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2049 Selva Marin Dr. ACC19-0007 Wood Deck mko ACCESSORY PERMIT PERMIT NUMBER Ce4 CITY OF ATLANTIC BEACH ACC19-0007 800 SEMINOLE ROAD ISSUED: 2/20/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 8/19/2019 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: 2049 SELVA MARINA DR ACCESSORY SINGLE OR TWO WOOD DECK $10000.00 FAMILY ACCESSORY TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 169506 1074 SELVA NORTE UNIT 01 COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: SCHOLL HARVEY H 2049 SELVA MARINA DR ATLANTIC BEACH FL 32233-4554 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. 1 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL Notes: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(904-247 -5814)to request an Erosion and Sediment Control Inspection prior to start of construction. 2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. Issued Date: 2/20/2019 1 of 2 ACCESSORY PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH ACC19-0007 800 SEMINOLE ROAD ISSUED: 2/20/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 8/19/2019 3 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL Notes: Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapells,Inc.,Republic Services,Donovan Dumpsters, Phillips Containers,JDog/Dennis Junk Removal,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City right-of-way. 4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 5 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 6 PUBLIC WORKS DECKING REMOVED INFORMATIONAL Notes: All old decking must be removed from job site by Contractor. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $105.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $52.50 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.36 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $50.00 TOTAL:$236.86 Issued Date: 2/20/2019 2 of 2 (i9?j. City of Atlantic Beach APPLICATION NUMBER -ar�� Building Department (To be assigned by the Building Department.) Ak �u tla Seminole Floridadi �CI�.,i? „ � 7 v-,-;, ......„..y- -.- Atlantic Beach, Fr32233-5445 -- _�., � � `- (_�(_� Phone(904)247-5826 • Fax(904)247-5845 <` J;il��' E-mail: building-dept@coab.us -� Date routed: �/ ( 1 ((31 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z O4-C7 EcL\iA Jr\AA2',;v pepartment review required Yes No -�13uirdin2,- Applicant: CA.) E�i c— ,,---"Planning &Zoning-) ryq l� 'Tree Admra misftor Project: � CX) �`) _K Public V11orl« ,{`-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: APPL CATION STATUS Reviewing Department First Review: Approved. (Denied. I INot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:ti ` /� Date: .G—721 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. I (Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 c..a,v,;,, City of Atlantic Beach APPLICATION NUMBER i .0 Building Department (To be assigned by the Building Department.) An800 Seminole Road C.�-,t9 —O�-Y1 Atlantic Beach, Florida 32233-5445 �— �-�C./7 Phone(904)247-5826• Fax(904)247-5845 . ;•Itnii�%" E-mail: building-dept@coab.us Date routed: Z/ I I (1-61-1— City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z 049 �CLVA nApkgip Repartment review required Yes No �irdini- Applicant: C/L C 1Z Manning &Zoning Tree A. ---dministrat-OF Project: kJ Cu Ei> 11- C�K ublic 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 'Approved. I 'Denied. of applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: 2-/5-I, TREE ADMIN. Second Review: A roved as revis d. ❑ pp IDenied. ❑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 rira,�r:. City of Atlantic Beach APPLICATION NUMBER r) Pel-,,ABuilding Department (To be assigned by the Building Department.) 0 Seminole Road .fl 1 Attllanti Beach, 32233-5445 ����� C.��-�✓7 Phone(904)247-5826 • Fax(904)247-5845 / J;sl'�' E-mail: building-dept@coab.us Date routed: Z/ II 1 (Iaj City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM c-\ Z 2 epartment review required Yes No Property Address: �� ,')CLVrA � i\ -131:iildiii'g- Applicant: C-3) (,ti E. IR !Planning &Zoning) Th It Tree Admii fFor at Project: 1�'� CL, E� _I� (- Ptiblic(iVork ,(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: proved. Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date—r -tG / TREE ADMIN. Second Review: A roved as revised. ❑ pp I IDenied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. 1 (Denied. I Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 r(Ilt,t�Lyj%, TREE & VEGETATION AFFIDAVIT FOR INTERNAL OFFICE USE ONLY i City of Atlantic Beach PERMIT# J �� Community Development Department 800 Seminole Road Atlantic Beach,FL 32233 J.31}� (P)904-247-5800 SITE INFORMATION ADDRESS 2,044q 5v1 v k MAR?Nk tJ SUBDIVISION IJ4 No ate, BLOCKI r I LOT 37 RE# I (e q .DI,— f o 7s{ [PRESIDENTIAL ❑ COMMERCIAL ❑ OTHER APPLICANT INFORMATION' ' NAME �i M&prt c 0 LJ. > /44-0v e y c5e-Vi 0LL PHONE# ciaq_sgi 3 -( b ADDRESS ao4.q c$ t 1- /`j,t(Z i NA- DR J CELL# gosi_6 16-.2.579 CITY A-t-I,A-N1 eectc,V, STATE pi ZIP CODE 3,2 2 3 EMAIL �c�,oeN1-445 0 dome/1-5r, Ner al OWNER ❑ LEGAL AUTHORIZED AGENT I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation", of the Municipal Code of Ordinances for the City of Atlantic Beach Florida and/or I have participated in a pre- application meeting with the Administrator of those regulations. Subsequently, I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed from the above-described property and/or adjacent properties including right-of-way. I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)or Authorized Agent c - - "- 6:0-rceg-rec�{'I,f/?oN cOJ'ic2i L .0,2--/44-.20t.�r /4/„I(/ N/AATUURE OF APPLICANT PRINT OR TYPE NAME DATE D / 'V /L4f2l/ 4/'g✓ — Y. Q/¢"e -, 2-)D4 i SIGNATURE ORM PLICANT(2) PRINT OR TYPE NAME DAT Signed and sworn before me on this 1 t� l day of Ttb , 20`6\ by State of r SY 1 Go on 1-\ oV uL J C Irk°\1 County of D u-N WC Identification verified: F\.._ i lb Y. 1�I C COV TDO-r ' . Mornings (214..- Oath Sworn: ❑ Yes 1=1No '� ISn1 State of Florida k My Commission Expires 04/12/2021 Notary Signature t Commission No.GG 266195 �'12'�UZ My Commission expires 04 TREE AND VEGETATION AFFIDAVIT 03.012018 C A,r, City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 g,CCt? ~0�7 Phone(904)247-5826• Fax(904)247-5845 . jj ;3 >% E-mail: building-dept@coab.us Date routed: Z/ /i0' City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z049 9 SL -A hApkg.tp (department review required Yes/ No rBui in V Applicant: 0 (0 C 12— ('Planning &Zonin } 1 Tree Administrator Project: A J Ou E') C K /amu i E-VUT: s-j ublic 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: Pendry 4Uri ,)1s'S 1400110 Y a/. :UILDING PLANNING &ZONING Reviewed by: Date: .2"12 TREE ADMIN. Second Review: A roved as revised. ❑ pp ['Denied. ['Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I Approved as revised. I [Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 rf',,, Building Permit Application Updated 10/9/18 "' City of Atlantic Beach Building Department **ALL INFORMATION �, lz. HIGHLIGHTED IN GRAY 800 Seminole Road, Atlantic Beach, FL 32233 �'t�rIS REQUIRED. �h_one: (,9247-527fEma_i_I__BuiIding-Dept@_c_o_ab._us [[��((��,, Job Address: 020 (11 5Iat.vA MAR2NA "OR. ,AiVo Tic 31'relt Fc Permit Number:%"11., _(�1 -0007 �+ 3.:I 3:3. Legal Description 3q-' 9 S09-d `D c1 t LOT 37 5tIva. *tic Lth if OKI. RE# IGR-S06, ` 107,-1 Valuation of Work(Replacement Cost)$ J n, ()(.70. " Heated/Cooled SF - Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration !R]Repair ❑Move ❑Demo ❑Pool ❑Window/t•& F I C E COPY • Use of existing/proposed structure(s): ❑Commercial ❑Residential • If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No • Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No Describe in detail the type of work o be performed: Itched c'v replace"cm 1, of- deck- p la+ 51121.40-I ttc I, 041 i L IV/ e xot i j -cram i vkg, W g U r Z 1,4 Florida Product Approval# for multiple products use product apprgtaiorm z Property Owner Information a U Z O R Name I- C rvey end. Slprcd Se.koll Address ?(pc19 StIV& Mall'v.a'bfr n W 0 E u7 City A'fIrov L 31;G.G47 State FL Zip 3aa.33 Phone (1 tel) 535'3' (Q 1 .5-go I3 p O F- E-Mail 11115ct.ct ec�iwtca3f. rte4 acet'rl ',SR, coif cast. ele-} w U °a () b Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) f" Contractor Information 0 Q 0 < Name of Company Qualifying Agent I-- F0- H cc Address City State Zip O Q — w Office Phone Job Site Contact Number L. �" � z State Certification/Registration# E-Mail LI © uu m Architect Name&Phone# W F-- W " L► Q w C3 Engineer's Name&Phone# W U U) W Workers Compensation Insurer OR Exempt o Expiration Date > CC Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or instalgion has w CC 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 REST IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND 0 TO 6 ►IN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RE•:- '�ING YOUR OT E F C ENCEMENT. cn co "Ai md Li Z Sign ture of Owner or Agent) (Signature of Contractor) O 2 ..:rrgd aid sworn to(or affirme•)before me th's F day of Signed and sworn to(or affirmed)before me this day of S_ 2 'Z a d-, -L go icy ,b "f�,c�'L(,(l!' , LC-I/l c(I , ,by I— . ff ' i -v"v"� ', • ' cc�� (Signature of Notary) �O (Signature of Notary) C7 U [ sonally Known OR [ ]Personally Known OR '.'.oduced Identification / [ ]Produced Identification;,hof Identification: �L �t i y(/� L((Q Type of Identification: :_._-?(1) b5/ I,09-cIci Owner Builder Affidavit OFFICE COPY-ALL INFORMATION ,5���''��/, HIGHLIGHTED IN vs "' City of Atlantic Beach Building Department GRAY IS REQUIRED. *-01''ti' r� 800 Seminole Rd, Atlantic Beach, FL 32233`' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: OW7 I. FLORIDA STATUTES;CHAPTER 489, FLORIDA STATUTES, PART 1"CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY;SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. . III. IRS WITHHOLDING;OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY;UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO$5,000 PENALTY UNDER FLORIDA STATUTE NO.455-228(1). AN "OCCUPATIONAL LICENSE IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY" OR THE FLORIDA"CONTRACTORS CERTIFICATE"TO ASCERTAIN IF A PERSON ISA LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904- 247-5826 OR BUILDING-DEPT@COAB.US) IF IN DOUBT. V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. Job Address: )0,-/9 Sddvu A.kari 1>r. Owner Name: Rani Cy ma, Skirr i S,Lott Phone Number: (q1) g5 3- 615V Mailing Address: jLi.vt& City: State: Zip: Notarized Signature of Owner , /-(AA /1--rehe-a7' The rgoingjUrc nstrument was acknowledged before me this r> day of 4"-lb, 2019, in the State of Florida, County ofU V ( v Tionna Bronau h g Signature of Notary Public Notary Public State of Florida [ 1 Personally Known OR }-Produced Identification ,.*0► My Commission Expires 06/24/2022 Commission No. GG 231616 Type of Identification: {'C__ V(1V { ( (CU) Cc(- p b7 J 1Pc'I a( Updated 10/24/18 MAP SHOWING SURVEY OF LOT 37, SELVA NORTE' UNIT ONE, AS RECORDED IN PLAT BOOK 39, PAGES 94, 94A AND 94B OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. mor?.' /-/2,V1 /{FFL FR `�� Q A / o� 4s F'"9"5. ,,�z-.vaa✓ / f 5.03'49'/o'F. 8700' ---o o _ H.' 4� �� R'333W ..40.-• ..T a 16 0 24,7• N 'a' pa'6, N N(4oNR F'C)LJt /o4 no/N/ tr (/0I pou,Qcc .,) orf Mrop,gLOGJ{BLe-.!(/I.9S) "Pl." 8 6' •N (99f.f,0T iN !2' f /'Loco Zo,✓�Q.. to c9 q) �q a� I'i mp IN(1 4') c 1 a N N o n' ��Nly —--; N 03'49 70..W g7ac7' .....,....,,....„5/.2-,,,,,,, F Fo✓.,•t,yvj^,taco,.. � .L.V4 Af6ei'R//-14 17R/VF rF�RM�s4LY oLo SNeRFfif pAvve.> 2 - 3 - (i' /o°�/W X-rcK.ttid-L i'vt( b ft p •FLa70 Z '44-/y%ie/vo r'i .,�-cdO....1 • FLaeo Za....x--'r3'NS PS 7./SEN 7-..-.e. ,,ao,iraFz 'V 9 S 0 .r f Z alJc.jGV Y.6-..1 o°' PL.GC,0.47rZEQ •T.,. /s 4 La.-v ,•,,Er- ' iZts''.IVI OG-1071 •,vb r3..1'L '/A/r.4c6T•r/ 7-'Z-"t/5 y"/= 477-- - caa O�L RE 5�v"jG�G4).oi✓ EF.4-.4 n n I hereby certify that this survey meets the minimum technical standards as set forth by the Florida Board of Land Surveyors,pursuant ' H. A. DURDEN to Section 472.07 Florida Statute& & ASSOCIATES ,NC. ‘, / : fr,c-cs;t1,--At LAND .a.uTotan luwravoa Mo.I574 M. SURVEYORS /O' Mg • � '� /9 rood B Post Mc* os 50670 SIGNED N 630 Bosch Boulevard SCALE: /''c.20' Beach,Jacksonvlile Bea ,Florida 32250 THIS SURVEY NOT VALID UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THE ABOVE SIGNED. =1 +• -c,v�ch !oot-lo rage 1 0b4, Number Pages:1 Recorded 02/21/2019 09:22 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL NOTICE OF COMMENCEMENT COUNTY RECORDING $10.00 State of is for l cl(A Tax Folio No. G a S(as c L/ County of 1)(.( kirk To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. �) Legal Description of property being improved: 39 - Ry Cp$-a $- �q E Lot 3-+ ✓" Se(VGA bt'-C U,Ai.- Ova Address of property being improved: QV-1q .Sdvc iitlftt lna "h r. General description of improvements:" c,sto to( CTAS rtf l(i f.t.rt&c iT al` (IOC itz p IA Vl z 1' r 9i`o i ftd- (f.�t Il t'-v1 ex131iv'y -t't w1III • I 11) 0 ner:44 �icifN? 6t l ,.511LirOi 5c.Lpl( Address: .sat%t ner's interest in site of the improvement: 100 Y. ee Simple Titleholder(if other than owner): Name: Contractor: RvA(n¢.t/ .57.4-1..e-✓i 612.1, P-1Y /woe-) 0- Address: Address: 073 O 3 73e. (U6De4 5 OQ 4)041 Telephone No.: 0[9'0 �0 9�f L /i 02 Fax No: /9O') ) A/ tJS Surety(if any) Address: Amount of Bond$ 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: 4-Z ON vac icaLl Address: .2o41? DA. Artato'iG Be.4cLi FL --333 Telephone No:(9c40.,9 -b�3� 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: ,ShAt-Ac� — Address: .204.9 t/40 i✓4 QR• Art tfA T,o i3 - t, - .32.2- .,3 Telephone No:Ooli) fry 2-tr' y 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 �I �a Signed: V: G /� < Date: V:rfOfBefore fne this da of . Uet,v- in the CoDuval,State Tionna Bronaugh �� y � Notary Public Of Florida,has personally appeared C l �L1.p t Notary Public at Large,State/ofFlorida, ounty o� f�Blaval. f. State of Florida My commission expires: vlG/ J Ito ° My Commission Expires 06/24/2022 Personally Known: or Produced Identification: Dr 1 Yt LICE 4/. s (_ 6� 1�r�617 Commission No. GG 231616