93 Kimberly Ct res19-0263 Win/Door rSrL''; RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0263
800 SEMINOLE ROAD
ISSUED: 9/18/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 3/16/2020
MUST CALL
INSPECTION
• • • (904) 247-5814 BY 4
• 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 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:
93 KIMBERLY CT RESIDENTIAL ALTERATION WINDOWS AND DOORS $14781.00
RESIDENTIAL
TYPE OF . BUILDING
ZONING: : ! •
• iGROUP:
169519 0785 TIFFANY BY THE SEA
COMPANY: ADDRESS:
Bluewave Builders Inc. 822 A1A North # 310 Ponte Vedra FL 32082
• + D! • ` '
DOMINICK ESMOND 93 KIMBERLY CT ATLANTIC BEACH FL 32233
LESTER III
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 $125.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $62.50
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.81
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
TOTAL: $192.31
Issued Date:9/18/2019 1 of 2
RESIDENTIAL PERMIT PERMIT NUMBER
' CITY OF ATLANTIC BEACH RES19-0263
800 SEMINOLE ROAD
ISSUED: 9/18/2019
EXPIRES: 3/16/2020
ATLANTIC BEACH, FL 32233
Issued Date: 9/18/2019 2 of 2
1 :Ly; City of Atlantic Beach APPLICATION NUMBER
0 Building Department (To be assigned by the Building Department.)
800 Seminole Road REsL9
_ OzG `�
J
,3 �. Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
COM )r E-mail: building-dept@coab.us Date routed: EEd Z,C'
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 K l f\kL�C�(_ Department review required Ye No
� " � uilding
Applicant: e)LU E Vl�(,Vl= 13 o( L6`�-(�S Zoning
Tree Administrator
Project: \` ( IU w iz5 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:
APPLI ATION STATUS
Reviewing Department First Review: Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: [—]Approved as revised. ❑Denie . ❑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
f� City of Atlantic Beach Building Department "ALL INFORMATION
V 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
•,..,i Jri 9y
Phone: (904) 247-5826 Email: Building-Dept@coab.us 15 REQUIRED.
Job Address: Ilir7z
, 4f,7-
ti m . .c- 1 e4 C p r Permit Number:
h
Legal Description [
Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New []Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool M�Vindow/Door
• Use of existing/proposed structure(s): ❑Commercial {Residential /
• If an existing structure, is a fire sprinkler system installed?: El Yes 0
• Will trees be removed in association with proposed ro'ect? ❑Yes must submit separate Tree Removal Permit o
Describe in detail the type of work to be performed: Ke"Ce l"Ap WNW PND DWA'
,;41 Florida Product Approval# Z for multiple products use product approval form
Property Owner Information I
Name E�-,gign cJ 1—e`, C' DC r,m n. t Address q' 9 r r Z
City _�� State I--/- Zip 3ZZ A 3 Phone D
E-Mail L
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information �/ ��,,tt'' t's'
Name of Company � /A/0" Quali in A ent f "w"
Address 5M.L fiwff ft Q CityVeVgft 6" a Zip .320
Office Phone—vLf swr03cl 6 Job Site Contact
3Number
State Certification/Registration# G E-Mail �fs4•v . CO
Architect Name&Phone#
Engineers Name&Phone# all
Workers Compensation Insurer ( 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 installatihasJ Z
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulaJ395
t p
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIG =O E
WELLS,POOLS, FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements F 0 �j
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county n V O
there may be additional permits required from other governmental entities such as water management districts,state agent*, t
federal agencies. O
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with$ S
applicable laws regulating construction and zoning. cc `
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMM EN EMENT MA U-
O
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPOWY. IF YOU INT _
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A O
RECO ING U OTIC F COMMENCEMENT.
If%01 421 VLEI Cr
i u p.,cOwn A n ) ( ' atu <f Contractor)
Signed and sworn to(or affirmed)before me this day of Signed and sworn toior affir d)before me thi9�day of
b by
fir": *� ge MiIIYYARr (Signature of No ry
MYC0WMWNW0FFln4Gsl Cynthia Young
y t'.z ARES MAmh M,2020
�/ rr a&
[ ]Personally Known 0 • `p &X"ThiuNa6tu�rN*unowm6m [Personally Known OR �'�� , Notary Public
dProduced Identificati �_� " !/ f ]Produced Identificatio . StO Of Florida
Type of Identification:�itari (Ar�,co� L7��Rilc54 Type of Identification: /05/2020
nrrb
Commission No,36480
NOTICE OF COMMENCEMENT Q
State of FLOPDKTax Folio No. I�y���—I - 0 70 J
County of 06L
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 uCOMMENC ENT. n
Legal Description of property being improved: 6-g4 10 - -`y2 �2-1 'r( 7 M T1f6 SO
Address of property being improved: t l:� ,`�G�1 t3 C�
P,� 1 V j
General description of improvements: 1.K• M� wWS
Owner: L e-S�"��' ��ry) �t C �L Address: 4 .3 e, ;r1b eC,
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor:_ IJC ��r,� an '•-/�LNS C /�Q ,�( /( �,, _
Address: 2� Ndl��t �t Swt7'� -310. AoTe •„ �`s t"-�. FL 31�_�i
Telephone No.: _d.'t b a 39 5 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 '
Doc#2010199854,OR BK 18012 Page 2478, Signed:— Date: go
Number Pages: 1 Before me this 22-Ad day of ZOe; in the County of Duval,State
Recorded 08/27/2019 11:07 AM, Of Florida,has personally appeared L. —" __
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of Florida,County of Duval-
COUNTY My commission expires: ST12HENp SWARF i
RECORDING $10.00 t
Personally Known: '�' h!YCOJ✓h!LSSfONiF§i97441
Produced Identification: EX0SESJWch24.MQ
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