83 NICOLE LN - FOUNDATION REPAIR , rte ,
Nis ' r`10 CITY OF ATLANTIC BEACH
r ,-- ? 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
r;; S). INSPECTION PHONE LINE 247-5814
RESIDENTIAL OTHER - SINGLE OR TWO FAMILY RESIDENTIAL OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES018-0004
Description: FOUNDATION REPAIR
Estimated Value: 7200
Issue Date: 1/29/2018
Expiration Date: 7/28/2018
PROPERTY ADDRESS:
Address: 83 NICOLE LN
RE Number: 169519 0825
PROPERTY OWNER:
Name: WALSH SUSAN
Address: 83 NICOLE LN
ATLANTIC BEACH, FL 32233-5979
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: FOUNDATION SYSTEMS, INC.
Address: P 0 BOX 50545
JACKSONVILLE BEACH, FL 32240
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.
0�vi l City of Atlantic Beach APPLICATION NUMBER
Js '', ,\,\ Building Department (To be a . ned by the Building Department.)
r `2 800 Seminole Road (r'
-- -- Atlantic Beach, Florida 32233-5445 C (�? ' C�Oo�-
Phone(904)247-5826 • Fax(904)247-5845 f
ij,tt9r Email: building dept@coab.us Date routed: 1 / ar1-A
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: V - Q ( L' c)„, L`-- Department review required Yes No
Building
Applicant: FO l Nc��TvvC�0I S._ S1-'— \ lannirrZoning
ITree Administrator
Project: r tJ U IV(J -ATI 0 ti R gP t 2 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 G
IJ
Florida Dept. of Environmental Protection -�L P'4'Florida Dept. of Transportation
St. Johns River Water Management District G
Army Corps of Engineers
Division of Hotels and Restaurants NN ei-- -
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: LTA;.proved. El Denied. Not applicable
(Circle one.) Comments:
BUILDING _.
PLANNING &ZONING Reviewed by: �'> Date: 0 ' `t;-5
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:
I
Revised 05/19/2017
Doc # 2018019715, OR BK 18262 Page 2142, Number Pages : 1,
Recorded 01/25/2018 01 :50 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
,
State of cla,Z/aA Tax Folio No. 16,q571-0 8
ar-
County of le)(.1 l.JF1 L.
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved:
'f6 -91 37- 2S — 296_ -rbeietfiuy gY 77/e. SSi Lo Z3
Address of property being improved: es /O(do-e.... LA/t)6 41Z. €E A G hi k. Z. g
General description of improvements: ::.u,UZ)A7/opt) 1J',I (2 - UN DFa2 4N,u,42
Owner: SuS4/1/ W AGS/1 Address: 83 //ICc 14/, //7Z./gd'Ac4/d A gez33
Owner's interest in site of the improvement: D GV/Le-/2-- - -
Fee Simple Titleholder(if other than owner): 44
p Name: /!///Q
)A' Contractor: 4u,Uz 47/tvt) S ,S7 415 _t--h.2
1\3Y.
" Address: -005—r. IrA&42 SZ 4 7Z 4/t.j7r /44C41 / Z Z 3 3
,
Telephone No.:QOV ZY lZ
/^WWWr FaxNo:90t/- Z Se7—''5-Sg
Surety(if any) /L//4
Address: /✓/r4 Amount of Bond$ /04
Telephone No: /v/iQ Fax No: N//9 .
Name and address of any person making a loan for the construction of the improvements
Name: 44
Address: /V
Phone No: /1/p4 Fax No: /Y�Q
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be
served: Name: 40;
Address: /✓//I
Telephone No: /1/f A Fax No: yfj4
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: /L,/4 g
Address: /V A
Telephone No: A/A Fax No: 4/4
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified): /t/A
THIS SPACE FOR RECORDER'S USE ONLY OWNER J
C.:Signed:-3 k0,4j D I k /1.1 0ivJ Date: Di--Z if—'/t
Before me this ZY7.Y day of 7.2it.n A e7 in the County of(Duval,State
Of Florida,has personally appeared Sc)S4N todLSS/
Notary Public at Large,State of Florida,County of Duval.
My commission expires:
Personally Known: X. I or
Produced Identification: I
ri!''), BILLY C MCMAHAN
4 ' . MY COMMISSION#FF230603
P, -?it,,,, EXPIRES May 13,2019
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CATALOG NO: PSA1001 CP) OR PSA]052 [0]
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,' II 3.ALL WELDING TO BE DONE BY VELDERS CERTIFIED UNDER SECTION 5
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A.MANUFACTURER TO NAVE IN EFFECT INDUSTRY RECOGNIZED WRITTEN _
QUALITY CONTROL FOR ALL MATERIALS AND MANUFACTURING PROCESSES.
5. SEE ICC-ES EVALUATION SERVICE,INC EVALUATION REPORT WI
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2. NOTE Actual Pier locations may be moved � 0••MCMA.•'4i oe
as necessary to avoid underground ,�� \,;.•\G E N SF••:', ;;,
utilities, obstructions, etc :���;' �' ••9
3. NOTE Following completed underpinning No 42677 ;•
operation Piers shall be loaded. = *•
:ot/,l/!g * --
4. NOTE Following completion of underpinning
operation, a cement basedgrout shall •:
% '9�• STATE OF
be injected to fill voids created during :�Q .• c P=�c���
underpinning. '. •• O R‘�•'•C� .`
5. NOTE Installation records shall be kept 0000is`S�ON A�-�?��,`
during underpinning operations. i,IH I l I it0
6. NOTE All Pier materials shall be hot dipped
galvanized to prevent corrosion.
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Building Permit Application Updated 12/8/17
P City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 y��
Job Address: gS N ICC LiE 44/VE Permit Number: OL-- C` -- ( C XID'
Zor
Legal Description 'flo-i4 37-ZS -Z44 77F4ANy fay Vie 5E4 =.3 RE# 1 ,q79- O5
Valuation of Work(Replacement Cost)$ 7Z00 .00 Heated/Cooled SF /6 68 Non-Heated/Cooled
• Class of Work(Circle one): New Addition AlterationRepair Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): Commercial Residentia
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No 6Th
• 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: .
/Co v A.AA 7/O N R E P/v/e. -- u Ai 66/2. P i 10 ti 1/u C-r
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: Su SA N W A L S H Address: 8 3 A/(COC.E, LAivZ
City /7 7LA/>,/7i j EA 0111 State Zip 3Z Z 3 Phone 9'Dc/-7VZ- S-S
E-Mail 5 USA Il/---WA C.SN 2.0_ tZW.Soy,?N,/(/E7
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) 4.00
Contractor Information ,,/
Name of Company: /COU Nb4 7/OAJ Sir S 7Z 1 S SNCQualifying Agent: ///}/ C.. /L1C/114l�i(/
Address ZOS-Z. E.bG-it4 S7 City 47 ,2 4)7/Cgatstate 1G. Zip 3zZ33
Office Phone 90(1- ZY/- 5(4 Z( Job Site/Contact Number goy- Z' i- Z S Ba
State Certification/Registration# C€G Cc 9306 E-Mail /?,'///i1/tZlN44)t , X47/o/05ySTlf75s"-C.• Cof) \
Architect Name& Phone# /VA
Engineer's Name&Phone# /3//40 /1: �W/J/,Ll•t> 5.2. r-C. 40 4'260 77 pe, -90-- ZW- yV Z'S'
Workers Compensation R(DGEF/EL L EMPCoye/4S .Zit.v A,iC.e_ Co,mqOn,/ 09/e ./ 7/5
Exempt!Insurer/i ease 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 OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
\.1. 4/66.ii,-)..) 0 X-itioix ) 4:7(. i'l"
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me thisZYrN day of Signed and sworn to(or .ffir led •efgre me this Z S day o
TAn.J U 4 2H ,,,.8 , by S 5c4.0 Q AGsff Tqn Zi)/t , . I 4.6 ('C. /h�-�?
(Si nature of Notary) ( •ignature of Notary)
fyl,Personally Known OR iti,Personally Known OR
O Produced lder,tiiicaiion
[ ]Produced Identification
Type of Identification: Type of Identification:
,.,�����:,,, ALBERT MOPEN:
;;��'''^ . BILLY C MCMANAN :o, P�#`„ Notary Public-State of Florida
MY COMMISSION>r FF230803 _•: "" »• Commission#FF 239295
;r,°�� oma= My Comm.Expires Jun 9,2019 k
EXPIRES May 13,2019 ��:F,,,,,,,°�,�` Bonded through National Notary Assn..•
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1 k 7 i?90.G 63 Flondy�p• 3Mnn-cpr