2207 ALICIA LN - Res18-0326 COAB Permit Form with Conditions Page 1 of 2
Enter Permit Number RES18-0326 View Report
IN 4 1 of 1 k H $ 100% v Find I Next 4- 1, a
ice' RESIDENTIAL PERMIT PERMIT NUMBER
�� RES18-0326
�ti v• CITY OF ATLANTIC BEACH ISSUED: 10/5/2018
800 SEMINOLE ROAD EXPIRES:4/3/2019
�'``'j' ATLANTIC BEACH,FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
l JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
2207 ALICIA LN RESIDENTIAL ALTERATION Bathroom Renovation $45000.00
RESIDENTIAL
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169519 0735 TIFFANY BY THE SEA
_
COMPANY: ADDRESS: CITY: STATE: ZIP:
On Target Renovations, 2303 University Blvd Jacksonville FL 32211
Inc.
OWNER: ADDRESS: CITY: STATE: ZIP:
JOHNSTON DAVID L 2207 ALICIA LN ATLANTIC BEACH FL 32233-5975
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $280.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $140.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $6.30
STATE DCA SURCHARGE 455-0000-208-0600 0 $4.20
TOTAL:$430.50
http://atlanticbeach.trakit.net/trakit/DocumentV iewer.aspx?&report=/Documents/PERMIT... 10/5/2018
01.i- . City of Atlantic Beach APPLICATION NUMBER
J� ? �s� Building Department (To be assigned by the Building Department.)
J �,� 800 Seminole Road n�S
�,,,,,-.__.__,.. �r Atlantic Beach, Florida 32233-5445 K O3Z CO
' Phone(904)247-5826 • Fax(904)247-5845 c, p
'�1f11;3ll'' E-mail: building-dept@coab.us Date routed: ! 2 iO
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: '
p y 2�0 7 �� t C.� 0., Reparnent review required Yie7 No
Buildin
Applicant: on Ta.r5e,:' ReflJ& (3r Planning &Zoning
Tree Administrator
Project: V r tmom Reno u c-f t'o n, 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: I[ pproved. I IDenied. ❑Not applicable
(Circle one.) Comments:
BUILD-1
PLANNING &ZONING Reviewed by: nif),-- Date:,0 -? - 'r
TREE ADMIN. Second Review: roved as revised.
'Approved I 'Denied. ['Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES '
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. I 'Denied. I 'Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
„La,r,
tir,, Building Permit Application Updated 1 /8/f7
WCity of Atlantic Beach
4:uxi 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845'
Job Address: 2.?O7 '��\\C lo, Lv\1 ikkkatilti .-Ztr,Can3(-Permit Number:Ile"-S18----452,34,
Legal Description %-09g 09-25-2 E."Tc l B•+T%'e_5eo U*S RE# 07%7 -.Oa()yd
Valuation of Work(Replacement Cost)$ 9`�)Dpv Heated/Cooled SF Non-Heated/Cooled Z
d = -Iz ;1
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door J V Q O
• Use of existing/proposed structure(s) D(Circle one): Commercial Residentia � W OZ H
8
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes 0 N/A 01:0177- Z Z H
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal 0000 p
Describe in detail the type of work to be performed: ooww cey� r. k Olr aec4e_: 1 i - e-a2
Oov ilo vn 5;x4-o,re5,kill, pa.%Nnk 0 0 Q
U --, � N
CC
Florida Product Approval# for multiple products use product rLL �aR c
Property Owner Information 0 0 w W >:
Name: U f Ic /Su8�n S.--36r1Y-5�dr Address: Z207 P��u c I�.v1 W y' n. ft 03
City Pt\\q,r, c', Zeach• State f L. Zip 32233 Phone 9011- q23 - 3gitW O 3
E-Mail Saf�l joNl1Y�6\-M Q S\n�S.�� 5'-
eN)ANIC ) .COj,r,n w CC
A '� W
Owner r/-gent(If Agent, Power of Attorney or Agency Letter Required) >
W
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Contractor Information i= CZ
Name of Company:aVl-1--CV3. )QrL ia_Qualifying Agent: &rye- ThV `
�
Address 2,3(1)33 vvioe_(-5‘�y II City c::)„(1<„,... 'yiI llt,State FL Zip 32211
Office Phone 4/04-6O0:; - KI Job Site/Contact Number 44`{ -299 -5 E.`1S
State Certification/Registration#I,GC(5 2 Py e 1 E-Mail c.e.y1e. WGckNi ..c c C'). UO H1
Architect Name&Phone# V
Engineer's Name&Phone#
Workers Compensation 7-25'
Exem-pDi 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,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 YOUR NOTICE OF COMMENCEMENT. 1
a / S 11
A , / 1 , tai t
/ (Signatu SIYOwner or Agent) ( gn.ture of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this 21 day of Signed and sworn� to(or affirmed)befo�e me this .-1 day of
by ' .i On SPQM /
'; O q ,by fel 1 iLkit
ignature of Notary) (Signature of Notary)
[N,Krsonally Known OR [ ]Personally Known OR•
LEANNE WILCHER
[ ]Produced Identification P` [ Produced Identification , . Ccrnmission#FF 987368
SUZANNE PRUETT
Type of Identification: Type of Identification: FkQ� Expires April 28,2020
• • ' ' '' • :,' Troy Fain insurance 800-385-7019
EXPIRES:August 17,2020 „?F Bonded Thru y
rN.►111 -41r)c Ok s&
NOTICEOF OFFICE COPY
COMMENCEMENT
State of lona A Tax Folio No. ()7 1(E 7 -620 90
County of Ou,va\
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: q6, -Q i Oq-2s-2`l f
--nsir,aviy By h Sea L..43-k- 5-
Address
Address of property being improved: 7267 > 1 ca Q Lk., m\an G 1eC1&rt11 3 2-2 3 3
General description of improvements: , i VAybpyA YPirY A-10A tie,* (1-cwi S ,
b.kv� c\x1rc�S ki 1e_ , p,;�AV23
V
Owner: S -1aMv-15,4cv1 {'Address: 727 MiC>)G1 l.LA M1oh 'C)hL 3
Owner's interest in site of the improvement: '/\mays 1 deexx_ef
Fee Simple Titleholder(if other than owner):
Name:
I(� Contractor: �1 Jit � T c
Address: _ . T: A 1,SaLiSCSrw_o , FL 32 rI
Telephone No.:gDy- ,�-//� - 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 OWNERAs
��
Signed: W l�//,,e D"u i//"' — Date: Q-2(-(Q�
Doc#2018226708,OR BK 18538 Page 1495, Before me fs 2( day of "Iron_ ,- .',;.'n the County of Duval,State
Number Pages:1 1 Of Florida, as personally appeared tw,;. S's s1c/ Te:AvnSkov% ae4e,
Recorded 09/24/2018 10:02 AM, Notary Public at Large,State of Florida,County of Duval..
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL My commission expires: 0-��-
COUNTY Personally Known: V or
RECORDING $10.00
Produced Identification •
:
' SUZANNE PRUETT
MY COMMISSION#GG22223
Viti EXPIRES:August 17,2020