2242 BAREFOOT TRACE RES17-0308 - INTERIOR REMODEL .<j yLy�
,�'`SJ CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
/ ATLANTIC BEACH, FL 32233
i'--013 S) INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0308
Description: INTERIOR REMODEL
Estimated Value: 40000
Issue Date: 12/28/2017
Expiration Date: 6/26/2018
PROPERTY ADDRESS:
Address: 2242 BAREFOOT TRACE
RE Number: 169463 0590
PROPERTY OWNER:
Name: ANTHONY & KATHERINE HICKS
Address: 2242 BAREFOOT TRCE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Russell Contractors, Inc.
Address: 10125 Terrell Pappy Rd ST
JACKSONVILLE, FL 32259
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),ay; City of Atlantic Beach APPLICATION NUMBER
4s ilk Building Department (To be assigned by the Building Department.)
800 Seminole Road R Es;7 - 0303 030 Q
r, Atlantic Beach, Florida 32233-5445 L/
r
Phone(904)247-5826 Fax(904)247-5845 `
J;t v g>' E-mail: building-dept@coab.us Date routed: I Z 1.5 1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
17L-
Property Address: 7 2.4 -z E if. , RC POOT De• . . i ent review required 1 Yes
Yes o
Buildin•
Applicant: 0 SSELL. cO DJ (Z CTO p'�'= ng &Zoning
Tree Administrator
Project: 1 ND sc E to(Z R CAA.Q("'E 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: Approved. ❑Denied. ❑Not applicable
(Circle one. Comments: n)
0 c____
BUILDING '
PLANNING &ZONING
Reviewed by: 1112 Date: i d 7' 0017
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
'-( 4rAOFFICE COhuilding Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: 7ta`1 a64,-/-- 1-1-,{e. i44il.)34%(� 3Ax?) Permit Number: Pr S( 7
Legal Description LI A- 13 09 - 2. - 2.% Cke4..,,..tL 7i r 4 kiln RE# /6`i(A3-05,0
Valuation of Work(Replacement Cost)$ ``/v J,,�-) Heated/Cooled SF ,2,1/i Non-Heated/Cooled .2, 78)-
• Class of Work(Circle one): New Addition testi Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial F esidentiaP
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes I , 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: /n4,)4..,
4(1'\a 6J`^/'o.i-•r`f,,-) it - ,-) :^_J rl- )( 71,--4..-, , ..7,-6,.,- t-,J d t ÷%)I) 'k:)✓-, `N
et(..t, k.kt,,, lf��.i„k. /eif.,4,-,L - , .4 s 1, I Si,a.,..e.�
)
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: n -'" :r 1C. 1.r,�,c /I1J Address: .Dfir oc-e -.J."€4 C/.
City /1-i1,..3‘,_ ,'jc;,._L, State Kt- Zip 3)2 7 ) Phone ("h•- `.I ) cit./V- 5-.?-7)--
E-Mail
-a3>--
E-Mail c.h;4.1) .wi t:::1 y,.A.I. rte--,
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) ,.,/4
Contractor Informat' n c� ,, �j, (� / �+ (�y�
Name of Company: Ktk.i ii tinily i -PC Qualif ing Ag nt: P10s? /C / iI 0 l'4�
4- 5/
Address 1 C) •) vitt City ����
((("'"' J V� State �, Zip_____32224___
Office Phone ` 7 (l / Job Site/Contact Numb r i. c - b •
State Certification/Registration# .,c( O ,LJy 1 E-Mail rVO CCh1'k ' o 4 C/ L (,_/))
Architect Name&Phone#
Engineer's Name&Phone# MI ; S0 '���/, U ►
Workers Compensation MAM
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. NOTICE: In addition to the requirements of this
permit, there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
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 e • AN ATT• •NEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT. ,��
dopiK'47.-• '
ire'
toy r
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor) d�
Signed and sworn to(or affirmed)before me this 4.7 day of igned and sworn to(or affirmed)before me this]3T day of
i.___ 201 ,by lyil 1.-I tC S a ''ato bei an.) ,b, . ._`-.,_7_ Irl‘ A ' r
ii ERIN F.KELLY r 4i r � HAIMObv�TZ
111 ERIN
Public,State of Fiaide k " •r•'•tv I r•N I FF91913s
Commission,/FF 910710 ilynature of of ) ..
`I]` Atf comm.expires Aug.18,2019 .,,a ; EXPIRES September 16,2019
;.ititf6°rtd�f ugry�p(Zg.�. [ ]Personally Known OR ''`'I......
98-0'53 F>ooda+1oa7somca.corr
Produced Identification [ ]Produced Identification
Type of Identification: .D 1/--- Type of Identification: ___
NOTICE OF COMMENCEMENT
State of 1 L County of f)v✓t.3 Tax Folio No. /G V—/6 3 -c) 5'1 v
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: Na - i 3c"/ - 2 S - 2' . Oce "Pr
Address of property being improved: ac 4 X A‘41,,,,7 71k,-c.. 4/1..rk 46-1.t ,L 3J?3 3
General description of improvements: IC:
�� J t.A. t�p.�-.i�+� , fn)�r. -ltJ� !.�W+ >.�+ `.3 s{ ✓c- retsx ,i
Owner: } �c ►{��-c /4,4, .—_ Address: " aeti ac... Ct. dial. V3e� 1L 3 3,s
Owner's interest in site of the improvement: /4/4/6., C
Fee Simple Titleholder(if other than owner):
Name: _
Sontractor: VA,
1 1 If'7 1 0/7W-5/,
J",
rY�
-71;r1
Address: J
Address: 0 A[9 / )
� i
Telephone No.: I Q t Fax No:�v ! gy "�1�3 7 -
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any per n making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No: _
Name of person within t e Stat of F orida, other th him/self, designated by owner upon whom notices or other documents may be
served: Name: t A '1�
Address: ! 0I)-c [' aMil . —
Telephone No: # Fax No:_ 11 ��,
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: r� � Date: /J43�17
Before me this t ay of Z4,031*.t' 20l}in the County of Duval,State
''6 ERIN R KELLY Of Florida,has personally appearedC�
I _*' No�Y Pubik.State d Fkrlda Personally Known: or
trawl; COm►msSIOMFF910710 Produced : bL
NYe"m.Wires kg./8,2019 Notary Public: �' 114.E 1trEU.
Mycommission e 1e4 1
Doc#2017296038,OR BK 18234 Page 69,
Number Pages: 1
Recorded 12/28/2017 09:28 AM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00
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