1793 E Park Ter RES19-0187 Int Remodel RESIDENTIAL PERMIT PERMIT NUMBER
ITY OF ATLANTIC BEACH RES19-0187
C
ISSUED: 7/9/2019
800 SEMINOLE ROAD EXPIRES: 1/5/2020
r ljjq�- ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-S814 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:
1793 E PARK TER RESIDENTIAL ALTERATION INTERIOR REMODEL $40000.00
RESIDENTIAL
TYPE OF REALESTATE BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
1720200418 SELVA MARINA UNIT 08
COMPANY: ADDRESS: CITY: STATE: ZIP:
No Limit Contracting LLC 12462 Toucan Drive Jacksonville FL 32223
----OWNER:----- ADDRESS: CITY: STATE: ZIP:
NIEMCZYK TODD R 225 SHERRY DR ATLANTIC BEACH FIL 32233-5237
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
BUILDING PERMIT 455-0000-322-1000 0 $255.00
BUILDiNG PLAN CHECK 4S5-0000-322-1001 0 $127.50
BUILDING PLAN REVIEW RESUBMITTAL SECOND 455-0000-322-1006 0 $50.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $6.49
STATE DCA SURCHARGE 455-0000-208-0600 0 $4.33
TOTAL: $443.32
Issued Date: 7/9/2019 1 of 2
City of Atlantic Beach APPLICATION NUMBER'
Building Department (To be assigned by the Building Department.)
800 Seminole Road G
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us L Date routed: (,62
City web-site: hftp://vvww.coab.us I _
APPLICATION REVIEW AND TRACKING FORM
Property Address: `7 q'�!) DqpArtment review required Y7 No
uilding
&p-CFACTI &Zoning
Applicant: L C-a
'7ree Administrator
Project: C_Z 10(Z_ &f"o k-�)C_L_ Public Works
Public Utilities
Public Safety
Fire Services
Review fee Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages-and Tobacco
Other
APPLICATION STATUS
Reviewing Department First Review: XApproved. ElDenied. E]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:7,
TREE ADMIN.
Second Review: FlApproved as revised. F]Denied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. ODenied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05119/2017
Building Permit Application Updoted 1019118
CRY of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: tire,C t Permit Number: L
Legal Description 5t (0- oAr I.&C, tA r, Z-0� 0 RIL4 Iq RE# tq�o2& -iOq 5/
LIA 0(9 0
Valuation of Work(Replacement Cost)$ '7!� Heated/Cooled SF Non-Heated/Cooled
f
• ClassofWork: ONew ElAddition M/Alteration DRepair ElMove DDemo E]Pool E]Window/Door
• Use of existing/proposed structure(s): DCommercial aesidential
• If an existing structure,is a fire sprinkler system installed?: ElYes �M/o
• Will tree(s) be removed in association with nr000sed oroiect? Dyes(must submit separate Tree Removal Permit) 4K10
[!s be in cletrfl the t pe of work to be perf P,( 0) 10 '-J
ilr_ 0
k All vevi- I C t
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name �J\�E 04(4L Address 11-7 el I Pa V
city POA /-, e"I- State 1�;_ Zip -3 -3 Phone 0 Ll - 6 a R - Lloi-9
E-Mail V�\ �,P_yy\ /- -� � �e U YA -eA v
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
COL^�C�-Ijokt J gi
Name of CompanV _Qualifyin A ent 4o"
Aciclressl'2-35-v�!rpu -I dofv-e; IW J City
-54 1�0 k rl�� State Zip
Office Phone-�01-1`-1017 fzl:� Job Site Qontact Number
State Certification) istration# C ff( (7-C Z 'T E-Mail/f:!;�','K P�G—
Architect Name& Phone# V
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt Expiration Date
"IS
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no wor/k or m4AI lation h&
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws FQ+t*ulg z
10
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBINVS04" —
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requireoiBpej
57::. fl dDt 145 LU
permit,there may be additional restrictions applicable to this property that may be found in the public records of this 9DIrdy,km&
there may be additional permits required from other governmental entities such as water management districts,state Qet§EE c8 40
federal agencies. Ll P < 13
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in complianccluri�aR -4 (7-I;ZZ,
L) -J ca
applicable laws regulating construction and zoning. II.- cn I.-
a: , I,- z
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU iNtWEE
5 t LU D
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER O-RANATTORNEY BEFORE U1
LU L)
V) LU
RECORDJNG YOUR NOTICE OF COMMENCEMEN X
>
-W--dAJ1 2AA 9 4AX LU
W
(Signature of dwnerlor Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me t is N-clay of Signed and sworn to(or affirmed)before me this&—day of
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Vr)e Y r)6" (-iq V- J L)O t I , by W",gto L
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CX4(�
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ASHLEY S.MACKIE
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e0mmis'sion GG 144711
Commission#GG 144711
Expires September 20.2021
Expires September 20,2021
Personally Known OR Bonded Thru T Personally Known 0
my Foin Insurance 800-385-701
Produced Identific r%P roduced Ident"ficat Bonded ThruTmyFmInIft1un1nft800.M5-7019
Or .-I
Typeof Identification: Type of Identificati n::::
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Revision Request/Correction to Comments "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept coab.us PERMIT#:
El Revision to Issued Permit OR Corrections to Comments Date:--i 6 el
Project Address: 1 -101
Contractor/Contact Name: (\CL rt'�-J fl,('e So-,/
Contact Phone: 0 Li - vz' Email: P, 6 k(V\P-5 o M&I
Description of Proposed Revision Corrections:
0 1 t)!!)
rRm Z E 0 uln% trz' F V mt D
affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name) JUL - 5 2019
• Will proposed revision/corrections add additional square footage to original submittal?
11 No El Yes (additional s.f.to be added: ) Building Department
City of Atlantic Beach, FL
• Will proposed revision/corrections add additional increase in building value to original submittal?
[:]No E]*Yes (additional increase in building value: $ (contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
W/Approved El Denied El Not Applicable to Department Permit Fee Due
Revision/Plan Review Comments
Department Review Required:
Buildin
nning&Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services Updated 10/17118
-OFFICE GOPY----
NOTICE OF COMMENCEMENT
State ofgor'ok s., Tax Folio No.
County of Pt'vC.- P�0 Z.0 - 0 K
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 COMMENC NT
5e
,e t VIC,_ 440,_f_41 joq
Legal Description of property being improved:-;Z-or— "IN, — t LQ!� It gi
Address of property being improved: 17 -k- 0 Aloall(l &Ad §C/ 312af
r, g, att
General description of improvements: �-6 0(e, let'404a ojzz
r '61 A(-"f 7 1-j
OwnerAIC16'." Wtrougv- Address: 1:7 1.3 Re*- e pi
onL
V
Owner's interest in site of the improvement: ---662, JNWAoA4 t
Fee Simple Titleholder(if other than owner):
Name:
Contractor: Ad"^J a A- to iio-�r"
Address: SJL' r.'rt A 0;s%f-C rJ. t) va's'
TelephoneNo.: ZI-rif 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 im, Doc 4 2019140346,OR BK 18829 Page 1479,
Number Pages:1
Name: Recorded o6ii 7/2019 09:49 AM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
Address: COUNTY
RECORDING $10-00
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 date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
-Mj,jSigned:
Before me this day of V J 10 in the County of Duval,State
Of Florida,has personally appeared ffltQ)0,r,-r1
ASHLEYS.MACKIE
Personally Ynown: or
'T Commission#GG 144711 -T�.
Produced Id t*fi t' ->O-z
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Expires September 20,2021
Notary Publt
Bonded Thru Troy Fain insurance$00-385-7019
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