101 Fleet Landing BV RES19-0092 Int Remodel RESIDENTIAL PERMIT PERMIT NUMBER
n CITY OF ATLANTIC BEACH RES19-0092
800 SEMINOLE ROAD ISSUED:4/1/2019
ATLANTIC BEACH. FL 32233 EXPIRES:9/28/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
• • AND CITY OF • • OF ORDINANCES .
ALL CONDITIONS OF
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 may be additional permits required from other
governmental entities such as water management districts,state agencies, or federal agencies.
JOB—ADDRESS: • • OF • '
101 FLEET LANDING BV RESIDENTIAL ALTERATION INTERIOR REMODEL $6800.00
RESIDENTIAL
ZONING:TYPE OF REALESTATE SUBDIVISION:BUILDING USE
CONSTRUCTION: NUMBER: GROUP:
169397 0200 SECTION LAND
COMPANY: ADDRESS:
NORTH RIVER BUILDING 6771 SHINDLER DR JACKSONVILLE FL 32222
SOLUTIONS
• DDRESS: CITY: STATE: ZIP:
NAVAL CONTINUING CARE
RETIREMENT 1 FLEET LANDING BLVD ATLANTIC BEACH FL 32233-4599
FOUNDATION INC
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 . r
n i approved list. Container cannot be laced on Ci right-of-way.
Roll off container company must be o City pp p City
FEES
BUILDING PERMn 455-0000.323-1000 0 $&5.00
BUILDING PIAN CHECK 455-0000.322-1001 0 $4250
STATE DBPR SURCHARGE 455-0000.208-0700 0 54.84
Issued Date:4/1/2019 1 of 2
RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0092
_ 800 SEMINOLE ROAD ISSUED:4/1/2019
1 ATLANTIC BEACH. FL 32233 EXPIRES: 9/28/2019
STATE DCA SURCHARGE 4550000-208-0600 0 J3357
WORK WITHOUT PERMIT 4550000-332-1000 0
TOTAL
Issued Date:4/1/2019 2 0(2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Roadq Q �i/�
Atlantic Beach,Florida 322335445 RLC 19—L )0 1
Phone(904)247-5826-Fax(904)247-5845 �51 19
- - ,✓ E-mail: building-dept@coab.us Date routed:
Cityweb-site: hnp:/hvvnv.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I C) t PL6ET LANI )fA' q Dgut@knt review required Yes No
'� ('� /J
building
Applicant: I oQYH DIVE-, 1(&)t Ln(" Zoning
D Tree Administrator
Project: I YVTF�IZ1[�2 I�EYYt��C L. Public Works
Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Reviewor Receipt Date
of Permit Verified
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: M�/pproved. ❑Denied. ❑Not applicable
(Circle one.) Comments: 7'hfS was 4nr vi /a4-Pp7 -Prro'
dycw S7'Uf9 LVoJ?jC
BUILDI
Of OL' R f Sh0✓(frt 12t or o V ue4200
PLANNING&ZONING Reviewed by: // ` Date:3I
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. ❑Denied. [-]Not applicable
Comments:
Reviewed by: Date:
Revised 0511912017
Building Permit Application OFFICE COPY Updated 101
91
18
City of Atlantic Beach Building Department *ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Jab Address: iol Fledr
'Permit Number: t \ �"�I�l - 000)
Legal Descript q � 'A?, �ea-13 £C SCRj;�a LC^�: aim 29 RE#
E4S , 1Corg "1011-ry9-FI
Valuation of Work(Replacement Cost)$ (iACb Heated/Gaoled SF 11hO_—Non-Heated/Cooled _
• Classof Work: ❑New OAddition xlAlteration ❑Repair OMove []Demo OPool OWindow/Door
• Use of existing/proposed structure(s): OCammercial Q4Residential
• If an existing structure,is a fire sprinkler system installed?: OYes XNo
• Will tree(s)be removed in association with proposed ro ect?13Yes must submit Separate Tree Removal Permit No
Describe in detail the type of work tobe performed - q 1 1 + {
o�lCr I f is 7'T�o"" HWm/' +. 49A , A0� tom Dl UyrtlOW I caRnsN WAI�
Florida Product Approval# for multiple products use product approval farm
Property Owner Information
Name CC RF .Address y
City State�_,Zip 4YJ3� Phone
E-Mail -f!}air Selma r
Owner or Agent(If Agent,Power of Attorney o gency Letter Required)
Contractor Information ��pp n 1' 1 r- Q.,
Name of Company -- OA(� RIVnri6iltlAtA �rnlnnCQualifying Agent GO -HO,�
Address Po Boy( "T-,Tl a City State _Zip N
Office Phone 9 t�38-9119 Job Site Contact Numh r
State Certification/Registration# Cf' C- 14)BQ IA E-Mail T^fN 1p�yl,Q„rlul '+� PnM w N
Architect Name&Phone# _ 1 O
Engineer's Name&Phone#
Workers Compensation Insurer ut fn OR Exempt H# Expiration Date Z
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work arinstallat�lv� U O
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws reguldurl= Q 6
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGO,Z X Q
WELLS,POOLS, FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requiremen f�y,
iN
permit,there maybe additional restrictions applicable to this property that maybe found in the public records of this count&a W F
there maybe additional permits required from other governmental entities such as water management districts,state agen U s 2
s w
federal agencies. U W W
OWNER'S AFFIDAVIT:i certify that all the foregoing information is accurate and that all work will be done in compliance witullw in
applicable laws regulating construction and zoning. it U N W 3
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MI$ ¢ GI
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INAND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YO OF COMMENCEMENT.
(Signaturts,lif Owner or Agent) (Si azure of Contractor) ry
Signed an swam to(or affirmed)before e[his day of Signed and swam to(or affirmed)before math s cl day of
,by 70 L4)ASft1w �IRtft'(- by
r (Signature of Notary)
yP Notary Public SbN M Flake yp Nayy Peglc Stele d FbfiEa
// Shan R Tmvrkentl Y Slwn R�Ownsentl
Ir'Personall Known OR ac My Comm eekn GG10a9a [tf6ersonalty Known OR y M Cam iwbn In is>eaa
y r +� E.O.11IpY2a21 [ )produced Identification q Fapim 11AMNal
[ I Produced Ideldficatio a p
Type of Identification: Type of Identification:
NOTICE OFCOMMENCEMENT QZ OFFICE COPY
State of f brM Tax Folio No.
Countyof hWVAI
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 COMM ENCE ENT. _
Legal Description of property being improved:AM 347 0241�f, OP :__ 5 8 f lows .
�e 29 TS sF f Duvrrl Co f�„y Rk Two — . 1 .4
Address of property being improved: Ini L, �Jy�� a 1
General description of imp1rovements: 4t1 o�aY "" Iy.._��
W Allow
Owner: Firset 1 undine _ NOCRF Address: i Ficcf I r.ndinn RI X111 I Ino int Aflanfin Rnorh
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
10r/ Name:
Contractor: Nnnh RI\IPr Ruildinn Rnhdine
\\'\V Address: P n ROY R40977 Rt Ai nuMinw FI A9f1Rn
Telephone No.: 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 Lienors Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owners 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
Doc p 201906001],OR BK 18721 Page 1184,
Number Paper:1 OWNER
Recorded 03/1&2]7904:05 PM, /
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Date; 3%fi aQ/
COUNTY Signed:
RECORDING $10.00 Beforemethis day of gArL In the County of Duval,State
?;AK
.y Npnry Punik Slrooi Flwlm Of Florida,has personally appeared r-
ShariRTowmaM Notary Public at Large,State of Florida,County of Duval.
ew� My Commiubn GG 147833 My commission expires:
Expires 11N 2-1 Personally Known: V, or
n Produced Identification:
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