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358 Royal Palms Dr RES20-0059 Siding/Soffit rS'yl,Jr��' RESIDENTIAL PERMIT PERMIT NUMBER �. �`,�� RES20-0059 CITY OF ATLANTIC BEACH " 800 SEMINOLE ROAD ISSUED: 3/4/2020 1119,- ATLANTIC BEACH. FL 32233 EXPIRES: 8/31/2020 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: 358 ROYAL PALMS DR RESIDENTIAL SIDING SIDING AND SOFFIT $3500.00 TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171712 0000 ROYAL PALMS UNIT 02A3.00 COMPANY: ADDRESS: CITY: STATE: ZIP: K.C. Services of North 12851 Southern Hill CIR JACKSONVILLE FL 32225 Florida, Inc. OWNER: ADDRESS: CITY: STATE: ZIP: HILL JAMES P 358 ROYAL PALMS DR 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. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $70.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $35.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$109.00 Issued Date:3/4/2020 1 of 2 C'`''�' RESIDENTIAL PERMIT PERMIT NUMBER ' CITY OF ATLANTIC BEACH RES20-0059 s. " 800 SEMINOLE ROAD ISSUED: 3/4/2020 ``'; 1)a V ATLANTIC BEACH. FL 32233 EXPIRES: 8/31/2020 Issued Date: 3/4/2020 2 of 2 `i,: ;y, City of Atlantic Beach APPLICATION NUMBER i �• oBuilding Department (To be assigned by the Building Department.) a s 800 Seminole Road QOJC t". Atlantic Beach, Florida 32233-5445 '9 Phone(904)247-5826 • Fax(904)247-5845 r� / 1� / • E-mail: building-dept@coab.us Date routed: l City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM De artment review required Ye�/No Property Address: --�--� � IC)(-1 A�- Al.-1�'Y1S p q �.// uilding Applicant: K C C j�(��/( C E S o-f N.I-(- anning &Zoning Tree Administrator Project: I E t K_7 G - )O 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 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: BUILDING PLANNING &ZONING 2t Reviewed by: Date: 3J /U/�-6 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. I 'Denied. I Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 5,,,,,,„,,„ Building Permit Application OFFICE COPY A i City of Atlantic Beach _ _ 800 Seminole Road,Atlantic Beach, FL 32233 I ` Phone: (904) 247-5826 Fax: (904) 247-5845 Job Address: ...57,5-5- /5v'/a7/ /9,9//17 6 ,d`'. Permit Number: R OOS Legal Description,57-/ /7-25 •-,Z' 2e'71-;,?e, RL,(--- 25 RE# /7/7/2-OODfl Valuation of Work(Replacement Cost)$ , _.e9V c0 Heated/Cooled SF /j/1'Non-Heated/Cooled _..1------ i • Class of Work(Circle one): New Addition Alteration i2e ai ' Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial sidentia_) W 0 1 • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A Z N • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal 'Q i J Z Q NN Describe in detail the type of work to be performed: f �, ��r'/t�J c��t a/ S'i�iG�y ���7�� yZ M /Pe yrlove" Ty/',s-oX�, /-�/y -XA c sem_t w o di /0./1/27e e t.v/ f,4 h a rd r e pi-o cd u c.7' . 0 03 o Florida Product Approval , J ../ i,.: , Jp S,r./�wvii 1514.L 2 101.10 for mu iple products use product appro>�l ffrr� 0 0 0 Property Owner Informa ' / O CI Z CC CC Z Name: /f//7 17:7-/)7e_5 ?( .67)-/ff uey Address:,3'5-1 £y / /9,7/r-s 27i- U a- City /. ."/„.7427.4-/e �� A,7C State 72 Zip .3.223.3 hone e)L/- ys/- 7 '746/k1.-4- i E-Mail LL W Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) �� W } Contractor Information L!J >'' ' g CO "� wu w p w Name of Company: / �° 5 tY!//C><s o ,�,�i /A.?. Qualifying Agent: ��Jiv/c e.7,—./.64 y0 (� N W Address /.? 3<5/ fou7ie'r.t) .//s 6k, .. _City ,T,"--7z.,,4-S ,,r)////ff,State /C2 Zip y_27.2%- CC w Office Phone goy- r//3-n 4?-'7y Job Site/Contact Number LU W State Certification/Registration# G'(c /5-/D/,20 E-Mail i"- - ,z-'i _522 - -..,Q/J74i1__i' 17 CC CC Architect Name&Phone# r cam') y - :Z 3 7- �,17/,,,2� Engineer's Name&Phone# Workers Compensation f-'X ersn,p 7- Exempt/Insurer/Lease Employees/Expiration Date Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that nnl o nsE . commenced prior to the issuance of a permit and that all work will be performed to meet the standards of ally iea w re�t4bn 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. rrtz 2Nyii - OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with 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.Yr'YOU INTEND , '- TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. IL3Q4k/d ,, , _ , , ......__ __......„ (Signature of Owner or Agent including Contractor) (Signat -of Contractor) Signed and sworn to(or affirmed)before me this 25 day of and sworn to(or of rmed)before •e,thi ay of Aet , /20gfi , bYfi-i/fr/ -y 1//l/ ��,ZOZ Gn�-/i L. dam, '?7(- P r l` �`�`��� ;...__.� RoM ' unt3t "a "" Si nature o Notary) • c My Commission GG 193169 `,.'%": .f'49',..:'. TONI GINDLESPERGER �'ia,Rod Expires 03/07/2022 *_ MY COMMISSION#GG 353178 ,i .w EXPIRES:October 6,2023 [ ]Pc'rsonally Known OR Pecfl s�4n1aII�erdedtihrOiotary Public Underwriters [WProduced Identification roduoe iuenum,ti, r Type of Identification: f/7/% -G'76-07- ' '-C Type of Identification: [`JJ O _]3 0 " 4 2 -4 4 J-0 NOTICE OF COMMENCEMENT OFFICE COPY (PREPARE IN DUPLICATE) Permit No. Res 90-605-q Tax Folio No. 171712-0000 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: 31-16 17-2S-29E R/P OF PT OF ROYAL PALMS UNIT 2 A LOT 20 BLK 25 Address of property being improved: 358 ROYAL PALMS DR. ATLANTIC BEACH FL 32233 o i iOD General description of improvements: ire-70/1e � y e f de 7/4,-e r, r fed , s.�„may �,�I -7idice 74, 1f 5e cc,Y. Owner HILL, JAMES P. & BRITTNEY Address 358 ROYAL PALMS DR.ATLANTIC BEACH FL 32233 Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) _ Name Address Contractor ( 5 F'p-//i' 3 ©/ �`• � /i'' Address /2 4-.4. SDG/ f7//4 Ci/ �.�j( A/ .X.222.5 Phone No. 96-y- S-/3- / $ 9 Fax No. .-//9 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 or herself,designated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax No. In addition to himself or herself,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 bN different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER _ (���/� 5:70 x 0 0 Signed: 1 W DATE 2'� g.n= m Before me 2 S day of ce o i M 8 fry ,Z f7 W in the o Cou of Duval.State of Florida,has personally appeared herein by 3.i.g i- i'7 V e v IV/7 Xl Doc#2020044103,OR BK 19116 Page 269, himself/herself and (firms That all statements and declarations herein o ri Number Pages:1 N> > g are true and accurate N j Recorded 02/25/2020 02:01 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL m �, COUNTY RECORDING $10.00 (1 m Notary Public at Lar9'e.State of . County of R. My commission expires: or Personally Known Produced Identification //yid —` 7' $'j//-U