NOTE: This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agent are shown.Items marked
(poc)were paid outside the closing. They are shown here for informational purposes and are not included in the totals.
Jody Lynn Sommers
D.Buyer: 1648 Atlantic Beach Drive
Atlantic Beach,Florida 32233
Linda Price,as Personal Representative of the Estate of Margaret Ann Page,deceased
E.Seller: 8844 Heavenside Drive
Jacksonville,Florida 32257
F.Lender:
920 Sailfish Drive
G.Property: Atlantic Beach,Duval County,Florida 32233
Lot 10,Block 4,Royal Palms Unit 1,Book 30,Page 60,Duval County,Florida
H. Settlement Agent: Duss,Kenney,Safer,Hampton&Joos,P.A.
Place of Settlement: 4348 Southpoint Boulevard,Suite 101,Jacksonville,Florida 32216 Duval County
I.Settlement Date: November 13,2017
J. Summary of Buyer's Transaction K. Summary of Seller's Transaction
100.Gross Amount Due From Buyer: 400.Gross Amount Due To Seller:
101. Contract Sales Price 199,900.00 401. Contract Sales Price 199,900.00
102. Personal Property 402. Personal Property
103. Settlement Charges to Buyer(line 1400) 43.50 403.
Adjustments for Items Paid by Seller in-Advance: Adjustments for Items Paid by Seller in Advance:
106. City/Town Taxes 406. City/Town Taxes
107. County/Parish Taxes Nov 13,2017 thru Dec 46.63 407. County/Parish Taxes Nov 13,2017 thru Dec 46.63
31,2017 31,2017
108. Assessments 408. Assessments
120. Gross Amount Due from Buyer: 199,990.13 420. Gross Amount Due to Seller: 199,946.63
200. Amounts Paid by or in Behalf of Buyer: 500. Reductions in Amount Due to Seller:
201. Deposit/Earnest Money 4,000.00 501. Excess Deposit(see instructions)
202. Principal Amount of New Loan 502. Settlement Charges to Seller(Line 1400) 17,678.62
203. Existing Loan(s) 503. Existing Loan(s)
204. 504. Payoff of First Mortgage
205. 505. Payoff of Second Mortgage
206. 506. Purchase Money Mortgage
Adjustments for Items Unpaid by Seller: Adjustments for Items Unpaid by Seller:
210. City/Town Taxes 510. City/Town Taxes
211. County/Parish Taxes 511. County/Parish Taxes
212. Assessments 512. Assessments
220. Total Paid by/for Buyer: 4,000.00 520. Total Reductions in Amount Due Seller: 17,678.62
300. Cash at Settlement from/to Buyer: 600. Cash at Settlement to/from Seller:
301. Gross Amount due from Buyer(line 120) 199,990.13 601. Gross Amount due to Seller(line 420) 199,946.63
302. Less Amount Paid by/for Buyer(line 220) 4,000.00 602. 520 Reductions Amount due Seller(line 17,678.62
303. Cash From Buyer: $195,990.13 603. Cash To Seller: $182,268.01
Buyer Initials: „1ArJody Lynn Sommers
,Rr
Linda Price,as Personal
Seller Initials: Representative of the Estate of
Margaret Ann Page,deceased
•
HUD-1 May 2007