349 3rd St RES19-0232 Kitchen/Bath Remodel (Unit 351) I-VI PERMIT NUMBER
RESIDENTIAL PERMIT
RES19-0232
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 8/1/2019
ATLANTIC BEACH. FIL 32233 EXPIRES: 1/28/2020
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, 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
349 3RD ST RESIDENTIAL ALTERATION KITCHEN & BATH REMODEL- $35000.00
RESIDENTIAL DUPLEX UNIT 351
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1698230000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
HOM SPACE 116 13TH AVE N ATLANTIC BEACH FL 32233
OWNER: ADDRESS: CITY: STATE: ZIP:
HOFFMAN DAVID A 349 3RD 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. 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 $230.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $11S.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $S.18
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.4S
TOTAL: $353.63
Issued Date: 8/1/2019 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-A
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes-,'-No-
auildi
Applicant: _1715-ffin-lng &Zoning
Tree Administrator
Project: 1"\/ C-(c:--P-.�) Public Works
Public Utilities
&-fyy 0 C)E 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: [�Kpproved. ElDenied. ONot applicable
(Circle one.) Comments:
E�3)
PLANNING &ZONING Reviewed by: Date: 7,
003
TREE ADMIN. Second Review: F L/ -]Not applicable
]Approved as revised. ODenied. F
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. []Denied. F]Not applicable
Comments:
Reviewed by: Date:
Revised 05/1912017
Building Permit Application OFFICE COPY Updated 1019118
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Buil Wu IS REQUIRED.
U
Job Address: Th;ej S _--�-P(e�`rmjlt N m)h e r:
Legal Description 5-0 i6-2_S-21CAIIJ&�. Ez�-r-nl , L,422,9 REtt 14;tj�!213—0 NO
Valuation of Work(Replacement Cost)$ '9�,,4WQ oodd SF Non-Heated/Cooled
V LLJ
• ClassofWork: E]New DAddition /Alteration DRepair 01VIove ODemo OPool 4( indow/Doo.r
• Use of existing/proposed structure(s): ElCommercial iResidential Z
r _J Z N,
• If an existing structure, is a fire sprinkler system installed?: E]Yes -/No Z< 0
0.
• Will tree(s) be removed in association with proposed project? E]Yes(must submit separate Tree Removal Permit) F99N
U
[escribe in detail the type of work to be performed: .��QA awj New HVAC— k
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0 ;i� e_�
Florida Product Approval# ?4�5 VlAyl 50 ::0! 1-7(:�,1(,-, 1 —for multiple products use product approaR n4L
PropertV Owner Information cc Z
N 4 2 413 'S 0 uJ
anne Address LL
Zip !3 Phone
Cit, State U W
iu— >. LL CC
E-Mailci�,J . (P- a M
Owner or Agent(If Agent, Power of Attorney o5r'Agency Letter Required) 0 W
W
Contractor Information > W
Name of Company 110 hA 5 PA6-- Y1%1�_ Qualifying Agent
Address 11C, 134 AV Q, City ]J�
$�k State Zip
461 Job Site Contact Number'
Office Phone qO+ 14:7 Z '�Z6 q
State Certification/Registration#e--W-A 7-641'51 E-Mail
Architect Name&Phone# V
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt V(Ex,ir OZ20
Application is hereby made to obtain a permit to do the work and installations as indicated.I cert a or i
z I Pf"
ifi x "D
commenced prior to the issuance of a permit and that all work will be performed to meet the sta i ar s o all e e la
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES,BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. 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 recoJULf t2i2co2ofo and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
uIldino
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will nein co pQPR4F#Wnt
applicable laws regulating construction and zoning. 4c 0 Atlantic Beach, FL
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LEND OR AN, A170 NEY OR
RECORDI 0 CE OF COMMENCEMENT.ND JA 0
_(S�'naturE�of owner or Agent) (Signat!!IC�.ntac Or//
Ig V
Signed and sworn to(or affirmed)before me this N day of g�necl and sworn to(or affirmed)before me this day of
ZDIL� by -bgA6, �..�kuJ,(AAPV\ W
< �A
06nSt�re of Notary)
_LSii�naturjoLNQLa'
AUTUMN E mCDONALD
Notary Public-State of Florida
a
9 1
SHANNON FAR ;16
Personally Kno L-1 LING SCOTT Personally Know' Commission 4 GG 309691
wn OR
'0
Produced Identificaltion .... COMMISSIN#GG 265884 Produced Identiii 4 y Co Mar 10,2023
!xplres October 28,2022
e of Identificati
Type of Identification: ype of Identificati
I—ded Tlo.Ticy FaIn Insumm WWII&
OFFICE-COPY
NOTICE OF COMMENCEMENT
State of 106 jl� Tax Folio No.
County of
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:1-5 — G-1
L6:� 2-n L_44- Z7- S)
Address of property being improved: S51 7Ti,Ird S1llyQ_4- h�j&�x�j& Se", r7L-
_e!�!
General description of improvements: K=I"PA 0AIJ 6A* r 43� j 14)
Xk4rocc IlAkb". Jrtbm , Wi
0 n e r: -2Z3.
W J i -A A, 4�"_ Address: A&t\ ic,
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: e)144 !!S Joe,/r.- I C_ 6)!�; Wj' i e, 4A- W-Jes I P-L
V- f, Zil
Address: 13+-1- Ave, N. -:?=5_0
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 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
Signed: Date: ?//7/11
Doc#2019170432,OR BK 18872 Page 1056,
Number Pages: 1 Before me this day of JAN Z00 in the County of Duval,State
Recorded 07/22/2019 02:46 PM, Of Florida,has personally appeared -DA\fi A . Ik4wLt-
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of Florida,County of Duval.
COUNTY My commission expires: I C1 -j�2-
RECORDING $10.00 Personally Known:
Produced Id tion: SHANNON FARLING
COMMISS on"
EXPIres October 28,2022
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