2233 Seminole Rd RES19-0254 Int Renovation YS�1.lr3�, RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
RES19-0254
-
800 SEMINOLE ROAD ISSUED: 8/27/2019
2/23/2020
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION • • + 1 i . BY 4 PM FOR • •
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' i BUILDING
CODE, ' OF • OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE
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:
2233 SEMINOLE RD UNIT 9 RESIDENTIAL ALTERATION INTERIOR RENOVATION $10000.00
RESIDENTIAL
TYPE OF
ZONING: :D •
• • GROUP:
169519 0118 OCEAN VILLAGE ONE
CONDO
•
ADDRESS: CITY: STATE: ZIP:
BOSCO BUILDING 2158 MAYPORT RD ATLANTIC BEACH FL 32233
CONTRACTORS
• ADDRESS: CITY: STATE: ZIP:
PETWAY BRETTE 1535 UPLAND AVE BOULDER CO 80304
ELIZABETH TRUST
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.
,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 4S5-0000-322-1000 0 $105.00
BUILDING PLAN CHECK 45S-0000-322-1001 0 $52.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $236
Issued Date: 8/27/2019 1 of 2
RESIDENTIAL PERMIT PERMIT NUMBER
r S RES19-0254
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 8/27/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 2/23/2020
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $161.86
Issued Date:8/27/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road �J i Q
J
�. Atlantic Beach, Florida 32233-5445 I lJ
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 2 Z33 JE in FA-)0j_L Department review required Ye No
Buildin
Applicant: OSC`• O lV kL-CI -D ('' Planning &Zoning
r
Tree Administrator
Project: N o P_1 0j%` 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 B
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: ❑Approved. ®Denied. ❑Not applicable
(Circle one.) Comments:
(EDG
PLANNING &ZONING
Reviewed by: Date: P-16-19
TREE ADMIN. Second Review: Approved as revised. ❑Denie . ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES (�
PUBLIC SAFETY Reviewed by: Date: d ' 7
FIRE SERVICES Third Review: ❑Approved as revised. ❑De ed. []Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
OFFICE COPY
Revision Request/Correction to Comments **HIGHLIALL HIGHLIGHTED
IN 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#: /� / " o2SI
❑ Revision to Issued Permit OR 1 Corrections to Comments Date: �p
Project Address:
Contractor/Contact Name: ,a�dCO /y1 U�C� � ��iY��aecTatLS i'�G
Contact Phone: gCI c 0 3 2° Email: `1�UQ�C6 CZC• C°M
Description of Proposed Revision/Corrections:
Z dA/
1 /040 !'4 da,JC0 affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Will proposed revision/corrections add additional square footage to original submittal?
F]No ❑ Yes (additional s.f.to be added: )
'•`Will proposed revision/corrections add additional increase in buildiDKvalue to original submittal?
E No ❑*Yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
�� (Office Use Only)
[9-Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Pue$
i,
Revision/Plan Review Comments
De ent Review Required:
Building
a ning&Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services Updated 10/17/18
• � � ��S y rj J�
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
(904) 247-5800
BUILDING REVIEW COMMENTS
Date: 8/16/2019
Permit#: RES19-0254 Site Address: 2233 SEMINOLE RD UNIT 9
Review Status: denied REM 169519 0118
Applicant: BOSCO BUILDING CONTRACTORS _ Property Owner: PETWAY BRETTE ELIZABETH TRUST
Email: TODD@BOSCOCBC.COM Email:
Phone: 9042410320 Phone:
9044228060
THIS REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS.
Revisions may not be submitted until ALL departments have completed their respective reviews.
Revisions submitted MUST respond to EACH department review. Submittals that respond to only one or a
few correction items will not be accepted.
Correction Comments:
1. Expound on the interior renovations.
-T
2. If any floor plan changes are to take place, please submit the existing as well as the proposed. 2 copies.
Building
Mike Jones
Building Inspector/Plans Examiner
City of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233
(904) 247-5844
Email:mjones@coab.us
em 0 j l-P fl C v m rn P✓l
Resubmittal Notes:
All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a revision by way of
completely encircling the change with "clouding".The revision shall also be identified as to the sequence of revision by
indicating a triangle with the revision sequence number within it and located adjacent to the cloud.The revision date
and revision sequence number shall also be indicated in a conspicuous location in the title block for each sheet on which
a revision for that sequence occurs. For projects still in the initial review stage and permit pending, all sheets with
revisions shall be inserted into each set of drawings.The original sheets must be clearly marked "VOID" but are to be left
within the set of drawings. Complete new sets of drawings will not be accepted. ADDITIONAL ITEMS MAY BE REQUIRED
DEPENDING UPON NEW INFORMATION AND CLARITY OF FINAL PLANS SUBMITTED FOR REVIEW.
VLA..an..15 I %.l 1119L !"1t./t.J..L.G.L.V.. upaa[eaw/V/16
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Fax: (904) 247-5845 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 2 02 3 Sir'L(�/11j�E' q Permit Number: IR
Legal Description 7S--a ��nnQClela�l/Vi //�� 04/ CVIVP - � RE# ��0 / ��9
Valuation of Work(Replacement Cost)$ 1mCyA�� g� Heated/Cooled SF r 94# Non-Heated/Cooled
• Class of Work: ❑New ❑Addition XAlteration ❑Repair OMove ❑Demo ❑Pool OWindow/Door
• Use of existing/proposed structure(s): QCommercial [Z]Residential OFFICE COP
• If an existing structure, is afire sprinkler system installed?: QYes ✓]No Y
• Will trees be removed in association with proposed project?—]Yes must submit separate Tree Removal Permit No
Describe in detail the type of work to be performed: , `Z—� ['i✓d I/�+1/d�✓ ���^�r C ii✓F7U
/�Efueer,4CE- F�oortS ! I�A`i�� ,t1o�rf�c� �vFW ,Or4�lf FiX/'�Ff /�✓6cr�s.— /s..oTif
,3"C2apc CerAL l,1
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Pe• W119y 5Re r/_1 17V14 >='TN Address ��35� U,0J1,q y 1�V•f:'
City &tl]_0 eik I State 0 0 Zip ffP30 4- Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) n/a
Contractor Information
Name of Company ff eSCO )3o/,4p/1V,7' COW�/jG7 ual fying Agent I '�P0
Address 9,1,"-g City ;3—&)<�41V V /?tate f L Zip 321 3�
Office Phone 1 d:!h^ )-f-1 - a s Job Site Contact Number 9 ai-- a,3 3- .0 jc f
State Certification/Registration# 11X1_d J4/ _ E-Mail r.0!)0 Pi h®pc:0 Cr3C• Crib
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer �t5AP,J 1T�F= ly r4lY.yrl OR Exempt❑ Expiration Date
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: 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.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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 LENDER OR AN R EY BEFORE
RECORDINO O F COMMENCEMENT.
(Signature of Owner or ent) (Signature of Contractor)
Signed and sworn to (or affirmed) beforemethis day of 'gnneedl�and sworn to (or affirmed) before me this Ai_day of
by Ct 1 G A�7_0 I!IJ by
(Signa�*bre of j (Si NPL rnMs
U9r ISO knr> NO ARY PUBLIC
NOTARY PUBLIC STATE OF FLORIDA
STATE OF FLORIDA Comm#FF966426
�[.�Personally Known OR *Expires
CarrwrW FF966426 �[•,)Personally Known OR •,4 1�0
( I Produced Identification [ i Produced Identification Expires 3/1/2020
Type of Identification:_ _—_— 3/1/2020_ Type of Identification:
NOTICE OF COMMENCEMENT OFFICE COPY
fit A, - �E_V11-easy
State of Tax Folio No.
County of 19 i t ✓4�--
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: 0 L
c9 c e gly ✓l llr$ b 1, t3��_ - G d'N/�a /�i.✓G�c INS u,�� T 9 0�✓' f j� G�sl -i S- �
Address of property being improved:
General description of improvements: 4/'7- ed 10 d Xt 6',1,10 L'1-61 ?�
Owner: �G7Te /-C"i` offfAddress:_J5"3r W/?4-411-1) 1�zve-
Owner's interest in site of the improvement: E?`/(,�e
Fee Simple Titleholder(if other than owner):
Name: ---
Contractor: C 0 13 Ut r '1-_V c cw7-41/ c-R tc f-i 1`11/6-
Address: a 5-l /M- Il D • "_ ��/� /�S�1,t/1i�%/e i ri, - }3 3
Telephone No.: Fax No: +1 6
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: A� Date:B �4
Before me this day of 6WV V SiO in the County of Duval,State
Of Florida,has personally appeared
Notary Public at Large,State of Florida,County of Duval.
My commission expires:
Personally Known: *4 r Denise A.Ennis or
Doc#201 91 891 82,OR SK 18898 Page 1667, Produced Identification: NOTARY PUBLIC
Number Pages:1 STATE OF FLORIDA
Recorded 08/14/2019 11:21 AM, Camra#FF9W426
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Yrs*E 14 Expires 3!1/2020
COUNTY
RECORDING $10.00