61 Beach Cottage RESO19-0015 Replace Deck RESIDENTIAL OTHER PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES019-0015
800 SEMINOLE ROAD ISSUED: 5/28/2019
ATLANTIC BEACH. FIL 32233 EXPIRES: 11/24/2019
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, 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 additio"strictions appi
that may be found in the public records of this county,and there may be additional permits reqL
governmental entities such as water management districts,state agencies,or federal agencies.
JOBADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
RESIDENTIAL OTHER SINGLE OR
61 BEACH COTTAGE LN TWO FAMILY RESIDENTIAL replace decking with Trex $15000.00
OTHER
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
COTTAGES AT ATLANTIC
1697000105 BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
NORTHEAST BROWARD 1229 FOREST OAK DR NEPTUNE BEACH FL 32266
CONSTRUCTION
OWNER: ADDRESS: CITY: STATE: ZIP:
Lee Kellison 61 Beach Cottage Ln ATLANTIC BEACH FIL 32233-5251
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 I QUANTITY PAID AMOUNT
BUILDING PERMIT .5-0000 322 1000 1 0 0 02�0
'0 D
.r
BUILDING PLAN CHE 5-0000�322 1001 �$293
STATE DBNR SURCHARGE 455-MM 208 07M 0
issued Date:5128/2019 1 of 2
RESIDENTIAL OTHER PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES019-0015
800 SEMINOLE ROAD ISSUED: 5/28/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 11/24/2019
STATE�SURCHARGE 0 $2m
TOTAL:$199.93
issued Date 5/28/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida 32233-5445 let-,DO ts
Phone(904)247-5826 Fax(9G4)247-51145
W, E-mail: building�dept@coalb.us Dale routed lei
City web-site: 1-th,//www.coalb.us
APPLICATION REVIEW AND TRACKING FORM
nt review required Y 'No
Property Address' U1 l6abi ittift Building ) -7—
Applicant: JJOJI�4,111i3k- &OWwd tAr1SJ(aIL*i4 Planni-ng &Zoning
Trets Administrator
Project: ir Utu- dL4tLL-j*ttL1 -3k)c Public Works
Public Utilities
Public Safety
Fire Services
Review fee $
Other Agency Review or permit Required Review or.Reco'pt Date
of Pe It V rifled By
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Any Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Ev�p'proved. ElDenied. E]Not applicable
(Circle one.) Comments;
CEE�
PLANNING &ZONING Reviewed by: D.to 1�2
TREE ADMIN. Second Review: OApproved as revised. ElDenied.v E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRESERVICES Third Review: E]Approved as revised. DIDenied. ONot applicable
Comments:
Reviewed by: Date:
Revised OW1912017
CITY OF ATLANTIC BEACH
MAY 2019 8DO Seminole Road
Atlantic Beach,Florida 32233
Telephone(904)247-5800
FAX(904)247-5845
REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COMMENT
Received b Resubmitted:
cce
urnbeir: �00
Date.;5-�
Permit N b�e,.
Crigiria] Plains Exerruner, Proje t Nam
Project Address: X / (,;,6 ZT0 7-
4a r,
Cordractor;�C�g
Contact Name
Contact Phone : Contact e-mail:
Revision/Plan Check/Permit Fee (s)Due: $
Description of Proposed Revision to Existing Pe�it.
Additional Increase in Building Value: S Additional S.F.
Site Plan Revised: Public W I U Approval:
By signing below.I(pnia�i affinn,that the above revision
is inclusive of the proposed changes.
Signature of Contractor/Agent(Cnw�.ip if im.mW..tim) Date
off.U.only
Ap��d N,Aifid by:_
Plan Review Cormoncrits:
Department review requirod Yes No
Building
Planning&Zoning Plans Examiner
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Seivices
OFFICE COPY
Building Permit Application Jrdatedl"118
CItY of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road,Atlantic Beach, FIL 32233 HIGHLIGHTED IN GRAY
�j
Phone: (904) 247-5826 Email: Build ing-Dept0coati.us IS REQUIRED,
lol:,Address:_j���d �.Pemtitilumber: �50 141_00T
J'k
Legal Description C`&-tka*4 t 14,q
RE#
Valuation*fWork(Replacement Cost) H.atd/C..I.d SF_NJ cl�qtlix,
-PfRepa (C
• CiassofWork: ONeW DAddition CIAlteration ir OMove []Demo
• Useofexistingtproposedstructure(s): 000nomercial DResidendal
• Itan existing structure,is afire sprinkler system installed?w Lives EjNo MAY
• Will tr..(,l bIreloyed I'association It h J 2ro 7 P7
D su mitse 4rate Tree Removal armat
TAW
4,;r nraN
rd: c �
Describe in detail the type of work to be perform, r iti
i's IL
Florida Product Approval V tV
-A-�for multiple products use product approval form
Propertir Onarrier Infopmation
NameijQ A, mi� Address A&!Sd 1-1 17'.
city State twZ ZIP IeV=�f Y Phone
E-Mail. W Rvfeo-.
Owner or Agent in Agent,Power a Attorney or Agency Letter Required)
Contractor Information
Akni� of
NameofCompany -ZA QualifyingAge
To�- Ai-2,7 U410
AddressZA2 q_ �xz-�r_CA k Z2,
Office More P
—Job Site Contact Number_AQ� !t/2 3.5?0 R 10
State Certification/Registration#0/ft7 llj�4,�07 C 2
Architect,Name&Phone If 0
Z P: (A
Ingineer's Name&Phone# ---------=.t7a J(A
0
Workers Compensation Insurer
ORUMPIX ExplrationDate Z UJI
0 M a 0
Application is hereby made to obtain a permit to do the work and installation,as indicated.I certify that no work or Installadc)We- U cl
commenced prior to the Issuance of a permit and that all work will be performed to meet the standards of all the laws regulat& < C3
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBI NG,SIGNE) W Z
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TAN KS,and AIR CONDITIONERS,etc. 0
permit,them may be additional restrictions applicable to this NOTICE:In addition to the requirements got U.
property that may be found In the public records of this countyM ch
there may be additional permits required from ofin, 1- Z
I 90�mnrerrtal entities such-5 water management districts,state agencl OIL Ld
federal agencies. f2 0 o: 2
w W
OWN ER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done In complianc with M CC 10
applicable laws regulating construction and zoning, W M a
Itu U 111 0 W
0 w 3:
I= Lit
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT It
YOU
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF I TE
TOOBTAIN FINANCING, CONSULTWITHYOUR LENDER ORAN ATTORNEY BEFO
RECORDIkG YO OF COMMENCEMENT.
Pgrawne Of Owner or 40;tj
nd; om to(or alfirmeq)before me this day of Signed and s
worn to(or affirmed)before me this lkp�.y of
, '2 by
(Ida
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,_z t5qvatwe of N�--,)
.4.Q,5W rv) -.0asslov...
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C_ ,t (I allyKrpwnZR re-p-c rally Known OR
r ured Id don
[ I Produced Identification
Type a Id.raill.tion:
121, Mtn,-
ad
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niffi ......
OFFICE COPY
N0710E OF COMMENCEMENT
State of TaxFolioNo. W)IIII- Old
County of
To Whom it May Cancer..
The undersigned hereby Informs you that improvements will be made to certain real property,and in accp5ance with Section 713
ofthe Florida Statutes,the following information is stated in this NOTICE OF COMMENCE A'1�711;e
Legal Description of property being improved:
Address of Property being improved: dIrl A5b4.—,/ CO j%Xqx
General description of improvements:
Owner:
Acldress�
Owner's interest in site ofthe Improvement c,�
Fee simple Titleholder(if other than o",):
Name;
Contractor:
Addrem�ZZ z
Telephone No.:?-o-4,-r-ew- 94,.z 5, Fax No: roll C7
Surety(if any)
Address: Amount of Bond
Telephone No: Fax No:
Name and address of any person making a loan for the construction ofthe improvements
Name: �6�
Address:
Phone No Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notictts or other documents may
be served:Name:
Address-
Telephone No: Fax No:
In addition to himself, owner designates the following person O0c#2019I159Q,ORBK1871 Pge411,
713.W2)(b),Florida Statues. (Fill in at Ownees option) Number Pages.I
Name: Recorded W17/2019 01:57 PIA.
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
Address: COUNTY
RECORDING $10.00
Telephone NO: Fax
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specifled):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
#j%%%kIIIIIIIII/1"z
N.'O�* Signed; 5&C Xo—� Date.
Before nu,UNWIj?—�—d.y.f
Of Honda,has personally a,,sgred eel I fi'�' n
Notary Public8t Large,State ofFlodda,O�unty of Duval.
myconn.l.l.rexpires: . MOV. U2,C)
Personally xnawn; or
Prod.cel Weattlication:
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F-PARED BY: T14E COTTAGES
ARD DEVELOPMENT, INC. AT
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