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1849 Ocean Grove Dr water damage repair permit CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 RESIDENTIAL -ALTERATION RESIDENTIAL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-S814 PERMIT INFORMATION: PERMIT NO: RES18-0026 Description: WATER DAMAGE REPAIR Estimated Value: 2500 Issue Date: 1/22/2018 Expiration Date: 7/21/2018 PROPERTY ADDRESS: Address: 1849 OCEAN GROVE DR RE Number: 1695980000 PROPERTY OWNER: Name: MOHSEN1 MICHAEL Address: 1849 OCEAN GROVE DR ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: ESTATE AND PROPERTY SERVICES Address: 13725 BEACH BLVD STE 11 JACKSONVILLE, FL 32224 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$7,500. Building Permit Application Updated 12/8/17 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 REsv"- ooz(�2 Job Address: C/ 06 ecl ki 61 r6 v e- De . Permit Number: C-5 Legal Description 26 - ZO Oq -.2S %2-9`9' - 09(e Ocean 67.10 U e-UAVEtt _6' Z: '_6+ ' Valuation of Work(Replacement Cost)$ �600. 0 0 Heated/Cooled SF 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 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: Ey4erior Florida Product Approval# for multiple products use product approval form Property Owner Information Name: Mt6� ,ae ( MoA:5 'n*, Address: OcIg oceak, 6) lcve belve City A-4 1 si C_ 6,0 4 r-k,_State Zip S 00_-5 -3 —Phone J�LZ .2 I'-IY E-Mail 07 C. :&,,'I . M i e-,A a-e/ t,� !j)" a; C_,z�r)�, Owner or Agent(if Agent,Power of Attorney orJAgency Letter Required) Contractor Information Name of Company: ,4,e �ve,- k4 &rVI 605_Qualifying Agent: Cgf 2 Address 13 2.2 5- �3-e4,e4, 610d :zf- '(I —city Ya"'t, o4o,, //eState Zip OfficePhone 1917-t Job Site/Contact Number State Certification/Registration# (f 6 /__)58 &7 -3 E-Mail rfb ee C-a- hot�-4,h L-*e Co nq Architect Name&Phone# Engineer's Name&Phone# Workers Compensation rL&T- ?5 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. OWN ER'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,n� Z (Signature of Owner or Agent) (Signature of Contractor) (including contractor) /0 Si ned and sw9nn.ito,(,(or afU�rmecll)before me this day of Signed and sworn to(or affirmed)before me this / 0 day of 1Y y (roujil-0 by_/_0rnz te. -Gw,.. A-oA ........... yp f Notary) e OM!" M Comm ion# 9 e of Notary) M ission*00* f� t ion# zExpires: SEP24,2018 Ecommiss FF1 3OA69 6Rires; SEP 24,2018 "(0jQ i,i rn� BONDED THRU Pers- Persona A I W11111 BONDED THRU LORIDA NOTARy UC i4l-rocl uNeviii&;�'t if 'ENORIDA NOTARY,LUc ��roclucecl Ident fic Type of Identificati n: 1:J C-1/j,5r— Type of Identification: Pl� Dr LiZ*-" 'J-C NOTICE OF COMMENCEMENT State of Fio r i J,3 Tax Folio No. / 3q /037 . 006cl County of I U 0 a 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: eg 6 — 2 6 0 LIZ 2,&4 "1 1 Oceak, 6-)e-w-e U;,J - Address of property being improved: l8q.56ce-am Grou< General description of improvements: c-e- ro4-4-e ti woo Ctro a m t' 4 M ct-S�� a,-�k,--c,c yvi j Owner: KeAaef M0hS1Pn*1 Address: )Aq q ocfa, Cjooe .5Z z Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: ontractor: j 5,L-6)4.e t Prq-eirj-�j �, -e,,o, ceS �tj e-06-� k" L 4 Address: 13-2�25- B-ea CA 6/0J. , 5ad11';-S-,,=11" )C6 szze- tl Telephone No.: qO Ll Fax No: N14 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: Doc#2018015306,OR BK 18257 Page 503, Before me this dayof -T.;�,Iqua)e! in the County of Duval,State Number Pages:1 Of Florida,has personally appeared Recorded 01/22/2018 08:38 AM, Notary Public at Large,State f F1 id County of Duval. RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL My commission expires: COUNTY Personally Known: or RECORDING $10.00 Produced,joentification: Pit e Swinton �VA'-.. Loma tcomrm SEP 0 xP . . 18 c-:E ires SEP24,2018 V—&! BONDEDTHRU %imvi nOMA WAIPAhv I I Cash Register Receipt Receipt Number City of Atlantic Beach R4878 DESCRIPTION ACCOUNT CITY PAID PermitTRAK $55.00 RES18-0026 Address: 1849 OCEAN GROVE DR APN: 169598 0000 $55.00 BUILDING FINAL 03/30/2018 RBE $55.00 BUILDING FINAL 03/30/2018 RBE 1 45500003221002 0 $55.00 TOTAL FEES PAID BY RECEIPT: R4878 $55.00 CITY OF ATLANTIC BEACH 800 SEMINOLE RD ATLANTIC BEAC,FL 32233 0+25/2018 16:16:07 CREDIT CARD VISA SALE '.'ARD �(XXXXWWX1594 INVOICE 0004 :3EQ#: 0004 3kh#: 000784 �Pl)roval Code: 010333 -nt�y Method: Manual Ade: Onlhe 4d Code: M .;ALE AMOUNT CUSTOMER Copy Date Paid: Wednesday, April 25, 2018 Paid By: ESTATE AND PROPERTY SERVICES Cashier: CB Pay Method: CREDIT CARD 010333 Printed:Wednesday,April 25, 2018 4:16 PM I of I TWIT