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1995 Brista De Mar DWAY20-0004 Driveway/Walkway t1v���f DRIVEWAY PERMIT PERMIT NUMBER 4,7? SCAT DWAY20-0004 j �'- �► CITY OF ATLANTIC BEACH ISSUED: 1/30/2020 ailior gate: 30/2(: 800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 7/28/2020 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: 1995 BRISTA DE MAR OR DRIVEWAY SINGLE OR TWO DRIVEWAY AND WALKWAY $6680.00 FAMILY DRIVEWAY TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 169506 1680 SELVA NORTE UNIT 02 COMPANY: ADDRESS: CITY: STATE: ZIP: CORNERSTONE SOLUTION 2280 LAKE SHORE BLVD JACKSONVILLE FL 32210 HOME AND BUSINESS I OWNER: ADDRESS: CITY: STATE: ZIP: ORMOND MARILYN E 1995 BRISTA DE MAR CIR 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. LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL Notes: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(904-247 -5814)to request an Erosion and Sediment Control Inspection prior to start of construction. 2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. Issued Date: 1/30/2020 1 of 2 Js? y. DRIVEWAY PERMIT PERMIT NUMBER ' CITY OF ATLANTIC BEACH DWAY20-0004 ~�" 800 SEMINOLE ROAD ISSUED: 1/30/2020 EXPIRES: 7/28/2020 ATLANTIC BEACH. FL 32233 3 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL Notes: Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off container cannot be placed on City right-of-way. 4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 5 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 6 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL Notes: Maximum driveway width within the City right-of-way is 20 feet. 7 PUBLIC WORKS DECKING REMOVED INFORMATIONAL Notes: All old decking and debris must be removed from job site by Contractor. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00 TOTAL: $125.00 Issued Date: 1/30/2020 2 of 2 4 ysrL�r��. City of Atlantic Beach APPLICATION NUMBER ,y, o Building Department (To be assigned by the Building Department.) 800 Seminole Road n 1 4;]0 _/' C0 Atlantic Beach, V Floridada 32233-5445 sJLJIJ`-t Phone(904)247-5826 • Fax(904)247-5845 I . � �� o„ r t� E-mail: building-dept@coab.us Date routed: r City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: J S! ( S \ 1 ) Department review required Yes No Building Applicant: JU R (ZS Toto c� O cA lanning &Zonings re- -. . or Project: ` ��/ 10( ` V V << public Work"s`'�� 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: Approved. ( IDenied. I Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:19 Date: I-1 3 2-GZz- TREE ADMIN. Second Review: ❑Approved as revised. (Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I (Approved as revised. Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 . ;.i�� l'.% Building Permit Application Updated10/9/18 J r € ', City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY i\Aortivl' IS REQUIRED. Phone: (904) 247-5826 Email:_ Building-Dept@coab.us + , 1 Job Address: 1b 13t::�k, bt Ur (t•r C „411,A4-it �.Ci Permit Number: >�uoc AL(Z(..)--CXXC - 31L 3 {{/ � Legal Description Oflvrt c� C"''' • Plu' ty2S IN 4.1...‹,- .) RE# C c" 0 rt 1.0r Valuation of Work(Replacement Cost)$ 6 t6o• CL) Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration ❑Repair EMove ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial ❑Residential • If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No • Will tree(s) 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: b r:,-..k20.42,,..\ ✓'t". /=. - P C...,(Lcu E (, AA t 7(.%tc,,, - try u-e- i. k_04-...(-.1 or i Florida Product Approval# for multiple products use product approval form Property Owner Information Name Ik(\Il,it)J O,c&LC& Address ICLCI 13fr,5-4c 4 ,Jo f cry City AVlit._k, t"56,ekcI` State c1,. Zip 3 Z23 3 Phone E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information r� Name of Company (J.,-Chss«.3E �Q ,`ON Qualifying Agent I�C?b1rVV:Y t'Oki, . 1A.Aiot Address L--O (.VaAC6 S kr,t 13 ow City - V_S)k) " State A, Zip 322c C Office Phone 904 -3i 3 -n5ok, Job Site��C��on�tact umber 904 - 3Z3-. 4Zo�a State Certification/Registration# E-Mail Sc.Q*SC,( 1062SS sC H L., • (U'INN Architect Name&Phone# Engineer's Name& Phone# Workers Compensation Insurer l PL, 0023 4Q' cA,03 OR Exempt 0 Expiration Date Cl//OS l 202 1 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 LEND OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN ) ,/) , / 7f j/id ) /11yv� _._- i `-,�( (Signature of Owner or Agent) (Signature of Contractor) -igned and sworn to(or af` m-d) befor- e t Z Z.d.ay ofsigned and sworn to(or affi me.)befor- me A's day of ^ ,20Z0,10\1.°` •N A,Al ► Cl' c\-C\ ,ZOZC),by r//, s..'� Milt ii �d�ma __•� r TONT GINDLESPERGE' , ,-i• atu fof N I 7;;----------- ti -. o FP'P'Le6o''' #GG 3531 • - w"'• •' TONI G T R r • /= MY COMMISSION2023 '1 MY COMMISSION#GG o. i «: 353178 ' EXPIRES:October 6, - .G •t: mak' 1'1 : . 1 d �66m ialNPiNi'1?. e'� rs ! 1-8...,„ $y n I :October 6,2023 I I ' OFF:•, ' ' .. : .enti ication 1 . „,,• rr4aq. Sti__ Pubic UnderMrpera Type of Identification:__ D t0 SS.-S ei S-35-84 CD•I'- Ype of Identification: .. )14 -89 - I 83-0 .,:s -',:"'', City of Atlantic Beach ��j�M�►� APPLICATION NUMBER �s Building Department (To be assigned by the Building Department.) 800 Seminole Road JAN 23 202J D -f -(�Qc�4- -, Atlantic Beach, Florida 32233-5445 K Phone(904)247-5826 • Fax(904)24 5 1 • / �© t Ja]`>r E-mail: building-dept@coab.us Date routed: z City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM 1\\ R R bte Property Address: { 9 9 6i.‹, , ,, _ ) ( - Department review required Yes No = Building 1 Applicant: Lu ((JI) E2_STOk)c- OLAI�1 & n>� ��PlanningZoni i � re � � or Project: `V e-,,0(.-` V V A (_Ie< C F`ublic Worlcs`�� 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: AXpproved. PLICATION STATUS Reviewing Department First Review: I IDenied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b 1 ate: f.•-a /-'d20 TREE ADMIN. Second Review: ['Approved as revised. ❑Denied. ❑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 PUBLIC WORKS PLAN REVIEW COMMENTS y Date: /-,e✓- 6 Application#: ‘,/.)R/41--(/6,24^g� Project Address: 9V5.--- k- ,‘,,4-,___ Pe. 1Y1 a ir- Ci k- CONDITIONS OF APPROVAL TO PRINT ON PERMIT Check Box to Select All concrete driveway aprons must be 5"thick,4000 psi,with fibermesh from edge of pavement Driveway to the property line. Reinforcing rods or mesh are not allowed in the right-of-way. ❑ Apron (Commercial driveways—6"thick). Full erosion control measures must be installed and approved prior to beginning any earth / Erosion disturbing activities. Contact the Inspection Line (247-5814)to request an Erosion and Sediment �}/ Control Control Inspection prior to start of construction. Onsite All runoff must remain on-site during construction. Runoff Post Const. If on-site storage is required, a post construction topographic survey documenting proper TOPO construction will be required. All water runoff must go to retention area and retention overflow 0 Survey must run to street. Pool Pool—Wellpoint (if used) must discharge into vegetated area 10' minimum from street or drainage ❑ Wellpoint feature (swale, structure or lagoon). Roll off Roll off container company must be on City approved list. List can be obtained at the Building / Container Department at City Hall. Roll off container cannot be placed on City right-of-way. rte"/ ROW V Restoration Full right-of-way restoration, including sod, is required. Utility Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid ❑ Road Cut 10' in each direction from the center of the cut. Repair must be shown on the plans. Construction Provide construction site management plan, including location of silt fence, dumpster, portable ❑ Site Mgmt. toilet. Right-of-Way Permit is required if using right-of-way for construction parking. Runoff All runoff must remain on-site. Cannot raise lot elevation. Document Strongly suggest thorough documentation of impervious areas be recorded. 0 Impervious Slab Slab and driveway to be fully removed. 0 Driveway Maximum Maximum driveway width within the City right-of-way is 20'. 1 Driveway Circular Maximum circular driveway width within the City right-of-way is 12'. 0 Driveway Grass Full site to be grassed. 0 TOPMust provide a topographic (TOPO)survey with water retention for final CO Inspection. 0 Survey Revision Any plan change must be submitted as a Revision to the Building Department. 0 Fencing All old fencing and debris must be removed from job site by Contractor. 0 Removed ,�/ Decking All old decking and debris must be removed from job site by Contractor. [t Removed Infra- Any damage done to infrastructure must be repaired by Contractor. 0 structure 0 Revised 12/16/19 ..p.. low 0 et* mum, warrilMtry00 hor°41Fairogangher"1/06".0.074;11:4;,,— v. Am, li 0•411 f,4# VII 0,4111110n owe '01.3010;V a 4V4, MAIN, V1400701. • BRISTA DE MAR CIRCLE °la**. . ...1 . , PIO -114AD4JS.1021100. je ems,it 14 N'r ....•,• -a( '—‘••1611006011.14111` -- ' "• *was,' _ .1. L11ll tu too iir .., it * I t . 111.. . •• 4,•l I , * •11 1 s...• . 6, .... , a 7-1 ' ' 66 6 i Is 4 4* t . ft-sfoltv IOWA* moo Emlisok 1 : low t*•*wages, row. lIttastoiC I ' arirrypdc 4 4. .4 ••0 'i • . ' No t11111 „ V , -$ i A _ - mi '.4 .., .., V-.1.04,i, ir,,77....._ l •*": ,.., ., ...... . __, it let ,s2, 7 .2‘ * .....—"- *amoomp iiZt .„,,, ,,,,,,..,..;.. f•' ,'' '• •L.0 - •I'At so* ,q pi a/ -, is. •••••••—ig - -.1, ' 1. ••—.' •-N 004 29 t5"E-- AO* 9T-4••)CI' WC* . sq 4 it 9• '6 P . * :) r 15•11 • •4, 0 SA' ••:‘ COX!0.we od r -41 aft/•ciai * rearmigto .1 104,4 f•• 11141141, x***sr : lemarri talenry ItJ 44LIICE ,sett.. r•_, MAX11% L.> ttillti:APAPer. MEOW, z•Vi*JCL lihig : -111.2 110.1W OM mmpmeo), ltie I HAW 3141NEYIEL 1111. 716 AS 311:110i 111 tli.‘i MIV *mkt -Titas *V 1,t% A ile .!t 011(11(FrT WPM i 'mixt VateLl, Pil NA': ',IF 9.71P>irt ?AMU) tiktellit Pil 94 'T. 141 rff 1441,31erf *UNIX hEldttIts AkilAilf Tr, ' it , ,. tiltra,1101 11111011CAL 7141-411% 'sr ttif: A Joaltea SIVA"' XV, '4* AM 9A• p‘ry iiel, PE , 0 OP alr1113.1111%;' WPM! ;I 444-*°- Pt: 1. itiVr.tliti 1.10; Mt" IA* -rt.tri. 110,0w0t: Fume, POW itlii itruppric r-,,-wtrAt ea*vs v eat •04,.imr.,11$$ \bt ‘itb* ''' 'IN''Ns. itillii- oa...••••••• .4.. art.a14.tidasimalarit a O. ''' rHIGHn.-ti�i_,;,,, REVOCABLE ENCROACHMENT AGREEMENT �' '›n1 City of Atlantic Beach **ALL INFORMATION r LIGHTED IN GRAY 800 Seminole Road,Atlantic Beach, FL 32233 IS REQUIRED. REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and existing and r the laws of the State of Florida, hereinafter referred to as "CITY" and ' ' &J(( 64, CMa01 of Atlantic Beach, Florida, hereinafter referred to as "USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property for the purpose as described in the City of Atlantic Beach. �� This work is generally described as ?au 642 Ltlaat `O� l �`,of-wC�+3 • L+ ���. Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty(30)days' notice by CITY to USER,said notice to USER shall be given by certified mail,return receipt requested,to the following address ICAV 136(JG 1 E k)Cf. QcCIQ ,M1AmkiC ritACi+ 1C` 3223i • In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above described easement or property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing or adding to of the utilities and facilities of the CITY or franchise utility provider. • The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code and all other land use and code requirements of the CITY, including City Code Section 19-7(h) which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks." • The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach Public Works Department, for said change within 30 days after the day of completion. • This permit shall inure to the benefit of, and be binding upon, the USER and their respective successors and assigns. • USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications, to include utilities locate requirements and use limitations/requirements of easements, public right-of-ways and other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by the SER from any of the work herein under the terms of this permit and that all of said bili 'es are hereby a umed by the USER. ! 1/ ''' Date OI / 1 J / )07 i.) roperty Owner/Agent (signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged' this I day of Q(1 , 20 Z.), by KQ.ma., LV 1 C CL( [ rYNq d who personally appeared before me and printed name of Signer) ackn ledge that /she sig ed the instrument voluntarily for the purpose expressed in it. c.k ,. •r- - ^"partment Approval: Signature of Notary Public,Stat:r Florida /0:t : EXPIRES:Oct ber: ' —TONIGINDLESPERGER 't , t [ ] Personally Known : : s MYCOMMISSION11GG383178 , / '-1 ( �Ate ? ..(41..(41[ ] Produced Identification(Type) �. ••..o;int Bonded They Noisypublc411E00,84/"Cams, Public Wor s Director 7...-01 y.,20:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 H s:vir, RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION **ALL INFORMATION �t •' , City of Atlantic Beach HIGHLIGHTED IN GRAY IS 7J --ty 800 Seminole Road,Atlantic Beach,FL 32233 REQUIRED. PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address IggS 5(iSSG i Ltd Cif C f A410M.It fleIP(1nPermitNumber DWA120-000y p1_. 3.233 Contractor Information , Company E1bNC SOLI-:O j4OJA 4•11." 3OSit s1 ti.Qualifying Agent KGINvC- IQ • ErYy x>c Address 2?'�C) 1,11 E. SV-CVE, t3(,0CI City j�(;J.‘atiii,63- State FI, Zip 3Zl,1 O Phone G04 • 3-17)-• 4e.Cfc, Email 6d2SO000a 4-0^1( kli3. CCYTh State Certification/Registration# Architect Phone Email Engineer Phone Email Workers Compensation Insurer Fu5 L OOZO kg (off GO OR ExemptEExpiration Date Q( ltf,/201 r • Permittee declares that prior to filing this application they have ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. • Whenever necessary for the construction, repair, improvement, maintenance,safe and efficient operation,alteration or relocation of all,or any portion of said street or easement as determined by the Public Works Director,any or all said poles, wires,pipes, cables or other facilities and appurtenances authorized hereunder,shall be immediately removed from said street or easement or reset or relocated hereon as required by the Public Works Director and at the expense of the Permittee unless reimbursement is authorized. • All work shall meet City of jtlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of CtIm�J� /J rnf‘Cdl (Project Superintendent)tt����--��! with(Company Name) CD -3c0144-:o&) Phone C10 -3L 3- IO4i+o • All materials and equipment shall be subject to inspection by the Public Works Director. • All city property shall be restored to its original condition as far as practical, in keeping with City specifications and the manner satisfactory to the City. • A sketch of plans covering details of this installation,as well as a copy of a recent survey shall be made a part of this permit. Calculations showing any increase in impervious area on owner's lot or in the City right-of-way are to be included with this application. • The permittee shall commence actual construction in good faith within days. If the beginning date is more than 60 days from date of permit approval then permittee must review the permit with the Public Works Director to make sure no changes have occurred in the area that would affect the permitted construction. • It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder,and the holder will,at all times,assume all risk of and indemnify,defend and save harmless the City of Atlantic Beach from and against any and all loss,damage and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. • The Public Works Director shall be notified 24 hours prior to starting work and again immediately up n completi n. / t a4.,C Z27141/lit Date I Z P() Permittee(signe in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL �J The foregoing instrument was acknowledged this Z Z day of G ("N ,20 �C) by ar ( l4 (\ E IIL4.kp Oc- rna, 6 w �nd— ` .tinted name of Permittee) `' '' j c; ,a_ :, MY COMMISSION#GG 353178 ackn dged th the/sh s :ned the strument voluntarily for the purpose expressed in it. ';,F EXPIRES:Oct°her 6,2023 �,,?1 F .. 'Bonded Thru Notary Pubic Underwriters ' .- [ ] Personally Known (>� Signature of Notary Public,State . ida [ ] Produced Identification(Type) H:\Applications&Forms\Word Documents\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18 NOTICE OF COMMENCEMENT ++ //� / State of ( Tax Folio No. 1 C.C7� �LS�`'-I lt, County of 1 )V Vc>-.( 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 Aated in this NOTICE OF COMMENCEMENT. _ Legal Description of property being improved: p�Vim Of e U n 12-{- *Ain L_p+ 9 Address of property being improved: IC-\O �� t 0\ Do i--- c r- General description of improvements: ISE k.“Dvc=.- CON3c4-&A‘- 7(1\* AC-.�-� Owner: AAA 1 L.)k) ADC IO oL Address: Fig c �IS I AOC C( tt\\+"Z- Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: KPIL MMOL • y Contractor: Kj1Nti('Q N 1 01, Address: 22"00 L E & ?--AN d ' �PrC�co13`1 9- ,ct 3 2 Z t O Telephone No.: Fax 31/4.0 Fax No: 1)414))k 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 at ,pk r,QcorafrfArd �is ;r• `"�% specified): '., 1.: Ur11MH,"401 AFX` ; EXPIRES:October 6,2023 THIS SPACE FOR RECORDER'S USE ONLY OWNER �" BaMedThruNotaryPubGcUndemilters Doc#2020018794,OR BK 19080 Page 1784. /2 ' - `v Number Pages.1 Signed:, �,`t.4 / " - Date: (l 2- �ZL� Recorded 01/24/2020 12:03 PM, Before me this , d v in the County of Duval,State RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Of Florida,has personally app ar • A A• •. COUNTY Notary Public at Large,State o F rida,Co : I RECORDING $10.00 My commission expires. Personally Known: «. or Produced Identification: (,C(p.S S-J 4 7 `1 -