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2133 SEMINOLE RD #6 - STUCCO REPAIR ' lJ`' Ss, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 RESIDENTIAL - ALTERATION RESIDENTIAL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RES18-0294 Description: STUCCO REPAIR Estimated Value: 15000 Issue Date: 9/5/2018 Expiration Date: 3/4/2019 PROPERTY ADDRESS: Address: 2133 SEMINOLE RD UNIT 6 RE Number: 169515 0400 PROPERTY OWNER: Name: THOMAS MARY K TRUST Address: P 0 BOX 4781 OCALA, FL 34478 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: WEYER CUSTOM RENOVATIONS INC Address: 10139 Deercreek Club RD JACKSONVILLE, FL 32256 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. rtyA,v;, _ City of Atlantic Beach APPLICATION NUMBER i' 7: • •,.i1 Building Department (To be assigned by the Building Department.) •r' ` 800 Seminole Road �� Q /� !•it :!/ Atlantic Beach, Florida 32233-5445 B-- 1`T Phone(904)247-5826 • Fax(904)247-5845 !Z 3/IP)/I ,Py \wil>`' E-mail: building-dept@coab.us Date routed: ` ` P City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z l 33 S i-y\uooLe )20 lO Department review required Yes o uilding) Applicant: 1id E,y CCS C00 C-1-_,N)O • g &Zoning EPA-( Tree Administrator Project: `J To C_o R Gt A}(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 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: :UILDI e PLANNING &ZONING Reviewed by: Kr' y Date: P-c7P 1 g- 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 Building Permit Application 4, City of Atlantic Beach tliefAv 1147017, 800 Seminole Road,Atlantic Beach, FL 32233 Phone: (904) 247-5826 Fax:(904)247-5845 a Job Address: a-`�3 -5��../\\ NOV,� * LO Permit Number: .R ..-..-Sl — 3 ' T_ Legal Description O . 2S • Zei 6 , I y o t.4-(" u-c- t Re c d Gig /cal -1S# i.k) 15 - 01 e 0 Valuation of Work(Replacement Cost)$ I St 00 0 Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition AlterationRepair ove Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): CommercialResidential • If an existing structure,is a fire sprinkler system installed?(Circle one): eY s N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Descri a in detail the type ofwork to be performed: �c L, O (7_,T0,:, r - Rex e e...-,Lo Q, -,L,: --1.,,„,_s . ---1-_/A.6(,, W s I I n ��� 4 5 4-1., e c._'c Florida Product Approval# for multiple products use product approval form Property Owner Information ``,^, �4, l, 8' Name: \>r�� CJ1S Address: Z.\33 Se w\o\ `(C.d :4V Cto City\�A - \ SIC \,� State Zip Phone 3 — �P 0 0`� � 3 E-Mail 1NN 1 0 `S t� -€Gs-•� - GLC .S t . Cot." r Owner or Agent(If Agent, Power of Attorney or Agency Letter R quired) Contractor Informatio I ,' 1�' 11 1 \,� 11-6„,{/ Name of Company: �'1' Z). <-re L 4,,,1_ l kV 11oL +'•+)Qualifyin�gent: V> \l`a.I'. `40v �r Address (073Dee C.nP•elc e ii.,6 (Cr' City 1,0tate aZip c Office Phone Job Site/Contact Number("44----r<6(Y f 3 "tif 7 Z N State Certification/Registration# ('� --�('L5&q C3 E-Mail y A f"( W ele., Q be(i s�.:,-I-I-,n-( J I -1 Z Architect Name&Phone# a. Z Engineer's Name&Phone# m Q 0 — Workers Compensation // •- /— 9 C3 CO 2 H / emp3,yr'nsurer/Lease Employees/Expiration Date V 0 (] C.) 0 Application is hereby made to obtain a permit to do3Tie work and installations as indicated.I certify that no work or instgat9ngap commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws r©ljio�g Q construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,PI St,- WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. O Q N r2 z S ILI OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance 14it illcr 2 applicable laws regulating construction and zoning. 12 NN0 } a m I— w -5 p WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT I $ ww w RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE s cc RECORDING YOUR NOTICE OF COMMENCEMENT. X f)//16? -4-/ (DAG)1A0t— / • (Signdture of Owner or Agent including Contractor) Signature o ���) Signed and sworn to(or affirmed)before me this?( day of igned and sworn to(or affir !d) , ore le this P_-►day of •Aki , Pale , .v I. ... . _ ..e‘/A Lt.* ?Dig ,by 4 .0 Lel'. _�_ — .-_ ^ �• +a ure of No ORMAN o >b� (Signature of Notary �\ Notary Public-State of Florida I I li Commission#GG 226111 �;�:::y•., W.CHRISTOPHER MEDLIN or�°` MyComm.Expires Jun 7,2022 �'' �?' P :.: "., •r. Commission#FF 933761 Bonded through National Notary Assn. ".t Expires November 4,2019 [ ]Personally Known OR [ I Personally Known OR Roo Bonded Thru Troy Fan Insurance 800385-7019 Produced Identification [ ]Produced Identificatio p Type of Identification: F(. O(- Type of Identification: t1-v�+R. Pe r nict es./ a2. 9 V NOTICE OF COMMENCEMENT State of Tax Folio No. eta c1 `T5(S vy C ) 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. n , Legal Description of property being improved: 0g -`L� iC. . (,±0 &oyr ,-� ! c 0/11--16,80ci '2,0 Rd Address of property being improved: 2\3-3 4( I re- General ZGeneral description of improvements: 5y\.c.t..:+ Owner: VI\Cv( \,,NtAN./\GSAddress: 2\33 S \v\t\� w rti ri c Sc Owner's interest in site the improvement: F. Fee Simple Titleholder(if other than owner): Name: Contractor: VJ kiU-v"‘ V!r iii "4 -� Address: ‘C,k < {'� k C �%t. � ;z 2 ( Telephone No. E'�p� e( `A�,tiC/T 2-5 Fax No: 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-4Th!�Signed: / i/ )/tOi& —, Date: ?/ ;fore me this '"t day of ,9C)(8 in the County of Duval,State Doc#2018199585,OR BK 18502 Page 1463, Florida,Fhas personally appeared /Met/ /:.► rr•a-s Number Pages:1 nary Public at Large,State of Florida,County of Duval. Recorded 08/23/2018 11:35 AM, y commission expires: T.!C))t..¢ a Al RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL rsonally Known: .otr°"►u•., AMYGORMAN or COUNTY xluced Identification: f(� 0(._ , _ Notary Public-State of Florida RECORDING $10.00 ' P Commission#GG 226111 •!;•ov r7, My Comm.Expires Jun 7,2022 P rIrtraCY'rZ+Q✓k Bonded through National Notary Assn.