1551 OCEAN BLVD - DEMO r,` f,j l-Al
.�� '; _ CITY OF ATLANTIC BEACH
-• m XL*, ;I
5v P', . , r 800 SEMINOLE ROAD
�\ ATLANTIC BEACH, FL 32233
o.V),' INSPECTION PHONE LINE 247-5814
DEMO - PARTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DEMO18-0016
Description: Demo
Estimated Value: 10000
Issue Date: 6/18/2018
Expiration Date: 12/15/2018
PROPERTY ADDRESS:
Address: 1551 OCEAN BLVD
RE Number: 171874 0000
PROPERTY OWNER:
Name: RHODES GARY A
Address: 1551 OCEAN BLVD
ATLANTIC BEACH, FL 32233-5757
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: BOSCO BUILDING CONTRACTORS
Address: 2158 MAYPORT RD
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.
'' Permit Conditions
' , City of Atlantic Beach
04
f );; rJ
Permit Number: DEMO18-0016 Description: Demo
Applied:6/12/2018 Approved: 6/18/2018 Site Address: 1551 OCEAN BLVD
Issued:6/18/2018 Finaled: City,State Zip Code:Atlantic Beach, Fl 32233
Status: ISSUED Applicant: <NONE>
Parent Permit: Owner: RHODES GARY A
Parent Project: Contractor:<NONE>
Details:
LIST OF CONDITIONS
SEQ NO ADDED DATE REQUIRED DATE SATISFY DATE TYPE STATUS
DEPARTMENT CONTACT REMARKS
1 6/15/2018 EROSION CONTROL INSTALLATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(247-
5814)to request an Erosion and Sediment Control Inspection prior to start of construction.
2 6/15/2018 ON SITE RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site during construction.
3 6/15/2018 ROLL OFF CONTAINER INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapell's,Inc.,Republic Services,Donovan
Dumpsters). Container cannot be placed on City right-of-way.
4 6/15/2018 RIGHT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full right-of-way restoration,including sod,is required.
5 6/15/2018 RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
Printed: Monday, 18 June,2018 1 of 2 •
41" Permit Conditions
vl City of Atlantic Beach
6 6/15/2018 DOCUMENT IMPERVIOUS AREA INFORMATIONAL
•
PUBLIC WORKS Scott Williams
Notes:
Strongly suggest thorough documentation of impervious areas be recorded.
7 6/15/2018 SLAB DRIVEWAY REMOVAL INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Slab and driveway to be fully removed.
8 6/15/2018 UNDERGROUND WATER SEWER INFORMATIONAL
UTILITIES
PUBLIC WORKS Kayle Moore
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field
coordination is needed,call 247-5834.
9 6/15/2018 DISCONNECT AND CAP INFORMATIONAL
PUBLIC WORKS Kayle Moore
Notes:
Disconnect and cap water and sewer lines.
Printed: Monday, 18 June,2018 2 of 2
r (T�o ,,; City of Atlantic Beach APPLICATION NUMBER
.�s' Building Department
o be assigned by the Building Department.)
800 Seminole RoadEI)
j<� F � Atlantic Beach, Florida 32233-5445 De m Q Q , D �
Phone(904)247-5826 • Fax(904)2 8CwJN3 2018
�r i3 �� E-mail: building-dept@coab.us Date routed: Co//21/ ?
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (55 ( 2e 13 vd (-Doiment review required Yes No
Bun
Applicant: BO SCO Planning &Zoning
Tree :•1 inistrator
Project: -1i'eXn 0 _ -ub• A • .
Inc Utilitie
Public Safety
Fire Services
re : ,, , VitDe10f1Sl 6t4re
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: 'Approved. ['Denied. . ❑Not applicable
(Circle one.) Comments:
BUILDING
`
PLANNING &ZONING Reviewed by:itiel( ) 2i 'oz Date: b--7(4--,
( �
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑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 05/19/2017
APPLICATION NUMBER
s 0!..Q./-1.,0 City of Atlantic Beach
J Building Department (To be assigned by the Building Department.)S 800 Seminole Road 1 Q' /
Atlantic Beach, Florida 32233-5445 �� 1 (� �QI�0
Phone(904)247-5826 • Fax(904)247-5845 Q
01119 E-mail: building-dept@coab.us Date routed: liz_/i 6
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ( S S ( ce 73(Vdment review required Yes/'. No
Buildin //
Applicant: BO SCO Planning &Zoning
Tree 1.1 inistrator
Project: e n . -u. A A .
'bfic Utilitie
Public Safety
Fire Services
Review 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: Approved. ['Denied. . ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: rill(y--- 6"/�1 r
Date:
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:
Revised 05/19/2017
�s!J-14.j.r, City of Atlantic Beach APPLICATION NUMBER
_ pp s, Building Department (To be assigned by the Building Department.)
s� 800 Seminole flECEJ' 1El
-. !? Atlantic Beach, Florida 32233-5445 Dein() I $ �Q
Phone(904)247-5826 • Fax(904)247 45
JUN s.?..'/s.?..'/ E-mail: building-dept@coab.us JUN 13 2018 Date routed: eO I/Z- a
I/ Q
City web-site: http://www.coab.us /
8Y•
APPLICATION REVIEW AND TRACKING FORM
Property Address: (551 O2e 'B.(Vdment review required Yes No
Buildin
Applicant: B 0 sco Planning &Zoning
Tree Administrator
Project: --li't%YYI,° •ub• A • .
' blic Utilitie
Public Safety
Fire Services
. r � '.4'xt .,_ [fie{ l Wart
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:
APP)ICATION STATUS
Reviewing Department First Review: Approved. ❑Denied. . ❑Not applicable
(Circle one.) Comments:
BUILDING /J
PLANNING &ZONING Reviewed by: ? r Date: G l 't1 LS
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑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 05/19/2017
tItiftit) Duiming rermit Application Updated 12/8/17
" City of Atlantic Beach
'` c v 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 . , ,Q
Job Address: ISS 1 OCf V E N,ck. 40kr&(*(.e7Cn) Permit Number:D`-'perI/,L0l -O
01(e
Legal Description (°- 11 I(.'2S •ZaIE PIQrd .( 1--03r q S1I4- (a3 RE#111$114- 00cao
Valuation of Work(Replacement Cost)$ tO oOo o Heated/Cooled SFt000 F Non-Heated/Cooled(o $F
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial esidentia
• 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: 1:::lie ono c iC/tce.i/ c®,A_Ol, „ /yi//e.41-rlid*4 711
,cat-coc+0
Florida Product Approval# for multiple products use product approval form
Property Owner Information 1
Name: 1'i2Y1�1L ' -EVQ- pctnbC-S Address:1 o$4 Caanv�Ort b ir.
City f4.f%d• CJ State UT Zip 164098 Phone To(S•41S- OCcrI5
E-Mail Lin cS eCoO'+CCNSJ'. t1(,-k-
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: elOSCe Bu4td t n5 Corrk-rackor VelmaVyingAgent:
Address 2t5iS Pf for-1- Rd City dr-SOfl t t t , State 6— Zip 32233
Office PhonegOy- 2_ -233 20 Job Site/Contact Number Tocld. eyoSCD CIOLI•Z33.o104
State Certification/Registration#CGC I2502-12 E-Mail 4odd@ bo .CO C{DG- C.orn
Architect Name&Phone#
Engineer's Name& Phone# _
Workers Compensation 1iv-tem CkSiro. <AS1l'B 11511$
Exempt/Insurer ease Employee 7T piration Dates
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
GYYOUR NOTICE OF COMMENCEMENT.
(--1552e:
(Signature ,1/4____Y_....igigrAd-----
of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this r
g ��� day of Signed and sworn to(or affirmed before me this � day of
,2DIIt, ,byWrw-1-n` Q,nlosk--r1 NI-id) ,.2°IT) , v ncd�. Ro co
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11",,..,..: e at i" � i Fmic �. • 1r•,.:
•• NOTARY PUBLIC
]Personal/ Known OR _ _ STATE OF FLORIDA t _ STATE OF FLORIDA
`��: ]Personally Known OR IP" Comrrrk FF966428
Personally
. . . " Carta FF966426
[ ]Produced Identification . �... . [ ]Produced Identification 4CE t Expires 3/1/2020
Type of Identification: ' Expires 3/1/2020 Type of Identification:
. .,-,1!--'11‘.1-,J, EXHIBIT A: LETTER OF AUTHORIZATION SS J�u,f
ff ': City of Atlantic Beach
arill Community Development Department
v~ 800 Seminole Road Atlantic Beach, FL 32233 FOR INTERNAL OFFICE USE ONLY
ost19 ' (P)904-247-5800 PERMIT# R ESVL i-1)6131---
OWNER INFORMATION 1X nu)._ O/ Ca
NAME r e fe_Vh Otr16_,Sky1 PHONE#
ADDRESS 155 I Ocean B Ivd. KA-Ian-hc, (3 CELL# G 151.9 15 -otorl S
CITY -\CiL.ry\l-A C STATE ZIP CODE T 223_3
AGENT INFORMATION
NAME ft'X-3 ,-,---/� t..� (fAcce c-r . / PHONE# 7�Si'fV41.0y.
ADDRESS _.:2-/ S ,/q/9 Y f 0` -0 / CELL#
CITY _I IC f v't/ L//I YC STATE (Z- ZIP CODE 72 3 3
7UiZO gesco is hereby authorized to act on behalf of
X'e'87-e YID D .q.i ef' --re the owner(s)of those lands described
in the attached application and as described in the attached deed or other such proof of ownership as may be required
in applying to the City of Atlantic Beach,Florida,for an application related to a Tree and Vegetation Removal Permit.
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)or Authorized Agent
. _:76512d,12-62 kenr, nbcs 0 S�9 \�
SIGNATURE OF OWNER OR LEGAL REPRESENTATIVEPRINT OR TYPE NAME DATE
SIGNATURE OF APPLICANT PRINT OR TYPE NAME DATE
Signed and sworn before me on this 2ci day of MCU) ,2-018 by State of Rv f I C
la-
-21e nr\c--tA'1 pc.( bc S -(1 County of 0 L-1v04_'k
Identification verified: .21n6,/J r' PQ sons LL MC
Oath Sworn: ❑ Yes [1 No A. -
��. ..�. Amu Ab
- . Signature Denise A.Ennis
NOTARY PUBLIC
My Commission expire .. _ STATE OF FLORIDA
02 TREE REMOVAL-EXHIBIT A:Letter of Authorization 03.01.2018 Expires 3/1/2020
NOTICE OF COMMENCEMENT
State of'\oft CI a Tax Folio No. 11 V14 c
County of b .Val~.
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: \O - 1 XI.-25- 29-E Mcvl&o_ w) _ T'
Address of property being improved: I,S S D C. ./4.14 6LND /ATL tI G[5,A-14 32.23
General description of improvements:�oo - 1‘,14 in 4o4010�`c1C n-itr 4 G
I off. . ,Door
___ - _ '
�grcdee.S4,a�Fe..Suk% , e ~+
.ro,-Er,1ncialo ,R ig3 a45rw on JJe
Owner: \j tin Cl Z '-EY c OR Address: "to BLk Co.:m.55n Or.f'c►,A4-GINUT 5 4o 1S
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: gcc) UU1crTk^rotc o(1s,�,If1G
p.LiAddress: 215 , (Ylatapo fr�- d J AC1e-BQ N'i Lt � — 3223 3
Telephone No.:CIO 4-2-Lk4-o320 Fax No: (Ao4-241-°3 zc.
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: 5129 I le
Before me this 2_91 day of jar eb in the county of Duval,State
Doc#2018128466,OR BK 18405 Page 243, Of Florida,has personally appeared YiaincM1 UtIrNtr-SAIrAl
Number Pages:1 Notary Public at Large,State of Florida,County of Duval.
Recorded 05/31/2018 09:31 AM, My commission expires:
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Personally Known: a DeniseA Ennis or
COUNTY .Produced Identification: NOTARY PUBLIC
RECORDING $10.00 • STATE OF FLORIDA
I.
� � Carta #FF966426
Expires 3/1/2020
- ,e DUIIUIII� t'eih u t HpFJIIGdLIOfl Updated 12/8/17
,, "'l City of Atlantic Beach
,:1,--,3-,;.,..?./ 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 � }�,�`'1n
Job Address: IS 10Ccs,�n e —
\J d- p+�on c.4.�Cn l� V/Permit Number: V'V,Q
O 0/(et
Legal Description 14' It 1L'2 S -25:k E. P'1a,rdalcuu) lam} .B114— C3 RE#111814` Co coo
Valuation of Work(Replacement Cost)$ IoPoQ"o Heated/Cooled SF Iia F Non-Heated/Cooled G y$F
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial esidentia
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: t/I.—a c /veva 60•As'7li'r-mac ^ /f,,/i L.4-tea/
fOGLow'
Florida Product Approval# for multiple products use product approval form
Property Owner Information 1
Name: K@M
,IQ- cL 4-EvOCY11e.-StC" Address:1 o ,4 Gun v :,(1 b (--
City �n,'rl`- C- e 98
t'tu� State UT Zip St- Phone VIS-91S• owl S
E-Mail a t.A3 c 5 .v\e Cb OnCgs4.heA-
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: SCO Bu.11d l(ID CAr,rkaCkOrs\yalifying Agent:
Address 21546 (V 10,41:10 r-4' PId City&Gl4So(1t)t 1(Z State Zip 32233
Office PhonegO14- 2 -7307 Job Site/Contact Number Toci. foSCD gay•233.olo4
State Certification/Registration#CSC 12S 12 E-Mail -}odd@ bosOO do C.- CoM
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation 1rneac4$}o• cage ;8 IIS 112,
Exempt/Insurer ease Employee twepiration Dates
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 maybe 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.
."" .3(-769(0(--Ig „____Ziih —Ad------
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me thisc
g '�.-� day of Signed and sworn to(or affirmed)beforeAmenthis 1 day of
MU.) ,2O1 ' ,by -1`liltkAl Dtvlb s4-/' ("c ,'2°I� ,�jo -A. Ras co
.
:•,'�S NeFfMtstskIBUC
•at r - .... n•,
NOTARY PUS.LIC
�[i]PersonallyKnown OR _ STATE OF FLORIDA � ; STATE OF FLORIDA
1. STATE �[3]Personally Known OR ��.-3r�` Comm*FF966426
. L . Commit FF966426
[ ]Produced Identification .....- . [ ]Produced Identification 4tE t Expires 3/1/2020
Type of Identification: A'L`E t' Expires 3/1/2020 Type of Identification:
NOTICE OF COMMENCEMENT
State of ort t�a Tax Folio No. 111 V.1-1A^ Wo
County of b
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: ,O - 11 V,-25- 29 I \c Lar ° 1 LK G
Address of property being improved: 1.S S GE A t4 EjLVD pTLASTI G€ACc IL 322_33
General description of improvements: t:ROOc W I ndov0 `gcArritnk Goro.U.Oo0C PROu reM.
�ckrdce.Shake.SIck nen , e_r+nn 1-ErAnc {►ot,ai,54,} a�-W QAP p ,`
Owner: \ r,C1 e.k1r,ik-E.V 4 DRn\ k e - 1 Address: -10 S'{ CR,,, n a r.7c►r�-Ct[LL'tl� UT S 40
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: C3o5 co (3LiA dCoc'ack)r'slr c-
kVAddress: 21343 (Y PAJ)QO(4 d, JAc,�so N V k L je: _ 3'2_23 3
Telephone No.: t0 x-I-24-4-Cra2o Fax No:c\04-2M-03 24.
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: ' '.Z4175CX— Date: 512-Ci I�S
Before me this 291 day of r'n in theounty of Duval,State
Doc#2018128466,OR BK 18405 Page 243, Of Florida,has personally appeared Yle..nncleh D i SXI
Number Pages:1 Notary Public at Large,State of Florida,County of Duval.
Recorded 05/31/2018 09:31 AM, My commission expires:
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Personally Known: pia A Ennis or
COUNTY Produced Identification: ;•••. • NOTARY PUBLIC
RECORDING $10.00 `` '' • STATE OF FLORIDA
Conan#FF966426
Expires 3/1/2020
SURVEY OF
RECORDED IN PLAT BOOK 10, PAGE
)RDS OF DUVAL COUNTY, FLORIDA.
I
-5 c ,,.._, 10 20 40
6 SCALE: 1" = 20'
J�o
mmc
v v,
I LOT 14 -1 m- mm
' LOT 13
2 N Gil
•, Q,W
ON-LINE O 'N O
v Z` • Z
S.• 10 _13- ir_ 0.4'
�e -ALM y� -oil 7# ..0*
o P.-. DN D11 C 7211 ,
c Oce K 4) K r
F o EAG <1 ;
—mi \ x 72m _ I'
/ " ; NOTES:
/ �tEI 1. THIS IS A BOUNDARY AND TOPOGRAPHIC SURVEY
/ ,oNOR 11" I WITH TREES.
PALMI CJS 2. NO BUILDING RESTRICTION LINES AS PER PLAT.
�.. m 20' BAYO PALM II ® LOT 10 3. INTERIOR ANGLES PER FIELD SURVEY AS FOLLOWS:
' I�IIC.1�l7CII� ® A = 90'00'00"
I I ; �
f *10" PALM 11.9' B = 90'00'OO"
0 9."o PALM 10.2' PALM I I C = 90'00'00"
'• 122 , W000,. D = 90'00'00"
F PALMx •. SHED is? *P1ALMI: • 4. NORTH PROTRACTED FROM PLAT.
6' CREP 10.2' 5. - _— ,--DENOTES 6' WOOD FENCE UNLESS
17� CII OTHERWISE DENOTED.
13' DOUBL u u PALM 1.9'
9, BAY m o , tib' X0.1' 6. BENCHMARK IS A NAIL AND DISK, LB3672 IN THE
. t -p cr, EAST SIDE OF A WOOD POWER POLE AT THE
CONCRETE BLOCK WALL 39- =6� SOUTH-EAST PROPERTY CORNER OF RESIDENCE
QUADRUPLE 0.8 m
BAY CD LOT 7 NUMBER 1456 BEACH AVENUE. ELEVATION = 13.00'
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DONN W. BOATWRIGHT, P.S.M.
FLORIDA LIC. SURVEYOR and MAPPER No. LS 3295
SURVEYORS, INC` FLORIDA LIC. SURVEYING & MAPPING BUSINESS No. LB 3672
.LE BEACH, FLORIDA 241-5550 DATE: DECEMBER 5, 2017 SHEET 1 OF 1
MAP SHOWIt
c.4 LOT 9, BLOCK 63, MANDALAY I
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THE PROPERTY SHOWN HEREON LIES IN FLOOD
ZONE "X" (AREA OUTSIDE THE 0.2% ANNUAL
CHANCE FLOODPLAIN) AS DETERMINED FROM THE
FLOOD INSURANCE RATE MAP NUMBER
12031 C0409H, REVISED JUNE 3, 2013 FOR
DUVAL COUNTY, FLORIDA.
"NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED
SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER." BOA TWRIGHT LAN
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CHECKED BY: DRAWN BY: PGP FILE: 2017-1678 1500 ROBERTS DRIVE, JACKSOF