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537 AQUATIC DR - RES20-0085 �iJ-.61-; City of Atlantic Beach APPLICATION NUMBER �� Building Department (To be assigned by the Building Department.) i r, � 800 Seminole Road Reszo q�v) -, AtlanticBeach, Florida 32233-5445 —w,BS ,I,� Phone(904)247-5826 Fax(904)247-5845 ;::!,,,;1104 E-mail: building-dept@coab.us Date routed: I City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 7 R Q V PvL( C_ bC— Department review required Y7 No �Applicant: �. E 1\ 1 TEzQuiIding O S'� anning &Zoning Tree Administrator Project: Ptrn fskC�C-D 1 I I l S1 p t2,0�Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature �°C Review or Receipt Other Agency Review or Permit Required of Permit Verified By Date cFlorida 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: 1 Approved. Denied. fNot applicable (Circle one.) Comments: Do v Id P Pee -O n S Lk/ C) BUILDING I.J PLANNING &ZONING Reviewed by: Date: L/•2-a CJ TREE ADMIN. Second Review: 10 'Approved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. Denied. nNot applicable Comments: Reviewed by: Date: Revised 05/19/2017 `N) OP\ BuildingOF •CE C Permit Application U64otr 1 ,, firL City of Atlantic Beach Building Department �, t �it a ifoRMAT►oN •A, IDI Ar. a 800 Seminole Road, Atlantic Beach, FL 32233 HIG-LIGHTED IN GRAY Phone: (904) 2415826 Email: i3uildin:-De.t . co?b.us IS REQUIRED. Job Address _537, ROA)A Ti C. 'D i' r M,.. .N Tl C r RE,�Cl� lermrtNumber:_ �� 00 legal Description 3% '11 11 a S-__15- ra>^ri ui,.i Lor 7 "?-6 En_ 1a!til a1 .3 4_ Valuation of Work(Replacement Cost)$ _ • Heated/Cooled SF 1 328 Non-Heated/Cooled 2G 0 ay 1OO .0t� __. to cO • Class of Work C)New []Addition i_,Alteration /'ltepair OMove CDerno DPooi [11P'xtoWrnnv _,.1 `C 0 • Use of existing/proposedW © C) structurals): LlCommeraal Residential _ • If an existing structure is a fire sprinkler system instailetl7 t;iYes /NO (5 00 ca '- F., 0. • W>liLt.'.` nc, , :n w, h .r..o,. rr ?r1Yrs mint submit se•arate tree Rrmr oyal Pte- ,r V U eX c� U • �aibelndetail tr� ,rpr...ii wc �.lu�e performed: i gMAE aNa I TLACE ALL i MAGEDIt? -1�+ TI - (I 0 `- a FXT 10P pr}, •a e Z *Florida Proauct Approval n _ for multiple products csrproduct a p P appal mQ _ t.tl Property Owner Information 0 Name -_f' f')C Y 640'1`1 I La a. --�N TH t 4 ��1 [`��. __Addrt'ss Lt City_, c3 Lr l; N 1 _�..�f Slate (-_Q to } E-Mar! _ __Li. , Z zs 4 C c r, Fl zip_ 3,) Phone (r)0.4 1 q A4, 7 F- u rn n ,+ , n C.1- l _.� u) O Owner or Agent(if ___1t� U N W 8 Agent,Power of Attorney or Agency Letter Required) 7 CC Contractor Information W Name of Coni san D A71t'T, 1A__CPwp INC Qualifying Agent 1lI EC. /41A -4 PPAt , Lt Address 116 sEe¢Ej_ R DeAy - sty_jylu State Zip3225} Office Phone q f 8' USite_ __ �'_ 5 • 1_ �� Job Cont�xt Number 9(4 5123- 103 �- State Cert,ficat.on/Registration if C I (. t-Mail deprin der Con5frfivn >"Tit t.Cern— Architect Name&Phone p l`+,4, _ 1 Fnpincer s Name&Phone N N 4 --- - _—_____ Workers Compensation Insurer OR Exempt 0 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,I'LUMDNNG,SIGNS, W Etl S,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements of lhs petit-10i,there may be aod,t,anal re rrictoris applicable to thus property that may be(mind in the public reitord<of th, county, there may be.§rldrtional perry its requ=red from other governmental entities such as water n+anag•mment di E VSE IV E federal agencies, V OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done. 4 "1x$''2020 applicable laws regulating construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCBKt1FNT M4Y RESULT IN YOUR PAYIG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND • TO OBTAIN FINANCIN4, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR No TICE OF COMMENCEMENT. / �__e— 't,UAZ-fa-A-, Com.: ___ (;,gnaturn of Owner Or Agency —I (Signature of Contractor) .i Signed and sworn to(or affirmed)before me this s day of Signed and sworn to lar affirmed)before me this_�r ey of „< tT�:r-u1. �a Q by�.Tit1 .i_, tJ------ ..�__ __ t!z(K..)1..21,?.. Z,by_ 1 'X'LITE y�r 1. rE .✓•.;, JO JiNRENDA l +�lEL _ ' ;. r „ (S,t;rurrure of Notary) al11041•••IP Guaurdsaaon 1 GC is ., .A.4.';'Frites Aucuif 24,20:1 i. `.n",- s I Fuprrura ..a Steil r • Notary Public State of f,a+G1 . I )P est naify Known Cie -� Commrutor,I GG 451219 44 Produced Idcntifleati n I 'roduced Identification r'a''� r •ret re: '1 2::' Type of Identification :....X42_:, 2 . !�' 2 : _ type of fdrnt,ffration t.1d i..'i!r a r , ' NOTICE OF COMMENCEMENT JOB COPY State of F(or do, Tax Folio No. County of S-4-`467 . O V Vti 1(r .I To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT Legal Description of property being improved: 38-�-1 17 -25- 29 E COMMENCEMENT, C44-NS LoT2'7-74 Address of property being improved: 531 .At u 111 bK I'iL / ATS t f 1 t- General description of improvements t �� �1~ ���� t�1UQ ��1�(T1 Owner:_ik�ACL(�. Address: P.0-133X 60D 741 Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: R C Contractor. MILA-TTE1gnu cflot.t C c p Q 2 _J Address: 47 b5 3EU?e 14Atez 3AC witl.Ll f .FL. 32251-� O 2 Telephone No.: 704 5516• 1U33" Fax No: c- F L1J f� iu Surety(if any) N/R U o () ri •; Address: Amount of Bond$ A rx ° Telephone No: Fax No: O �p Name and address of any person making a loan for the construction of the improvements a Q h Z iL lt' i`w Name: /C/f — 0 Ili +.CI Address; L:AVA LA C.3 �. Phone No: Fax No: Li U U) Li LSC u Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other docur ,ts may > be served:Name: I �A Address: Telephone No: Fax No: Y In addition to himself, owner designates the following person to receive a copy of the lienor's Notice as provided 713.06(2)(b),Florida Statues. (Fill in at Owner')option) Name: N./A Address: _ Telephone 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 ��,�y"��+, �7 Date: 3)7 j o C' Before me thisi7 t' day of M c c� in the County of Duval,State Of Florida,has personally appeared C�tt�Sni C+ L1 I nl Notary Public at Large,State of Florida,County of Duval. My commission expires- (It 4 1 L')I 2 t Personally Known or Prodr{ced IQ 1 ion �� 41 t=, Commissions GG118582 Expires:June 25,2021 Ann,laic inn] alrnn f,latAri