670 Sherry ACC19-0013 Pavers around Pool/Backyard ri RESIDENTIAL OTHER PERMIT PERMIT NUMBER
r S \ ACC19-0013
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 11/21/2019
EXPIRES: 5/19/2020
ATLANTIC BEACH, FL 32233
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:
RESIDENTIAL OTHER SINGLE OR PAVERS AROUND POOL/
670 SHERRY DR TWO FAMILY RESIDENTIAL $6500.00
OTHER BACKYARD
TYPE OF REAL ESTATE BUILDING USE ':,
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170398 0000 SALTAIR SEC 03
COMPANY: ADDRESS: CITY: STATE: ZIP:
Castle Pools LLC 11560 Mandarin Forest Dr. Jacksonville FL 32223
OWNER: ADDRESS: CITY: STATE: I ZIP:
VAN KEKERIX JILL CHRISTA 670 SHERRY 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.
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: 11/21/2019 1 of 2
I
,-,--_-7,:7--,.
' RESIDENTIAL OTHER PERMIT PERMIT NUMBER
I / ACC19-0013
? CITY OF ATLANTIC BEACH
'', ISSUED: 11/21/2019
�� 800 SEMINOLE ROAD
-,. EXPIRES: 5/19/2020
J ATLANTIC BEACH, FL 32233
1 3 J PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapells,Inc.,Republic Services,Donovan Dumpsters,
Phillips Containers,JDog/Dennis Junk Removal,All American Roll Off,WCA Waste Corporation). 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 DECKING REMOVED INFORMATIONAL
Notes:
All old decking must be removed from job site by Contractor.
7 PUBLIC WORKS PERVIOUS PAVERS INFORMATIONAL
Notes:
Pervious pavers must be used to receive 50%credit.
FEES ...:
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $55.00
BUILDING PERMIT 455-0000-322-1000 0 $85.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $42.50
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $50.00
TOTAL:$261.50
Issued Date: 11/21/2019 2 of 2
Building Permit Application Updated 10/9/18
c
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
01 yr IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us �t
Job Address: [p 1 b cher Dila., Permit Number: Acc /9 -0043
Legal Description La T p o e( 7 0/, I/O. 3 St1/1a/d- RE#
Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑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: 4,1 S f-o it 2'p 5t. pool ode c k �( I erv' a u$
pave15 4- tActigll 69E41 r1A) G-Ja1I l
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name y� 11Vailr�C- c_ Ker I V Address e7o Jher Irl V.City P7fpll
U1 ti(. v tG�l State FL Zip 3Z 33 Pho a 402- 6/7- 6,211
E-Mail j'aLSab homL e /lp+ll1QIl.coi7 - _ _ _ __
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company (JFk o /S L� Qualifyin Agent
l[S4'O v� 4 "/, //f .FE- ZipZ7 Z3
Address oitJ r�r• frit- City �aGKS� State 3
Office Phone 9d`'1- 7(0 Z - 37 3`? Job Site Contact lumber 90N- ( O 7- 756 7
State Certification/Registration#ICJ C)4 S gq(o 0 E-Mail Q4drtc Q Cas f l e1O /)• of)
Architect Name& Phone# J
Engineer's Name&Phone# /
Workers Compensation Insurer OR Exempt p� Expiration Date
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 LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT. /
TikiliGke,i4i.tck.
)tti
(Signature of Owner or Agent) — Signature of Contractor)
Signed and sworn to(or affirmed)before me this 1l day of Si�n� ed- and sworn to(or affirmed)before me this nI I day of
fl , ?Ai0 , by AJiJ e1e- ,e. rtk✓K€ `l -- 2-x2D ,by k- R- Pa.Y<X
.`fit`:COm;ri55iUf1 GG 358447 4 R.PARKER
(Sib ature of Notary) oY ANGELA R,PARKER (Sin ature of Notary)
%%-;' Expires I:2,e:a:.er 23,2023 : • s
• • Commissar#GO 358447
4'!+;(:'•' Banded Ttro Trc,F-in Ins800-3&3401$ •••',-,a.`lExpires November 23, 23
`•- --Kw- 1.` ., ••.. L DY\WEIS CACCI se. .1241 ersbw tcnisorf 10414We (Jrwexs• UCA-,Se-
NOTICE OF COMMENCEMENT
State of Ft O a G.. Tax Folio No.
County of ,tJ(,1\)
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 COMMs
CEMENT. / _Legal Description of property being improved: 10--ILD /s -Z3 -2`i Cal}Q i� SEG 3 _i d'O
Address of property being improved: /210 .Sher .1)0n- Ve- Af ia4C. 8e-a- rk.,k- 32233
General description of improvements: f.h91 pa Val IX.p(cAc P
Owner: LII I 1 Van/�e�(I k Address: ( 7O .Sheml
Drive. lll�tCui�)C Pecc`i 3
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name: /
Contractor: to CYS'4/e. Poo 11 LL c.-- _
Address: //54U /ilarderA/''1 / ws} M `7
Ve uw, FL_ 3ZZ.Z3
Telephone No.: 701 .. qi,2 -3737 Fax No:
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 tht d. c,.."•
,„ cordi�noti2Ipt�,eglkii.,,tp •a : is
., ':,_ MY COMMISSION#GG 3.53178
specified): :F,„7. ;, EXPIRES:October 6,2023
'�Op F`O' Bonded Thru Notary Pubric Underwriters
THIS SPACE FOR RECORDER'S USE ONLY OWNER I )/fes (��� ��
Signe V l`'/`— Date: 3 I k ZC.0
Before m his ,') ,ay•41\\ OZ Cdthe County of Duval,State
Doc#2020057461,CR BK 19135 Page 1595
Of Florida,has personally a pear•d • (1 X.
Number Pages: 1 v
Recorded 0111/2020 12:56 PM, Notary Public at Large,Stat- . lorida,C. nt4ileuval.
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL My commission expires: er.
COUNTY Personally Known: ' ' �w or
RECORDING $10.00 Produced Identification: VS 2.Z- 4 3 - (o 8 • - t)