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332 Seminole Rd RES19-0284 One Door r�'A.' RESIDENTIAL PERMIT PERMIT NUMBER �, .---- r, CITY OF ATLANTIC BEACH RES19-0284 �r ISSUED: 10/4/2019 800 SEMINOLE ROAD �``�°rs1>" ATLANTIC BEACH. FL 32233 EXPIRES: 4/1/2020 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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 332 SEMINOLE RD RESIDENTIAL ALTERATION ONE DOOR $5800.00 RESIDENTIAL TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170431 0015 SALTAIR SEC 02 COMPANY: ADDRESS: CITY: STATE: ZIP: HOMERITE WINDOWS AND DOORS 4801 Executive Park CT N JACKSONVILLE FL 32216 • OWNER: ADDRESS: i CITY: STATE: ZIP: BUSSEY JULIE A 332 SEMINOLE RD 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. 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 $80.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $40.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2 00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $124.00 Issued Date: 10/4/2019 1 of 2 - t'`'''' RESIDENTIAL PERMIT PERMIT NUMBER r �s � � CITY OF ATLANTIC BEACH RES19-0284 ." 111,1— ISSUED: 10/4/2019 800 SEMINOLE ROAD "r 13 WI' ATLANTIC BEACH. FL 32233 EXPIRES:4/1/2020 Issued Date: 10/4/2019 2 of 2 r 1�.Uyrr, City of Atlantic Beach APPLICATION NUMBER "w4.-:-., Building Department (To be assigned by the Building Department.) 800 Seminole Road E�� _ /� Q/1 ,�.k , Atlantic Beach, Florida 32233-5445 �J L J'"T- \ Phone(904)247-5826 Fax(904)247-5845 (� /2-3 / lQ\`o;; �T E-mail: building-dept@coab.us Date routed: `-1 c City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 33 S Ern,l 11.)0 L C De nt review required Ye : No uildin � Applicant: L4 o - 2l R t(J L&)c o c.. Panning &Zoning Tree Administrator Project: CD IND e coP___. 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: roved. [1]Denied. ❑Not applicable (Circle one.) Comments: BUILDIN4 PLANNING &ZONING Reviewed by: Date:/0 _c2 i9 TREE ADMIN. Second Review: ['Approved as revised. ❑Den d. ❑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 Ur�lUt UUNY rs-'''-'-i4; 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 AI,.11,�;. IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: 33- Se is d/'P 120 Ct,cl. Permit Number: R.-s( 9 07,84 Legal Description /O•- /S /‘-2.5 -111E/ SCC .2 54/ /fj Ze I-'�S RE# / 7ey-3/ do/S Valuation of Work(Replacement Cost)$ C-8.06' ' Heated/Cooled SF /o24.''7 Non- -H \�//Heated/Cooled • Class of Work: ❑New ❑Addition DAlteration ❑Repair ❑Move ❑Demo ❑Pool E r ndotz CEJ NEE • Use of existing/proposed structure(s): ❑Commercial ❑Residential • Ij • If an existing structure,is a fire sprinkler system installed?: - ❑Yes ❑No • Will tree(s)be removed in association with proposed project? DYes(must submit separate Tree Removal Pre tit)' DNo?019 4Z)."•. Describe in detail the type of work to be performed: L,� C9 E (BOG g., LU ` - - .. .. OFlorida Product Approval# F F . o�S��• 9 for multiple product�'i pr t ttim dc1Bral Q1, Fl Property Owner Information CL�1 CL W C) Name ftu5SeS i " A Address T3•L 5c` male A Ui - 0 a City / Na✓L f�iG �tcs c `( State �L Zip 3 1� Phone l�dG/, �.TA. 02 0 0 0 0 E-Mail dUSSC�jL1 e-,Q4,t..4 V. COfl4 w_4-_-_� 0 Owner or Agent(If/Agent,Power o1�Attorney or Agency Letter Required) — Z-•�Z Q Contractor Information n� f�0 ;J LL U) Name of Company �O(. /Ne 14/0.,dd�45/ 0 /3Qualifying Agent Al :-/�'t d4 Ll, /� tZ Address L/R / s.GU f/tl1 irrk.-G� SJRG.)Ocity J eA.a•1✓%s State �L. Zip 3c?-t �i 2 I a Office Phone %'oy. nt•41(e r 4,44--P? Job Site Contact Number j To 1. Wile,-7o 0 0 'a la m State Certification/Registration tie' Ash a7017 E-Mail afGFeO� tri k-Id GO/Y/ .- I w a 0 Architect Name&Phone# 4/1/ W (,) Cl) w Engineer's Name&Phone# � 5.w. u! Workers Compensation Insurer OR Exempt o Expiration Date W W Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installaon has cc 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 ATTORNEY BEFORE REC 0 I i YO NOTICE OF COMMENCEMENT.DiviA . _ gp a , .--)_-__ • / (Signature of Ownerkit)or (Signature of Contractor) Signed alsworn to(or affirmed)before me thi day of Sign d and sworn to(or affirmed)before me this , day of 71 by e. 4 e.5v , 2.011 ,by f� _ � fi I_AI / _ _ w.� - signature of otary) i_n:t r�u��0�Florida R ehmrd O.Walden 1: 0^1� My Qomm�eelan GG 247920 NctarY public State of Florida wl� Expires 1210812022 personally Known OR �0 Richard 0.Walden [ ]Personally Known 0• [ ]Produced Identification • My Commission GG 247920 ( roduced Identificati. f Expues 1210812022 Type of Identification: Type of Identification: 0 NOTICE OF COMMENCEMENT OFFICE COPY c (PREPARE IN DUPLICATE) Permit No. ge J t/Q--dd f G// Tax Folio No. /7(94/3I 461/S State of Florida County of Duval 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. Q Legal description of property being improved: fid-/s— /6- oZS ^ a (n- $mac sq./f« ,y 44,t- dab Address of property being improved: ,5eN.t mei/e General description of improvements: Replacing windows doors. Size for size. Owner i vs.S t y ,ruI;t 4 Address r.)-.), f 4it,rno IG 4dad /`Li//01,4/ / •w 4, CG 3'1.113 Owner's interest in site of the improvement Primary residence Fee Simple Titleholder(if other than owner) Name Address Contractor Homerite Windows and Doors Address 4801 Executive Park Court Bldg.200 Suite 200 Jacksonville,FL 32216 Phone No.904-296-2515 Fax No.904-296-2528 Surety(if any) Address Amount of bond$ 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 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)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY �O NER Signed /Ali / 2 ')—DAT in the I Before 4 day of un of! I, tate f personallyappeared Doc#2019219632,CR BK 18941 Page 1132 -i l herein by f �a� vnselU herself and affirms that all stateme• and declarations here/ • Number Pages: 1 are true and accurate Noury PuCliO State at Florida Recorded 09/23/2019 01:55 PM, 4°611440 Richard 0.waiden RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL r My Commiaslon GG 247920 COUNTY :/ �� a Expires 1210512027 RECORDING $10.00 �� Notary Public at Large,Stet- .1 ,V.�E� ,County o My commission exlres� P7L Personally Known ✓ or Produced Identification 0L