2212 Laughing Gull Cir RES19-0225 Bathroom Remodel/Win Repl RESIDENTIAL PERMIT PERMIT NUMBER
RES19-0225
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 7/25/2019
ATLANTIC BEACH. FIL 32233 EXPIRES: 1/21/2020
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:
T
2212 LAUGHING GULL CIR RESIDENTIAL ALTERATION BATHROOM REMODEL & $5000.00
RESIDENTIAL WINDOW REPLACEMENT
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
GROUP:
CONSTRUCTION: NUMBER:
1694630026 OCEANWALK U NIT 01
COMPANY: ADDRESS: CIT) :
RJ VINAS CONSTRUCTION 2215 LAUGHING GULL CIR ATLANTIC BEACH FL 32233
ADDRESS: CITY: STATE: ZIP:
WALLACE RUTH N 2212 LAUGHING GULL CIR ATLANTIC BEACH FL 32233-4680
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 45S-0000-322-1000 0 $8&00
BUILDING PLAN CHECK 455-0000-322-1001 0 $40.00
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $124.00
Issued Date: 7/25/2019 1 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 C� z
Phone(904)247-5826 - Fax(904)247-5845 Date routed: -:z L9
-4 ri jw -mail: building-dept@coab.us �z
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Cityweb-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
,z z I ,z- LA oct-, (&-)c �_C_ C 1,2 cc Yes No
Property Address: ,p�ent review required
Buildin22
Applicant: V (\S, C-C)t-�)Z7(-(ZL)Qt7/c),( 71anning &Zoning
Tree Administrator
Project: !Seij[4RC)0(n Public Works
Pu blic Utilities
0II Q C3 V\J t r,3 C_-)0 Q_9 L Pk C-C IYN E-0 7- Public Safety
Fire Services
Review fee Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: MKIPproved. [:]Denied. [:]Not applicable
(Circle one.) Comments: il�l 111� 1111111��11,
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PLANNING &ZONING
Reviewed by-.— Date:
rVI, k C__�
TREE ADMIN. Second Review: F V
]Approved as revised. OlDenied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. []Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05119/2017
OFFICE COPY
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Builcling-DeptPcoab.us 15 RE I Q I UIREM.
Job Address: Permit Number: C) Q
Legal Description teOA 04/k t�,A.k 0�e_ RE#
Valuation of Work(Replacement Cost)$ Heated/Cooled SF Z-300 Non-Heated/Cooled 25�
• ClassofWork: ONew ElAddition 2/Alteration [Aepair ElMove E]Demo DPool ElWindow/Door
• Use of existing/proposed structure(s): ElCommercial 211esidential
• If an existing structure,is a fire sprinkler system installed?: Dyes EZo
• Will tree(s)be removed in association with proposed project? Dyes(must subf ,it separate Tree Removal Permit) 2<0
5crib,i in detail the type of work to be performed: '1"A&JO I— Hal bctA
[+e.
Florida Product Approval for multiple products use product approval form
PropertM Owner Information
Name- W-111CI&I tvNkx�4 Address I[�,_tlt�V, kL 111 (f
City �-1 (&2 -JA State (7L,- zip 3-Z-2-3 Phom�
E-Mail
Owner )r Agent(if Agent,Power of Attorney or Agency Letter Required)
Contmi-tor Information
Name of Company 11A.� L_ Qualifying Agent
I
Address City A4-6,vV(C.� -Ck State T-�- zip �3
OfficePione ',qyt1' 5'0f 4 '� Y 2- Job Site Contact Number
State Cprtificatior�/Registration# k!�k60% E-Mail r i V -^dl.3 Q4 fyk""k -C� YVI\
Architect Name&Phone# ry
Engineor's Name&Phone#
Workei s Compensation Insurer OR Exempt a Expiration Date Z,? L,>2�Z)
Applicz�tion is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installatiorlWs
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulati Q
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS co
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WELLS,POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements o i 1 0 V�
95 1 �
permit,1!iere may be additional restrictions applicable to this property that may be found in the public records of this county,4W < 0 t=
there may be additional permits required from other governmental entities such as water management districts,state agencie4rui ;Z in
feclerE'�gencies. ca Z 9
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OWNEPS AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with alLIJ 4
applicable laws regulating construction and zoning. Z M
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WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
10 i�
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RESU13 IN YOUR PAYING TWICE FOR IMPROVEMENTSTO YOUR PROPERTY. IFYOU INTET�.' 2UJ
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TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE W W
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RECQRDI I a LU M 0
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(Signature of Owner or Agent) (SMil/ature of Contractor) E
Si edtand sworn to a;ffikrmbefor ine dfyof S gne and sworn to(or aff r �dL bef rn�this day 10 M
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(Signature of Notary TONI GIU1 LESPERGE.R
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C;"-' MISSION#FF924951
d EXPIRES:October 6,2019
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Type of Identification: % A Type of Identification:
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NOTICE OF COMMENCEMEMOFFICE COPY
(PREPARE IN DUPLICATE)
PermitNo. REIS/ Tax Folio No. 9 ye,_?- 6e,2.6
State of County of pilvd-f
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: ZC4 6e ean 6--10-IA-- Z�11 14 OA
"Se C C,
Address of property being improved:
r,'c(�7--3 L 2 3 3
General description of improvements: �gcce tj d,,,l t4c,(( 6,A fe4,;,�Je_j
Owner ,j i Ito C-c-
Address �?-,;_IJ, Li,,L_� k"IAS 6�, 5
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Owner's interest in site of the improvement ;ree-
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor V1-1(0,
Address 7R---44_ 6e-c-4
Phone No. Fax No.
Surety (if any)
Address Amount of bond $
Phone 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 1411 4L
Address
Phone 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 Statutes. (Fill in at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement (the expiration date is one (1) yearfrorn the dbite of recording unless a
different date is specified): EX�-
THIS SPACE FOR RECORDER'S USE ONLY WNER
Signed: 4�h ?�, 1�11Z��/-,,p
I�/_ DATE,?�l
Before m-7e-this in 4th
L_a day of
County of Duval,State of Flori nally appe�red
t , (v a -_--here"
Doc#20191664337,OR BK I a86e Page 1829, him9ilf/6e ec1f and affirms that I statement8-and`de':C'fi"'_
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Number Pages!I arE.tru curate 094 51
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Recorded 07/17/2019 11:06 AM, Xpi r
K CIRCUIT COURT DUVAL
RONNIE FUSSELL CLER
COUNTY
RECORDING $10-00
3, of _(291ty of
My commission expires:
Personally Known or
Produced Identification W/t 2 0-'7:�4- - 9 e--7- (-73