1800 SEVILLA BLVD W - DEMO GUARD SHACK 51.m:Jr, City of Atlantic Beach ,. APPLICATION NUMBER
.6' Building Department 'r" (To be assigned by the Building Department.)
i 800 Seminole Road C
�` -:. E-Mo ( 8 -0035
jf
�.., �� Atlantic Beach, Florida 32233-5445 � O(,�!� `�, •:��`� �
' v Phone (904)247-5826 • Fax(904) 247-5: 'yji
_on 9•r E-mail: building-dept@coab.usIBVDate routed: ( ES
City
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
�
Property Address: 1Q,�0 S &Y ISR 6L-VO Department review required Yes No
Building )
Applicant: I— &RCusi,:-.) b ,,Lp C->Q S Planning &Zoning
cecv- o
Tree Administrator
Project: - Go�p.A ACK� ublic Works)
ublic Utiliti' >
Pub iI c Safety
Fire Services
Review fee $ ,9 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:
APP - a TION STATUS
Reviewing Department First Review: :J Approved. ❑Denied. I of applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: (,.✓ ate: //—ZG—/r.."--
TREE ADMIN. Second Review:
Approved as revis d. nDenied. nNot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I (Approved as revised. ❑Denied. ['Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
,,,, ATLANTIC BEACH BUILDING DEPT.
it i .fir,, DEMOLITION — PROPERTY OWNER
f �5d RELEASE FORM
r '-'•n.--- ,s, )
.J 4.. r
,.L
11 I
Date: i - 13 i 1.
To Whom It May Concern:
I / We the current property owners of: Lot 0 q 2 S` Z9 -2 .221 b
Block VT C ci v LA5 4,1 c, ( ( R •)70 --
Legal Description of Property
AKA l CJ CSO &_l.`i «cam V oa C G,cc v'c 2 �i✓s have contracted with to have
(Address of Property)
to remove the �.e'.v�- lit 6L,S.E
(Company Name) (Single Family,Duplex,Commercial,etc.)
•
c.
Prior to the construction of : Q kS cic� t.:..) 4IA 11 C L .
As a condition of issuing the permit we agree to the following:
1. All utilities are to be located and clearly marked.
2. Once house is removed, lot is to be graded and leveled.
3. All construction debris is to be removed from the property.
4. AffecteO area is to have grass or seed in place.
5. Erosio control devices will be put in place and will remain in place until grass
has c• ered affected area or new structure is completed and landscaping is in
place.
----.)
Signatur:
Ciltr-uait9--, -(,„LY-Y6)..Ni
Signature
THIS SPACE FOR RECORDER'S USE ONLY
OWNER —
.
Signed: Date l 1
Before me this I v' gay of L. o J 20 i in the Coun(y0
of Duval, tate
Of Florida,has personally appeared?? : /)1 i c 17,. ( yG 11 e — e D 3 Q ieiq/i r
Notary Public at Large,State of Florida,County of Duval.
My commission expired:
Personally Known
M i oheel I-�Illepsbs or
hlnrwry P..,,,,c State of r1..,kin
Produced Identification: Commission FF179002
My Commision Expi.os N.,v.48,t078
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. B Tax Folio No. 169399-0503
State of Florida County of Duval
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: 08-2S-29E SEVILLA CONDOMINIUM #I COMMON ELEMENT PARCEL
O/R 3770-413
Address of property being improved: 0 SEVILLA BLVD ATLANTIC BEACH, FL 32233
General description of improvements: DEMOLITION OF ENTRANCE GUARD SHACK
Owner SEVILLA CONDOMINIUM ASSOCIATION INC
Address 7400 BAYMEADOWS WAY STE 317 JACKSONVILLE,FL 32256
Owner's interest in site of the improvement OWNER
Fee Simple Titleholder(if other than owner) N/A
Name N/A
Address N/A
ontractor ALL AMERICAN DEBRIS & WRECKING
Address P.O. BOX 24071 JACKSONVILLE, FL 32241
Phone No. 904-262-9600 Fax No. 904-379-2498
Surety(if any) N/A
Address N/A Amount of bond$ N/A
Phone No. N/A Fax No. N/A
Name and address of any person making a loan for the construction of the improvements.
Name N/A
Address N/A
Phone No. N/A Fax No. N/A
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
Phone 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 Statutes.(Fill in at Owner's option).
Name
Address
Phone 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 or AGENT
(If •nt,P•we • : • ey ,•ency Letter Required)
Sign.. i �1� may_`L/tea. Date:
Before m- his ii,e4day of -/:.1 in the
County of Duval,State of Flor da,1 as personally appeared
' f 1 i ck c herein by
himself/herself and affirms that all st22a/�����!l/777ments are true and accurate..
Notary Public at Large,State of fir/A�/County of_b/, PA/
Doc#2018271170My commission expires/:! q— i'i—a2
OR BK 18599 Page 1851, ersonally Known Y or Produced Identification
Number Pages:1 Tara Ramos
Recorded 11/16/2018 11:51 AM, Notary Public State of Florida
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Commission No.GG 143025
COUNTY My Commission Expires Sept.14,2021
RECORDING $10.00
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
J
�i`'''9` Phone: (904)247-5826 Fax: (904) 247-5845 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: ig9d d �Qi`l-f- ZL 'y 6v Permit Number: cE.MOtB ' DO35
Legal Description ...ya/ 1i R.p (.6 tJSIL RE# I (0 9 399 - CD4-OO
Valuation of Work(Replacement Cost)fie Do?, ,e -. Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move AIDemo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes r,No ❑N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit No Tree Removal P
Describe in detail the type of work to be performed:
� _f\i\-o — C 0 PRP S (4A Q___(
Florida Product Approval# for multiple products use product approval form
Property Owner Informs on //�� ,,,,$11.IV Id;' •CTD
Name 001kil4- tJt � f,Af. 43 Address•)g3? �iii/re.4R $`'VP, i.U.
City ?� /)T —. 4/ State rL Zip 3.? 33 Phone 'D- s Vi 2}9
E-Mail in4r/vo&, @ /4e34. 4-9/'l
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Informati•n /
�C
Name of Co a/ny .IZ. ' ' ..SSS Ai/LPf4 3 (!V e Qualifying Agent c{l` 4 /'- i i
Address �C7 • "IAA) , AVp City 4 . i:3 State L. Zip�=,..Y.Z3
Office Phone 113s OrJob Site Contact Number (;),.9 vl.Rj S
State Certification/Registration#C13d.D2(i(.3 E-Mail _a it .i G- _IP_ah:-• ( • 6I . .Cb -
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer (c co/•��f_ 0 {rh OR Exempt4Expiration Date o )' �0??!
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 regulating
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.
QC—C• 841(1( cA)
(Signature of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed) before me this day of iksl and wajn to(oczpf , befor- m- is6•.y of
by 1 ( ,s‘ ..„,1 . N(4 t 4 >`a°' 0it
(Signature of Notary) S� .- of��
}Il,,"-T,-:',e: iONIGINDLESPER:=ER
[ ]Personally Known OR [ i Personally Knowra'OR A ';x Mf COMMISSION#FF 924951
[ ]Produced Identification=_' Fxr RES.oclober 6,2019
[ ]Produced Identification •...„•• g�•,i.^:edl'niPtary^u9licUndern xrs
Type of Identification: Type of Identificatiodt e.a.� —