1870 LIVE OAK LN - PERMIT RESO18-0181 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,Fl,32233
(si'_',D19 INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NE)Cr DAY INSPECrION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0181
Description: bath remodel
Estimated value: 10387.5
Issue Date: 5/31/2018
Expiration Date: 11/27/2018
PROPERTY ADDRESS:
Address: 1870 LIVE OAK LN
RE Number. 1720201422
PROPERTYOWNER:
Name: ROSENBERG MARK D
Address: 1870 LIVE OAK UN
ATLANTIC BEACH, FL 32233-4649
GENERAL CONTRACrOR INFORMATION:
Name;
Address:
Phone:
Name: BOSCO BUILDING CONTRACTORS
Address: 2158 MAYPORT RD
ATLANTIC BEACH, FIL 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 govermnental 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
Phone(9G4)247-5826 Fax(904)247-5845
E-mail: building-dept@wab.us Date muted
City%velo-site: hftp://�.wab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Il D rtment review required Yes 'No
Applicant: 61psco &k��Jkf�� C_b(*AL�hy 5 Planning &Zoning
Tree Administrator
Project: "D V�) Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Al
Review=P,'y Data
Other Agency Review or Permit Required Of Permit
Flonda Dept.of Environmental Protection
RoMa Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: —WDPMVd. [-]Denied. E]Not applicable
(Circle one) Comments:
4" 4F
PLANNING &ZONING Reviewed by: Date:
TREEADMIN. Second Review: ElApproved as revised. E]De�nied. ONot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date*
Revised OSM9/2017
r RECEIVED
OFFICE COt Building Permit Application Updated 12/8/17
City of Atlantic Beach MAY 18 2018
Seminole Road,Atlantic Beach,FL 32Z33
Phomic(�)247-5826 Fax;(904)24,7)M5
Job Address:_00 a� '5eelA& hatz Permit Num n )a
Legal Description 37-12c? 9q-0?5 _a9r FQ1!!Jdj'o�M' L
Valuation of Work(Replacement Cost)$ 10��W,50 Fleated/Cooledsli -2ff'o Non-Heated/coled Afy
• Class of Work(Circle one): New Addit!I terati,on pair Move Demo Pool Window/Door
• Use ofexisting/proposed stnucture(s)(Clrc��Commerctal
• If an existing structure,is afire sprinkler system installed?(Circle run!e!PY�/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: AAW J9J
Ad fVb5", daJ &IA--6
Florida Product Approval# for multiple Products use product a pproval form
Prothertv Owner In wa ipp
Name: dchress' /9�0 '�*Ow4w
1Z f0n K
atej�z�ilp JvIA33 Phone 6W. -) 3W— 71JK
E-Mail KoAOK"6 hn.3
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name:Oarrtpa 10 Qualli ing ent:
Addre � w AWIAW " city ate zip 39R33
Office Phone elft) aw-opo
State Certifficartion/Registration# 6M 1XIVoWhA E-Mail
Architect Name&Phone#
Engineers Name&Phone#
Workers Compensation �Ew�'
Exempt/Insumr/ selmpl;�,
'ji.e. :./Exprition6ate
Application is hereby made to obtain a permit to c X s 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 fou red 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 coning.
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 A 7N
R5TfD1JMR NZICE OF COMMENCEMENT.
I B `Z17M
(Sighature'f ow 'Agturtl (Signature of Contractor)
finclu fin,co%rltor)
Signed and sworn to Jor aff r befor me is day of ne an sworn to(or affirmed)=reZ lAs�1%. day of
6 b, by 7v
iSignatureoff4crtary) (Signature of Notery)
Personally Kn=R. Olin X Ent" �N Personally Known OR Denim A.Errift
I Produced Ida n NOTARY PUBLIC [ I Produced Identifican in, NOTARY PUBLIC
Type of Identification: A%STATEOFFLORIOA Type of Identification ANSTATE OF FLORIDA
�rriinoax— Corramill FIp9e8M
Expires 31112020 E)om 3/1/2020
11�4 - aW
I L4
vrn?lj #- R,531F 0/(f/ OFFICE COPY
NOTICE OF COMMENCEMENT
State of /I
TaxFolioNo.
County of
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 ofproperty being improved: 37-aq le,6r
/of /0 —
Address ofproperty being improved: 1970 4XII.- OfeZA&
General description ofimprovements— Awe—win AACAL
Owner: hul/ 9 95r,)&& — Address: 1970 Z-Mrodtl&A�_ ArlAkrZ
Owner's interest in site ofthe improvement: 12oze
Fee Simple Titleholder(if other than owner):
Name-
Contractor: &-ye, AWA� O_Awmna
, W
Address: 0115-8 0
Telephone No.: 050 &I-_0�0 FaxNo: q CZ0
Surety(ifany) -C 0 �j
i:
Address: Amount ofBond$
a 0
Telephone No: Fax No: no
ILL! < 0
Name and address of my person making a lown for the construction of the improvements 0 z = z
0
5 04
Name: I& U)
Address: M
Phone No: Fax No: LL Ia- FE 2
coww
Name of person within the State of Florida, other than himself, designated by owner upon whom nofioes or other WtOrnavibe
RHO - W
served: Name: Us
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(die expiration date is one(1)yew from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER,,,
_. red: Date: k%lovb
Doc#20181195M,OR BK 183R3 Page 665, bremetIlis I?, day oflv%�A21Q in the ty ofDuval,State
N�.�r Pagea:I Florida,has personally appeared 1�
Rec�ded M1 SC018 01:28 PM, wy Public at Large,Sure ofFlorida,County ofDwal.
COUNTY I wmmission expires:
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
RECORDING $10.00 sonally Known:
duced Identification: =�Ajw Ic
STATE OF FLORIDA
I W� Cor"FFOW28
Exp4ru 3/1, Expinat Win=