1969 Brista De Mar Cir RES19-0257 Int Renovation RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0257
v� 800 SEMINOLE ROAD ISSUED: 8/19/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 2/15/2020
MUST CALL INSPECTION ' • (9 04) 247-5814 BY 4 PM FOR NEXT DAY ' •
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL • • • OF PERMITAPPLY, PLEASE READ + .
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:
1969 BRISTA DE MAR CIR RESIDENTIAL ALTERATION INTERIOR RENOVATION $29643.00
RESIDENTIAL
TYPE OF •
• • GROUP:
169506 1670 SELVA NORTE UNIT 02
COMPANY: ADDRESS:
LAMMLE CONSTRUCTION 1827 AZALEA DR JACKSONVILLE FL 32250
INC BEACH
• ADDRESS:
KANE PHILIP B 1969 BRISTA DE MAR CIR ATLANTIC BEACH FL 32233-4525
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 • . •
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 4SS-0000-322-1000 0 $200.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $100.00
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $4.50
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.00
TOTAL: $307.50
Issued Date: 8/19/2019 1 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
j800 Seminole Road jj Q
Atlantic Beach, Florida 32233-5445 4� C�S� 1D e_S7
Phone(904)247-5826 Fax(904)247-5845
s);� E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: l -I(oq 6 KILSTA J E Department review required Yes o
Building .'
Applicant: 11�a �' m L L Co ( Planning &Zoning
Tree Administrator
Project: I fy �{��Q (� ��C> 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: PApproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING Reviewed by: Date: P-16-19-
4
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.cf ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit Application Updated 10/9/18
OFFICE COPY
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: NO 13VIS46L Oe Nlu.✓ r_.71Z Permit Number: E_s- i 9 Oz CJ
Legal Description 40-3704) - 1.5" - 1.61 Z 1,af90 RE#f(,q.;'06- /670
Valuation of Work(Replacement Cost)$ ���(3, Heated/Cooled SF 133 Non-Heated/Cooled
• Class of Work: ❑New ❑Addition HAlteration kfiepair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial residential
• If an existing structure,is a fire sprinkler system installed?: Dyes 19'�lo
• Will trees be removed in association with proposedproject? [--]Yes must submit separate Tree Removal Permit 911-0--,
Describe in detail the type of work to be performed: (t plaoti Kihtti Gabwel3 ct.vcl Cofwl�CvJ��C, J�,�lo�/
1 S 1(tti11 Cab lk" , V p d a*'< r t+CIA0„ c(t of vi cal i(/r�r /f fc l+� "V4 C4t4114-c-) kr--" r/uoilr-t-y
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name P6 i 419 r3i hoL.Ve-1 T Address 1%cl %wsha OP, ,^A� r-i(r
city4fi11,,hc 13tac�, State Zip 31.233 Phone Cloti— 571-77-3 Z
E-Mail_k_hcl•tiK It 3 0 a mot) eo�►-�
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information n /
Name of Company Lh,4Mk CO.G VVL'�7o� ���G Qualifying Agent_/[abe1 4.u.wIt
Address 1?27 A2.a. f'ta IDvivo City_at,Chso4,v►14 13,eacN State FL Zip 3 ZZ.C-O
Office Phone q04 3Fr6- 6395' Job Site Contact Number CI0y-3k6-63kr '
State Certification/Registration# G QC O t-G •L3 L E-Mail /G,um/c C,0 4.,sf"ct,,6,y Q r-o44 cc sf,
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer JS-/rA.1d F4 VM OR Exempt❑ Expiration Date 6$ d/ Z01 b
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating
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 71! aU4121 "t84UgW4QY0J()his
permit,there may be additional restrictions applicable to this property that may be found in the WiggdbEf 63pp"and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will bed&@ 0Arbpls&AX with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A OF C
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS OIYOUR P1 ��
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC R G YOUR NOTICE OF COMMENCEMENT.
9� Ji
_-
(Signature of wner or Agent) (Signature of Contractor)
S' ned and sworn to Aa (
fore me this day of Signed and sworn to(or affirmed)before me this`7day of
U - 2� r F- - A-�f- u v%4 g by o�a� A L
ar o N to )
1�Y°�e`• ALBERT MORENO j4'�r Poti Notary Public State of Florida
' Dennis A van Deusen
Notary Public-State of Florida e` My Commission GG 106041
;� o-e` Commission�GG 304875 [ ]Personally Known OR SOF F"°4 Expires 06/14/2021
[ ]Personally Kno OR '�oF Fti°•' My Comm.Expires Jun 9,2023
[}Produced Identific tion Bonded through National Notary Assn. [produced Identification
Type of IdentificationType of Identification: L-
NOTICE OF COMMENCEMENT
/— p �e �IY7, 7� �/zEs/g-00' q__2
State of f- /otr ic& Tax Folio No.
County of PV Vw4
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: L{Q —3 7 00l—"L5'- 2 cl Ic. ,se.Jua /(J.trFe Utitii 2 tot- 90
Address of property being improved: I C1 91 I3 V'i SfU De *ja.li Ci,,-
General
1„-General description of improvements: R-olo” 1Cikh•tit, C_m6w,-Ch d- Go" fv IvIes,
Owner, t' Yl I It p �3 Q ����hl n , Address: (q 6_9_13 VlSfu 0-t McLt, C jL,
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name: _
Contractor: L&44,41--
Address:-11?-Z-'7
01.44,41 Address: 1g"Z'7 A-zmlca Qyive TachSomi k (3f,,,lk F'L 3 2z5'O
Telephone No.: y(gN -3 9'(► '�O 3 ffG 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: V
Before me Jhis 1 • day of G 7o 0 in the County of Duva,State
Of Florida,has personally appeared 141,f�= K A..,E
Notary Public at Large,Stat' of Florida, un o u al.
My commission expires:D(,
oe,l
Personally Known: :'�*"Y°Oe`._ A Ria
Produced Identification: 1TV <
My Comm.Expires Jun 9,2023
Bonded through National Notary Assn.
Construction site management plan. OFFICE COPY
Kane Job
1969 Brista De Mar Cir
Atlantic Beach FL 32233
1. All parking will occur on owners driveway. Street parking is not needed.
2. Material handling and storage will occur in owners driveway and garage.
3. Owner has given access and permission to garage bathroom.
4. All debris will be hauled away each day by work vehicle.
5. Traffic control will not be needed.
Robert Lammle
Lammle Construction, Inc.