700 BEACH AVE - PERMIT RES18-0167 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
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RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-S814
PERMIT INFORMATION:
PERMIT NO: RES18-0167
Description: FOUNDATION REPAIR
Estimated Value: .7900
Issue Date: 5/18/2018
Expiration Date: 11/14/2018
PROPERTY ADDRESS:
Address: 700 BEACH AVE
RE Number: 1702440000
PROPERTY OWNER:
Name: SLEEPER JULIETTE ADAMS TRUST
Address: 700 BEACH AVE
ATLANTIC BEACH, FL 32233-5414
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: FOUNDATION SYSTEMS, INC.
Address: P 0 BOX 50545
JACKSONVILLE BEACH, FL 32240
Phone:
PERMIT INFORMATION:
Please see aftached 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 C- "7
P
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E mail: building-dept@coab.us L Date,routed: C40,
City web-site: hftp://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: '70D ESap,,nav-� P�iv Dep;krtment review required Y No
'7
M,
Applicant: of)L2 (Ym CD P-3 (pTa'ni�i�J &Zoning
Tree Administrator
Project:
Public-Works
Public Utilities
Public Safety
Fire Services
e.view 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: E�rApproved. []Denied. []Not applicable
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: []Approved as revised. F-]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 05/1912017
Building Permit ApplicationOFFICE CWY/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FIL K233
Phone:(904)247-5826 Fax:(904)247-5845
Job,Address: 700 964CI-V 1QV,6. Permit Number: P"
Legal Description (o-1 1(a-Z.5 -217 4. 01/ 00C//G ef�'�^J/
7,4� ZftAl RE# /-70 ZV 5(- 0 000
Fr Wv7C1 Rf54QV4;*0A--' 42teb
Valuation of Work(Replacement Cost)$ _He'ated/CooIedSF -E.7-So Non-Heated/Cooled 31'Vo
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/poor
ED
esidentia
• Use of exisii n g/pro posed structure(s)(Circle one): Commercial 4�
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes <1��) N/A
0 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/14
40t,04-2-10,V ?__4Pd1R - U A.,Z,15,C F1A.),1L)1A4:g-
Florida Product Approval# for multiple products use product approval form
Property Owner-information
Name:-S-uL tF_776- S4&&PzR_ Address: 70-c; 964614 4116
City &744^,7,e_ 60-4C-14 State r-L zip -7.,-Z_F.3 Phone 5W-7-Y 19-IVI-e E-
E-Mail &A4alka7"su,"A Q Y41-loo. Co en
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required) -73 L I f-7--,-e- Se-,6z dogle
Contractor Information
Name of Company: <u,,uZ A71n.-J SvS22EMS ZAK. Qualifying Agent: 0-/415'It;,41,ktl
Address-Zo5- Z &Z1,94,-a S7140455i- C.itv4r44"7-',c' &A/' State dc(- zip 3?--e ?.3
OfficePhone /- Vy-zv Job Site/Contact Number '70C1-'ZVV- Z68'T
State Certification/Registration# C&-' 0517309 &Mail co�-
Architect Name&Phone# &1_1q
Engineer's Name&Phone# VoV- e.V1-c1VZS'
Workers Compensation Sle I D If t 4) z-/6
Exempt/Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to do the work and installations a,s 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
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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 YOU OF COMMENCEMENT.
(&i_g_Ea'f�ri&f�Owner or Xg!En1tY (Signature of Contractor)
(including contractor) q-TIA
Signed and sworn to(or affirmed)before me this 4OW day of Signed and sworn to(or a 'rmed)before me this day of
-Z416 by -,T-oL m77e_
(6gnature of Notary) (Signature of Notary)
ALBERT MORENC)
P/4 Personally Known OR 13ILLY C MCMANAN I Personally Known
Produced Identification roduced IdentificatP' n mate ol Fjorlda
motary Public-
MY COMMISSION N FF2306J Y
Type of Identification: I 1pe of Identification: S commission'I FF 239295'19
eXPIRIES May 1 3.20 t9 s Jun 9,20
my Comm.
1407)N-0-53 FWA314otayService.cw.
Bondadthrough National Notary s3i
r
Pe'r'7; 7L y OFFICE COPY
NOTICE OF COMMENCEMENT
State of 4�oRIZA TaxFolioNo. /70?,51Y-0000
County of b j VjAl-
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: S-01 e-- 2!WA A e Z.5'
P7' Ajo-r6L R&SARV4-7,10.,U 406)1
Address of property being improved: 7,0 D 9"e"q 4 V,6
General description of improvements: AUA,1ZA71o,1J 4,10,0112- Q
Owner: -Z-ue-j07-/-P 54,4ePZ4 Address- 700 &4C.-rw
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner): Alle
Name:
Contractor: AiQAW101t) g�eS—/Z.*7S ---A/—^ --C&e- 0'5q 308
Address:--Z05- Z 64)9�41Z A-6. --ZZ Z 2,7
TelephoneNo.: 02V- ZVI-VV2-!r Fax No: -90 V-?,V,9-C/9 1-3
Surety(if any) Lt411A
Address: Amount of Bond$ 41-11-4
Telephone No: Fax No: 69�
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No: AVIA
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be,
served: Name: A/
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.-,-4 Date:
Doc#2018106761,OR BK 18376 Page 773, Before me this 41 Zy da�of IM4-' in the County of Duval,State
Number Pages:I Of Florida,has personally appeared L_te S/-Ag Pe-R
Recorded 05/04/2018 11:54 AM, Notary Public at Large,State of Florida,County of Duval.
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL My commission expires: -Zo t 1
COUNTY
RECORDING $10.00 Personally Known: or
Produced Identification: otwk&, ku
A
MY COMMISSION#FF230603
EXPIRES M2y 13,2019
14C7)398-0*53 Fbr4",.a-y3ervic@.cWz