275-277 1st St 03-00025887 New Kitchen/Bath ,C,� CITY OF ATLANTIC BEACH
800 SENIINOLE_ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 03-00025887 Date 4/21/03
Property Address . . . . . . 275 277 1ST ST
Tenant nbr, name . . . . . . NEW KITCHEN/RE-DO BATH
Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 37334
Owner Contractor
------------------------ ------------------------
REDICK, RICHARD BARNETTE CONSTRUCTION INC.
275-77 1ST STREET 447-3 ATLANTIC BLVD.
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 220 . 00 Plan Check Fee 110 . 00
Issue Date . . . . Valuation . . . . 37334
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 220 . 00 220 . 00 . 00 . 00
Plan Check Total 110 . 00 110 . 00 . 00 . 00
Grand Total 330 . 00 330 . 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
BUILDING OFFICIAL
Y�S'"a'�� RECEIVED
CITY OF ATLANTIC BEACH
J BUILDING &ZONING
V�
CITY OF ATLANTIC BEACH APR 1 4 2003
vr,.f3l�� BUILDING PERMIT APPLICATION
(FOR INTERIOR REMODEL) I BY:
Date:
Job Address: ? F1 ✓`5-t
Owner of Property: c L-L,.,rc VA,Q--Q, 4 k
Address: 1,✓1(�5- ��c� l„ l��c `Af4...t,z- �iC 4 C, Telephone: 9'(-1`7
Legal Description: Block Number: Lot Number:_13 Zoning District:
Contractor: B-C- .,dt�cz Lir.s r•��f �� State License Number: C Ly5 7027
Contractor's Address:
Telephone: aZl 1,7 - 1:Fel Fax: y7-77`/`-1
Describe proposed use and work to be done: d�� (� ���,�,,, �a, ,;�f i-vz -4v La"",
Present use of land or building(s): �E
Valuation of proposed construction:
New electrical or increase in service? fn C-, New plumbing fixtures? re-12(e. <rw -SLS
New fireplace? Y\p New heating/air conditioning? V11 CIS
Is approval of Homeowner's Association or other private entity required? Vlv If yes, please submit with this
application.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate.
Incomplete applications may result in delay in issuance of permit.
Please submit Building Permit Application,Energy Code Forms,Notice of Commencement,Owner/Contractor Affidavit if owner is contractor,
and two(2) complete sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Seminole
Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826
In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being
performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner.
I hereby certify that all information provided with this application is correct.
Signature of Property Owner: Date:
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and
ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the
800 Seminole Road •Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us
Page 1 Revised 1/15/03
governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the
above information being true and correct and that the plans and supporting data have been or shall be provided as required.
Signature of Contractor G Date:
Address and contact information of person to receive all correspondence regarding this application (please print).
Name:
Mailing Address:
Telephone: Fax: E-Mail:
AS TO OWNER:
Sworn to and subscribed before me this ` day of /'i ,20e3 .
State of Florida,County of Duval
Notary's Signature: �
Jason Arsen&*
my COrt1irrissim 00138M ersonally k , wn
f� c/ Expires Juy 1e.2000
❑ Produced identification
Type of identification produced
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of ,2003 .
State of Florida,County of Duval
Notary's Signature: �/ IA/v '
JENNIFER SCHLUETER ❑ Personally known
MY COMMISSION#DD 121301
a-Produced identification
EXPIRES:May 27,2006 Type of identification produced
Bonded Thru Notary Public underwriters
800 Seminole Road •Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 - Fax: (904)247-5845 •http://www.ei.atiantic-beach.fl.us
Page 2 Revised 1/15/03
f
NOTICE OF COMMENCEMENT
State of Tax Folio No.
County of
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:
Address of property being improved:
General description of improvements:
Owner:
Address:
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Address:
Contractor:
Address:
Phone No: Fax No:
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 Statues. (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 OWNER
Signed: Date:
Before me this day of in the County
of Duval, State of Florida,has personally appeared
Notary Public at Large, State of Florida,County of Duval.
My commission expires:
Personally Known: or
Produced Identification:
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J , • ATLANTIC BEACH,FLORIDA 32233-5445
its TELEPHONE:(904)247-5800
FAX:(904)247-5805
J , SUNCOM:852-5800
,. http://ci.atlantic-beach.fl.us
PLAN REVIEW COMMENTS
Permit Application # n-� - 2,58 317
Applicant: �/ ,c rn e (26YL 4ru c+ Lac -J n F
Address:n2 S -c,,2 r7 7 /,6-1 Sf
Project: feQla r r k r k i e n La, lei„P i -Jp c
o-"Your application is approved
o Your permit application has been reviewed and the following items need
attention:
Please re-submit your application when these items have been completed.
Reviewed by
Signed Date
Contractor Notified Date