1035 Big Pine Key RES18-0366 NO(�TICE OF COMMENCEMENT
state of
` Crk 111�(q rP Tax Folio No.
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To Whom It May Concern: N ' � `�`
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 im this OTIFE OF CO NCEMENT.
Legal Description of property being improved: �.!�5. �°S &�W �7i 7:z X74
Address of property being improved: Ad 35 r1 f1
General description of improvements: • '
Owner:
Address: A9 Aq r
Owner's interest' site of the improvement:
Fee Simple Titleholder(if other then owner):
Name:
1 � r
Con r: 1
,` Address Z y�_!y
d�' /Y-e/ir,✓1L
V Telephone No.: [I "NZ�SgS� Fax No:
Surety(if any)
Address: Amount of Bond S
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:
Expiation 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 OW
Signed: r Date: 5
Before me this day the Couvty of Wval, tate
Of Florida,has per al peered E
Notary PublivargE,S ate Floris + ty IF al
DCC#20Ib284.90I,ORBKIS591 Paget190, My commissionex Ines:
Nwm Pages:1 Personally Known: — or
Recorded 11IOfl MI810:08 AM, Produced Identification:
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL h
TONI IsNMSPEAOER
COUNTY My COMdISSON 0 FF RW
RECORDING $10.00
FJ(PIRES:October 6,2019
�#,n,� eomemm wunwea um�a.re
RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES18-0366
ISSUED: 11/8/2018
ATLANTIC BEACH.
FL 32233
SON ROAD EXPIRES: 5/7/2019
`'1 v EA
MUST CALL INSPECTION PHONE LINE (904) 247-5814
Y 4 PM FOR NEXT DAY INSPECTION.
ALL • • • • • • • • • r OF • • •A BUILDING
CODE, AND CITY OF • • 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1035 BIG PINE KEY RESIDENTIAL ALTERATION REPLACE SIDING WITH T1-11 $8400.00
RESIDENTIAL
TYPE OF BUILDING
• • GROUP:
1720275076 SELVA LAKES
COMPANY: ADDRESS:
SUPER SIDERS AND TRIM, 65 W. 9th Street Atlantic Beach FL 32233
INC
• ADDRESS:
BRITTLE CHERYL M 1035 BIG PINE KEY ATLANTIC BEACH FL 32233-4363
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT4ssWoa9zz-loon 0 $95.00
BUILDING PLAN CHECK 455 OOWd31!1W1 0 $47.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.14
STATE DCA SURCHARGE 455-0000-208-0600 0 $300
TOTAL:$146.64
Issued Date: 11/8/2018 1 of 2
City of Atlantic Beach APPLICATION NUMBER
n1
Building Department (To be assigned by the Building Department.)
800 Seminole Road —
� Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
^Gpj;19'� E-mail: building-dept@coab.us Date routed: L 162L
Chyweb-site: http://ry .mab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 103S L(�J(G P( ADC— KE De nt review required Ye No
�1� ildin
Applicant: S2L
u PEldF�LS e kiffl 'n &Zoning
\ .� Tree Administrator
t�
Project: 1 )eyo ( ( ` l � S( DI /C1 Public Works
Public Utilities
Public Safely
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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:BUILDy��
I / v
PLANNING&ZONING y _7
Reviewed by: Date: �61
TREE ADMIN. Second Review: A roved as revised. Denied.
❑ pp ❑ ❑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:
Revi d 05/19/2017
3 /�+
Building Permit Application OFFICEde'l!p
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
i 1e P`hL' r(B04)247-5826 Fax:(904):Z47-5945
Job Address: (DSS, R q ftxi Permit Number: R W� [S-0rJ3�&G
Legal Description �+- REN Z74?4907 —
Valuation of Work(Replacement Cost)
Heated/Cooled SF Non-Heated/Cooled
W
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door (�
• Use of existing/proposed structure(s)(Circle one): Commercial Residential Qz
• If an existing structure,is a fire sprinkler system Installed?(Circle one): Yes No N/A L) ¢ O 1
EL z �
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal n
Describe in detail the type of work to be performed: �� p�
Nps s,�;N G 9 a ff/L h� �l.� T1-12 s�� �L) � E
Florida Product Approval ff F 77,3 for multiple products use produ ml grin
Prooerlar Owner Infornsation t Q Q 0 Z
w
Name: CI' r Address: � 4,;e-4,;e— O LL
city &94 4t, state zip zzz 33 Phon w
E-Mai F zm
4.m. YO✓tr W L_ ..r 9 M
Owner or Agent(if Age t,Po erofA rn�ncy Letter Required) .may.. rt ;: Q 3
Contractor Information Aa,�� ,//�j�
Name of Company: s CI hM Z'qualifying Agent: r /•/rH�- to
Address r, city�T.�Y. state_ Zip ?77 yS"
Office PhoneJob Site/Contact Number
State Certification/Registrationll E-Mail ereMy to lW/-Kr •(SnalzC M. GdwI
Architect Name&Phone N J
Engineer's Name&Phone p
Workers Compensationite / Z
Exempt/Insurer/Lease pl es/Expiration Date
Application is hereby made to obtain a permitto do the work and installations as indicated.I certify that no work or installation has
commenced prior to the Issuance of 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 maybe 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 IMPROVEME O YO R OPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR DER OR ORNEY BEFORE
RECORDIN UR C MMENCEME T.
Signature O n or Age (Signature of[onhactpr
includi ntractor)
Signed and sworn to affl d)befo methis—Sdayof Signed and sworn to(or affirmed)before me this4&_*fday of
t'Zjrn! ZOI by P.&aJ b P� a
e•�IMf V'IrMINRB
TONI RIM filOZe NalWej
MYG(A1v1SSIO�Ni FF92aSit gra f otary) BgZ/gl�guaealwlua(7 }�- (signature of )
' EXPIRES:October e,2019 33DDONONH3NODO R r "sRlj
Nwu iKwd.
e nay nnwn OR
roduced Identificatigy ,/ oduced Identification p
Type of Identification, 1 )L ,_- '4. e1 -�_4 q- O eo Identification: F�-MS2t)V(31 '�6CA Io0
RONALD I.OGAWASSOCIRTES,INC. OFF-ICE COPY
5801
WARNERAWNUE,mn
HUNTI NGTON BEACH,CA 92818
714202-2002
7149118-1015PAX
PROJECT RIG-2261-11
JAMES HARDIE BUILDING PRODUCTS,INC.
1-00-542-TN3
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