2233 Seminole Rd - Permit POOL18-0013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
SWIMMING POOL - SWIMMING POOL RESIDENTIAL
MUST CALL BY 4PM FOR NE)(T DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: POOL18-0013
Description: RE CONSTRUCTE EXISTING POOL
Estimated Value: 12680
Issue Date: 4/26/2018
Expiration Date: 10/23/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD
RE Number: 1695190101
PROPERTY OWNER:
Name: OCEAN VILLAGE ASSOCIATION INC
Address: C/O SIGNATURE REALTY & MANAGEMENT
JACKSONVILLE, FL 32257
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: HENDERSON POOL SERVICE
Address: 159 11 TH ST QA ROBERT WAYNE HENDERSON
ATLANTIC BEACH, FL 32233
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.
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.
* 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$7,500.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 R5C)C_ -oo I
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us L late routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 7-Z-SS SCJY-\ I r,:)(3L_C_- DRRgrtment review required Yes-----]
No
Applicant: t4 Pt, '�(�OpD POC:) C, C-Building- _�)
Planning &Zoning
Tree Administrator
Project: 1�s s 0 1 ur� P o(D L Public Works
Public Utilities
j Public Safety
Fire Services
V
Review fee Dept Signature
Other Agency Review or Permit Required Review or Receipt Date C,(?,
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Wpproved. []Denied. DNot apocable
(Circle one.) Comments: 0 C"
(��D
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: []Approved as revised. F]Denied.U E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. FIDenied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
JobAddress: '2'Z*��3 Permit Number: Poo C- t 8 - DO 1,3
Legal Description RE#
Valuation of Work(Replacement Cost)$ 17. 10 250 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Dern<9 Window/Door
• Use of existing/proposed structure(s)(Circle one): 4�D Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No CN)
• 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: V-tmolicph 494-0c, 19ow i\,tw
41,00,- 101ZW , Jr%-5+ak1 n4w ecok 'n0+01-1 Cutck *M�V4SC;%W11 n-604t�- A-A �rAp (k,, Cf,�.Jt.
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Florida Product Approval# for multiple products use product approval form
Property Owner in rmation
Name: Fo ey-A
-.0k n V,I�-w op n(:, Address:
City 119+1&4�41e- Z��Ch State T:L_ zip Phonekal)L0 �)wei-96clq
E-Mail 1!�a� - Marvin 1,p- cbry-)
Owner or Agent(If AgJnt,P4A er of Attorney or AgaAcy LeAer Required)
Contractor Information
Name of company:+k^6-er_(bn Ppnk SRrv�u -rot- Qualifying Agent: ?_ o 10,&-Ar 4�en A_&-So v-\
Address 19q (1+1,- 1;f"-t+ CityA:�4yi4JL State 1�-L Zip 372-3-1
OfficePhone Job Site/Contact Number 0 4 --1110- S I 4G,
State Certification/Registration# (_I?C_09 to(A 5 k E-Mail S,6�-y'jcj 6b. n-w�k. co,-i,_
Architect Name&Phone# WA
Engineer's Name&Phone h A
Workers Compensation li�
Exempt I 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 01 1"Am'-- -NS,
WELLS, POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONC11-- of this
permit,there may be additional restrictions applicable to this properi and
there may be additional permits required from other governmental e es,or
federal agencies.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is acc.
applicable laws regulating construction and zoning. C&I 6
WARNING TO OWNER: YOUR FAILURE TO RECORi
RESULT IN YOUR PAYING TWICE FOR IMPROVEMI U 4 D
TO OBTAIN FINANCING, CONSULT WITH YOUR LEI
c2 C�
RECORDING YOUR NOTIC�OF COMMENCEMENT.
R
C
(Signature of Owner or Age
(including contractoi)
5 ne-cl-a-Ind 5 rn t e this
1g o for a rmed)before m day of Sign L� 8
E E
E
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#GG 192710
WedmMISSION C. 2
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EXPIRES:March 9,2022 IL co
Unded Ift Mfty RM W&mIh.- (Signature of Notary)
L,�4rsonally Known OR ]Personally Known OR Or
"0
Produced Identification Produced identification '0.
.........
Type of IdentIfication: e of ldentification� Fto a-i,C�C_ 0e�__
Doc # 2018096989, OR BK 18362 Page 1718, Number Pages: 1,
Recorded 04/25/2018 09:54 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
ptimp.14C. Tax
of Fluild. Du�vt
.0 CountV of
To whom It may cancei n:
The undemignad hereby Oforme.�*.11 Ina!hripro"ments vAl;he niade to tertsin mp.�prupai-ty,and in
acet"Fdance vAth Section 713 ofilto Florida Sizutes,the following Information is stated in this NOTICE OF
(;0 raMENCENIENT.
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