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1825 Live Oak Ln RES19-0315 Bathroom Remodel RESIDENTIAL PERMIT PERMIT NUMBER ' 'fr RES19-0315 CITY OF ATLANTIC BEACH \Y 800 SEMINOLE ROAD ISSUED: 10/23/2019 ATLANTIC BEACH. FL 32233 EXPIRES:4/20/2020 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: 1825 LIVE OAK LN RESIDENTIAL ALTERATION BATHROOM REMODEL $23642.00 RESIDENTIAL TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 172020 0738 SELVA MARINA UNIT 10A COMPANY: ADDRESS: CITY: STATE: ZIP: HAGERTY CONSTRUCTION 12850 WINTHROP COVE DR JACKSONVILLE FL 32224 AND ROOFING INC OWNER: ADDRESS: CITY: STATE: ZIP: PENDLETON RONALD L 1825 LIVE OAK LN ATLANTIC BEACH FL 32233-4509 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 $170.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $85.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.83 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.55 Issued Date 10/23/2019 1 of 2 ,;,)....,\A-5,,,, RESIDENTIAL PERMIT PERMIT NUMBER I . 1-- CITY OF ATLANTIC BEACH RES19-0315 ,itsiISSUED: 10/23/2019 � r';, _ 800 SEMINOLE ROAD EXPIRES:4/20/2020 ATLANTIC BEACH. FL 32233 TOTAL: $261.38 Issued Date: 10/23/2019 2 of 2 rt.:vir. City of Atlantic Beach APPLICATION NUMBER co Building Department (To be assigned by the Building Department.) • 800 Seminole Road R Es t - 03 i S Atlantic Beach, Florida 32233-5445 1v Phone(904)247-5826 • Fax(904)247-5845 4 E-mail: building-dept@coab.us Date routed: 0/1 / 1 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I BZ,S L(VC OR_ L D ent review i ew required YeNo ldin 411 Applicant: A C� ( OSSl &Zoning Tree Administrator Project: SPk f 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 k Florida Dept. of Transportation ��/,01 St. Johns River Water Management District \./\- `\ Army Corps of Engineers V Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Kpproved. ['Denied. ['Not applicable (Circle one.) Comments: BUILDIN PLANNING &ZONING Reviewed by: Date: /0'd/-a019 TREE ADMIN. Second Review: Approved as revised. ❑Denie . ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: _ Date: Revised 05/19/2017 #1 Building Permit Application r ;r4 City of Atlantic Beach .t. " 800 Seminole Road,Atlantic Beach, FL 32233 '.tg ` Phone: (904) 247-5826 Fax: (904) 247-5845 i.-__)Job Address: 1825 Live Oak Lane 1 \Permit Number: GS - 03 ``.ii Legal Description Lot#1,Unit#10-A,Selva Marina RE# 172020-0738 Valuation of Work(Replacement Cost)$ 23,642.00 Heated/Cooled SF N/A Non-Heated/Cooled N/A • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial Residential • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: remodel master bathroom-no added plumbing fixtures giN Florida Product Approval# ey►' 8 � j for multiple products use product apprU al form V Property Owner Information Z I, Name: Roanld& Patricia Pendleton Address: 1825 Live Oak Lane C( = J City Atlantic Beach State FL_ Zip 32233 Phone 904-246-8746 d U 0 Q E-Mail .. W F p al Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) 0 03 A O Q Contractor Information VU00 o Name of Company: Hagerty Construction&Roofing, Inc. Qualifying Agent: Quin J. Hagerty A Z Q 4 Address 12850 Winthrop Cove Drive City Jacksonville State FL. Zip 32228 *4 Q Office Phone 1-904-992-9960 Job Site/Contact Number 1-904-591-4354 F U) State Certification/Registration# CGC 019551 E-Mail hagertyinc@yahoo.com LLLL Q "' ucy L Architect Name&Phone# N/A V.. cc Engineer's Name&Phone# N/A L7 act CO Workers Compensation American Zurich Insurance Company �`J LJ 5 o Exempt/Insurer/Lease Employees/Expiration Date "''j () u) iii i= Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installatjon has CC W commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regdldtiong w construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SfONS, Ir WELLS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. 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 RECORDING YOUR NOTICE OF COMMENCEMENT.Q/'/� .....6"--0.--, ,,...,,Z c.7(Signature of Owner or Agent including Contractor) (Si.natur: of Contractor) Signed and sworn to(or affirmed)bef.re me this 14th. day of Signed an s o to(o• affir -d)bef• this 14th. day of October 2019 by Ro:Id Pendleton October , '• ' b Quin wigs-rty L.._ __ ' .. •I (. " Notary) of otary) � Qu' J.Hagerty ,.0:4;;;,, TONI GINDLESPERGER '•TARy PUBLIC 1 =#r ,.• :,1. MYCOMMISSION#GG353178 W , ,,. STAT OF FLORIDA ��.c4 EXPIRES:October 6,2023 y ".," [X Personally Known OR ,�- .� CnmiYMr 00119052 ��"��fII��ryPubUcthberwrlfars [ ]Produced Identification '1� Expires 6/26/2021 ' •• -' •e . o 1-A7,(,,--3 /� Type of Identification: Type of Identification: - 7( 0 - S-7-181 0 NOTICE OF COMMENCEMENT OFFICE COPY (PREPARE IN DUPLICATE) Permit No. ,e—S/9 — C7 3/,5 Tax Folio No. 172020-0738 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. Legal description of property being improved: Lot#1, Unit#10 A,Selva Marina Address of property being improved: 1825 Live Oak Lane,Atlantic Beach, Florida, 32233 General description of improvements: remodel master bathroom Owner Kurd&Patrica Pendleton Address 1825 Live Oak Lane,Atlantic Beach,Florida,32233 Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address Contractor Hagerty Construction&Roofing, Inc. Address 12850 Winthrop Cove Drive,Jacksonville,Florida,32224 Phone No. 904-992-9960 Fax No. 904-992-9961 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 p N N different date is specified): J o N THIS SPACE FOR RECORDER'S USE ONLY 0 N� j.. C� (V au- Ocp Signe.. DATE 10-14.414 O �n Before me this t day of YiR\t11^A warn: in the —i CLa ' Doc#2019236372,OR BK 18966 Page 797, Coun of Duval.State of Florida,has persona ly appeared c t— q g DPENDLETON herein by O t Number Pages: 1 to U W g -".7r r1 elf and affirm • at all statements and declarations herein d z Recorded 10/14/2019 1 0:50 AM, are true and accurate utl0k, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY /►ti' ;7'* RECORDING $10.00 diltA Notary Public at Lar., tSt•te•f Fu am]. , County of a . My commission expir=-:. - Personally Known x'• or Produced Identmcatlon 0 ri, g , . no 17, V, OFFICE COPY 10'-11 " —► ____1 � ; A 1 - m MASTER BATHROOM 4 ,511 (5724) l4EJ5 - m I 6 RONALD & PATRICIA , U CI‘ [- C4 I PENDLETON/ . • e , , 1825 LIVE OAK LANE I • .. ATLANTIC BEACH, 5 1DB21--7-- 4x;1 15 FLORIDA 32233 I H 0 1532a1R 1"42132ci 1t^41532 (NO SCALE)