1742 SEA OATS DR DEMO19-0002 INTERIOR REMODEL/DEMO RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH DEM019-0002
800 SEMINOLE ROAD ISSUED:
EXPIRES:
ATLANTIC BEACH. FIL 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1742 SEA OATS DR RESIDENTIAL ALTERATION INTERIOR REMODEL AND $50000.00
RESIDENTIAL DEMO
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1720200432 SELVA MARINA UNIT 08
COMPANY: ADDRESS: CITY: STATE: ZIP:
PRO-BUILDERS OF FLORIDA 1115 S OAKS RIDGE DR JACKSONVILLE FL 32225
LLC
OWNER: ADDRESS: CITY: STATE: ZIP:
FORSYTH VIRGINIA 1738 SELVA MARINA DR ATLANTIC BEACH FL 32233
ALLISON W
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
DEMOLITION 4S5-0000-322-1000 0 $100.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
TOTAL: $104.00
Issued Date: 1 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
z Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax (904) 247-5845
E-mail: building-dept@coab.us LDate routed:
Cityweb-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: llq_�_ Department review required Yes No
Applicant: P( C)—&A ui=ding 3
k L Planning &Zoning
Tree Administrator
Project: PWO(',ri 4 t-M L)dW Public Works
aAw i)o M 'N f�_&J4((k lk�'3r\ L rA Public Utilities
Public Safety
'S�A u Fire Services
Review fee Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
I
Reviewing Department First Review: VApproved. [-]Denied. [:]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: 7::11 - Date: Cn�OA(1-1
TREE ADMIN. Second Review: EApproved as revised. []Denied. ENot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [:]Approved as revised. [:]Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
_
""�"^�v'"Bu'Ud'og Permit Application v"
City of Atlantic Beach Building Department J A N 2 2019 "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 � 'j K mGousHTco|mGRAY
�– IS REQUIRED.
Phone: /904\ 247-5826 Email:�
]obAddrea: Permit Number:
Legal Description nsw
Valuation ofWork(Replacement Cost)$ Heated/Coo|ed5p_ Non-Heated/Cooled
° Class ofWork: ONew OAddition OA|te i lf(^� i �
�e^�m
o VPoo�| OVindow/Dnur
° Use of existing/proposed structure(s): OCommerda| tial
• If an existing structure,is a fire sprinklerU d? \ \
ON
• Will tree(s) be removed in association with proposed project? ElYes(must submit separate Tree Removal Permit) N�o
Ee scribeincletail the type of work to be performed: q Demo - 1000"A-�/ in cA et?, -� Xo etw
i_ _ A r oow,�, Ae-w 1A s 0(lje-74 0-wle— Move e-=� 6
M040 J a ore
Florida Product Approval# V-4 for multiple products use product approval form
Property Owner Information
Name Addlress AM4V 14
Owner or Agent(if Agent, Power o ttorney or Agency Letter Required)
Contractor Information_
Name of Company /-/ro—Aid 06A< Qualifying Agent 'S &S e—P 0
State A
Office Phone 6Z) Re. lob Site Contact Number
Engineer's Name&Phone#
Workers Compensation Insurer ORExempt X Expiration Date
Application ishereby made toobtain apermit todothe work and installations asindicated. |certify that nuwork orinstallation 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: |naddition tothe requirements ofthis
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may beadditional permits required from other governmental entities such aswater 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 T YOURPRO Y. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDEW-7- BEFORE
RETRDING YOUR N9TIC9-eFCOMi%ENCEMENT.----
mature of Own
.�
Signed d ornto(or a��rmed)before methis �� day of Signed and s"vomto(or affirmed)before methis –` day of
NOTICE OF COMMENCEMENT
State of Tax Folio No.
County of bVIX)OJ
To Whom It May Concern:
The und 6rsigned 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: M6. 1"'f'o, J.01,�- 0 it
Address of property being improved: Ck CA n+
General deqrriptinn nf e-Uj Cn &-LAD n at ct?,
4, V a ocLe- e I V-e4X 1'e-- 6 M I A C-
Owner: y 11 1,:5 0 Y-\ ro Laq�n Address:/ t '�j ;�'_ IL- eA 6, IaP. A-14 13,
Owner's interest in site of the improvement, knL 6 b a,3 e— 4 o C-e j-��
Fee Simple Titleholder(if other than owner):
Name:
Contractor: �-v 1, o 6
Address: 111's-5 6 Iz- V,-,j DA . 5-
Telephone No.: 9 0 L4,3S6- 6 001� 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 dpy.pf_�.qcq-rdipg yple�� a different date is
specified):
FF�2.;31
THIS SPACE FOR RECORIDER'S USE ONLY OWNER
Signed: Akzj/,A e:—
Doc#2019003755,OR BK 18649 Page 1801, Beforemethis- :7 dayof kg�,Lj-, in the County of Duval,State
Number Pages:1 Of Florida,has personally appeared�
Recorded 01107/2019 11:58 AM, r
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of�Florida, nty of D
__ X
COUNTY My c6mirnissioh e3iwes:
�Sz
RECORDING $10.00 Persohall 6 n: or
V-k ow
Produced id6rtifjcatjon,-i,, i