1203 Hibiscus St RES19-0149 7 Windows RESIDENTIAL PERMIT PERMIT NUMBER
-0149
RES19
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 5/24/2019
ATLANTIC BEACH.111.32233 EXPIRES: 11120/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
CODE, NEC, IPIVIC,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: PERMITTYPE: DESCRIPTION: VALUEOFWORK:
1203 HIBISCUS ST RESIDENTIAL ALTERATION 7 WINDOWS $6027.00
RESIDENTIAL
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1710100100 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
THE HOME DEPOT 9208 Florida Palm Drive TAMPA FL 33619
OWNER: ADDRESS: CITY: STATE: ZIP:
BOOTH CRYSTAL 1203 HIBISCUS ST ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. ANOTICEOF
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 PERMIT 455 DOW 322 1000 0 $85 00
BUILDING PLAN CHECK 45S 0000 322 1001 0 542SO
STATE OBPR SURCHARGE 455-0000 208,0700 0 $2W
STATE DCA SURCHARGE 455-0000 20"WC 0 $2.00
TOTAL:$131.50
Issued Date:5/24/2019 1 of 2
I.gmzo�- City of Atlantic Beach APPLICATION NUMBER
4PBuilding Department (To be assigned by the Building Department.)
800 Sam inole Road
Atlantic Beach, Florida 32233-5445 R 9
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@cwb.us Date routed:
City web-site: http:l/www coalb us
APPLICATION REVIEW AND TRACKING FORM
Property Address:* 1203 141at-sc 'Rpii�aerd review required Yes 'No
_�)is P -PMMIng &Zoning
Applicant: He Horn& But Idi
Tree,Administrator
Project: r\.)f_�,o v,*)-S Public Works
Public Utilities
Public Safety
Fire Services
fZeview fee $ Dept Signature
Other Agency Review or Permit Required Re i.ev�
v It=pt
of Pe By Date
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: R rpplved. ElDenied. E]Not applicable
(Circle one.) Comments:
CBUILDINDG
PLANNING&ZONING Reviewed by: Date:_���201
TREE ADMIN. Second Review: E]Approved as revised. E]Denied. ONot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable
comments:
Reviewed by: Date:
11.�m.d 0511912017
Building Permit Application 111o1PIc1jJP727-a37,-uw Uld.11d 1019118
City of Atlantic Beach Building Department 0 4-?,2 v`00 '*ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTEDIN GRAY
Phone: (904) 247-5826 Email: Budding-Dept@cclab-Lis 15 REQUIRED.
Job Address: ( �Os —PermitNumber:
Legal Description 4r-ly T1,prZ19C4&f1 RE# 1-11010VI'M
1 3_�
6-1 5", 1?J
Valuation of Work(Replacement X? Heated/Cooled 5F—Non-Heated/Cooled
• Class of Work: ONew DAddition LIAlteration LlRepair []Move 0Demo FlPool 4Window/Door
• Use of existing/proposed structure(s): ElCommercial 211tesidential OFFICE COPY
• If an existing structure,is afire sprinkler system installed?: Dyes 2Ao
• Will treesl be removed in association with proposed pro ect' E]Yes imust submit seizarate Tree Removal Permit) EINo
Describe in detail the type of work to be performed-
ftP(.cp '7 s,,,t74�i 5iz_�
Florida Product Approval# —for multiple products use product approval fofrn
Property Owner Information
Na Address I ;1 5-,
citme i oz State F`� Zip IJ231 Ph... !Folf
E-Mail
Owner or Agent ill Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company QualifyingAgent 4-,-17,-e Fr_,i,
Address 9.)OLT Tu, Crty'r�p_ State F7, Zip
Office Phone iril, 6.16-75 'thr Job Site Contact Number
State Certification/Registration# C-Ont 0616Y I E-Mail W�JAe rr-,L11�1 �1
Architect Name&Phone#
I =
Engineer's Name&Phone#
Workers Compensation Insurer 0 _J��,�a ed OR Exempt:r Expiration Date
Application is hereby made to obtain a permittodothework and installationsas indicated.I certifvthat nowork or ns8I1%.l
commenced priortothe issuanceol Ferdinand thatall workwill be performed to meet the standards ofallthe laws togbtfilgo .9
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICALWORK,PLIUMBIN P�S;
WELLS, POOLS,FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition tc !g
permit,there may be additional restrictions applicable to this property that may be found in the public records of this:105
there may be additional permits required from other governmental entities such as water management districts,state we4if
federal agencies. 0 U. 5
LL X
OWNER'S AFFIDAVIT:I certify that all theforegoing information is accurate and that all workwill be done in Mmplianc4l 49
applicable laws regulating construction and zoning. Lu F W D a
0 ad
CC W
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT*
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOUiNTEND w
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECf���MENCEMENT.
(Signature of OwnerorAgent) (Sig oi orl
Signed and sworn to(or affirmed eforemethis / day of Sig d and 1 zirmed)before me this /"/day of
F, Of T by 41'41-f FfIircluf
AOTARYPUBLIC ' ;6�- ' &!"
STATE OF FLORII ,;� (Sigri of NoEarj�'
Commill GG273006 LEY
Expires,10/3112022 ;117135
Personally Known OR Xpersonally Known OR
14 Produced Identification [ ]Produced Identification
Type of Identification -I- Type of Identification:
p go �4 9) p !P
-3. N
aL
0 M 3 m 0
M. 0
go
m m
o
b- C—O Oc 300
*0 0 0 0
co C�f) <
P
ir
ac z
5.
0
>
qq 3a
SL
3 E.
o' FL Z
M
I S. M
0)
m Ul 0 m
m
2
0
m M
MR M� m
OM
Cl)
-40 :0
0 <
1 5
0 3
8
Si
—————————————
0 0 M
3 2
@
> 0 0
z -0 z
Z
3 0
0 m n
3 — 0
3 3
=r ir
CD CD
-4 00 3
rl) := z 2:
4 -n 0
m 0
3 3 3
m
w CMI CD .. <w
4 0) C) > 0
6D CD > 0
4 �o , u —
0 0
a
-n 2 < m 9L
3
U.
m
m
LA: 0
m
A
2L m
z
0
3 -n
m 0
M 0
ZE qQ.
@ — 2:
m
a
0
fD 0
0
3
a)
mm
CD
l< 3 at
@
CD
Er
CD
CL
" I
m
CD
CD 9:
3
m
0
0 0
3 3
Fj
m 0, 0
3 fn
0
-n
C')
M
'rm 7P-
TIM,
Doc 111 2019109019, OR RK 18787 Page 1425, Number Pages: 1,
Recorded 05/10/2019 1D:35 AM, R014NIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
JOB COPY
THIS INSTRUMENT PREPARED BY:
NAM; TlmH--O-p,o
Adohnow 9man,,obp�1 D,
T,-, PT llll�
NOTICE MOMI�ENCEMENT L)
Ole
0 C
-1 L) 0
IL g P:
Tie undmiUmof hIm"94m mom that irmammot"by mde In�iuin mal pmmoy,wd in a=nlinm mflh Com.713.RNow.anto.,be2 0
kIII I.[ ..tion W P.MW 1.In.mom g onmmommint 0 M L- z
1, MIS, LVal., on4gr bw - m" allg L 00
.3 _�M
516 �l 4
h)tl--N A-emp Qo. -)4-
I QSNER&L DESCRIPTION OF IMPROVEMENT;
3. OWNER INFORMATION OR LIESSEE INFORMATION IF THE LIESSIME CONTRACTED FOR THE IMPROVEMENT: 0 U.
Narmand.dd.—C—ICX4)�J-214%4" ld-B.3 r�- 0 W w
-v� 64- 1 in M 2
—tu a. LC
f"Simply Tftlo Hamr of�ftn�liblind abo,n;)Nbm, �: w n 0
Z5 w ou
Inklm,'
4. CONTRACTOR:N;;;—i�e HOMe DePa PimmNoynw. 813- 7548
Ab,m: 92oo r1I Palm Dr TawalFI-33619 w ru
S. SURETY ffl.ppllombb,�.m,,d m payment band Is ollominbl):Mom
Md....
6. WENVER;N.. Phmo NI
Mdnon�
7. �n "hin floySININI d F�Voylipallytt by Obmy.pm�m.mom br Idov�mmydb my Im wmbd as pnoAdW by SmIlm
6 ,
Tllm'wl"Fkxkl.Simim.
No.. p1mm NI
.k
InWdiWn,Owmmombm.'
Ubme.Wim., nnnkkol n8y�713.13(ljob) HomaSymom.Phom mmor.
IVARNIAIS M OyyNEE MY PAYMENTS NADE BY THE W44ER AFTER THE EXPIRATION OF THE NOME OF COMMENCEMENT ME
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1, SECTION 713,13,FLORIDA STATUTES,AND CAN RESMT IN YOUR
PAYING IVACG FOR IMPROVEMENTS TO YOUR PROPERTY.A NOME Of COMMENCEMENT MUST BE RKORQED MD POSTED ON THE
JOB SITE BEFORE THE FIRST INSPECTION,IF YOU INTEND TO OBTAIN FINANCING, CONSULT VVITH YOUR TENDER OR AN Al WHINEY
BEFORE COMMENOING WORKOR RECORDING YOUR NOTICE OF COMMENCEMENT.
Stmw rl"i0f, Comity
vb�I.",i my of M!??le
b y 7 Y--�70-4- %hokpoybormlyloumntonmO OR
om,Gohdog
NOTMY PUBUC
vAvE-bF FL000m
,mm#QOV3W8
Emmoli