10 10TH ST #18 - DOOR �s ' `- � CITY OF ATLANTIC BEACH
�i 800 SEMINOLE ROAD
ilar)yr ATLANTIC BEACH, FL 32233
-c n �%' INSPECTION PHONE LINE 247-5814
RESIDENTIAL OTHER - SINGLE OR TWO FAMILY RESIDENTIAL OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RESO17-0010
Description: SLIDING GLASS DOOR
Estimated Value: 14000
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 10 10TH ST GARAGE 18
RE Number: 170237 0180
PROPERTY OWNER:
Name: RISA HERMAN
Address: 10 10THS ST#18
ATLANTIC BEACH, FL 32233-5760
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: HOMERITE WINDOWS AND DOORS
Address: 4801 Executive Park CT N BLDG 200 STE 207
JACKSONVILLE, FL 32216
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
-o_t , City of Atlantic Beach APPLICATION NUMBER
'is Building Department (To be assigned by the Building Department.)
` Atlantic8tla SeminolecRoad R �,SO 17_ DO ( 0
Iv,? lJ
` - Beach, Florida 32233-5445
\\ Phone(904) 247-5826 • Fax(904)247-5845 GG
.c:%_0;110r E-mail: building-dept@coab.us Date routed: S/( O/( 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I � I 0-41---- S4- 1-1-- (8.
- , . • 1 ent review required Yes o
Buildin•
Applicant: RC M�(�ITC- lllj f N oLa_ i_,JQ0 - Tanning &Zoning
Tree Administrator
Project: S(_..[n(,,�c , GLA S () O C.)le,— 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: roved. ❑Denied.
(Circle one.) Comments:
C3UILDIN.19)
PLANNING & ZONING Reviewed by: 779'9' Date: 5.*2 'i7
TREE ADMIN Second Review: ['Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
OFFICE COPY --�
' " BUILDING PERMIT APPLICATION IDT,-------------i
r •,. `; � � AY - 32011
�� CITY OF ATLANTIC BEACH
,D`;
• 800 Seminole Road,Atlantic Beach FL 32233 {1
J"),� Office: (904)247-5826 • Fax: (904)247-5845 L"
Job Address: )0 )014'51-./ 4-i U 41-C. t3ta�-�( 3?- 33 C Permit Number: QI SO -00/Co
Legal Description RE#
Valuation of Work(Replacement Cost) $ J 41 bcO a"- Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Mo emo PoolWindow/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residenti
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed AtctivniDescribe in detail the type of work to be performed:
5/-4/1 r'"ek &I6 ss sly .; tZ, ,
A I
Florida Product Approval# P / 845 4. / for multip1MgduEt.%.14alluct approval form
Property Owner Information
Name: 3h4- /fit. ma.. Address: 10 1 oiA ..tB� n�� �Ra le l
City 03-1e,h•c. 6YG.i.L State fl/Zip ??-23; Phone 564 - 91A� }Ic Beach, L
E-Mail
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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 Ce MMENCEMENT.
Contractor Information:
Name of Company: 144 opt Y "-L (,e)it-caro d- 0004.c Qualifying Agent: ()1 L 1 2.,, Q i&Zow,
Address: '-Sol fA.£ cttivL Pa../. Teri Fi 3<a tL City d<e . vi el State Zip ',.5, -a .
a 1
Office Phone f• low- a i G-a 51 c Job Site/Contact Number;by-a IG -mss 7s-t-1 a 46, • a. Si S
State Certification/Registration# CCC- /Sl a.7-)7 E-Mail P - Clat'TC //or,iF£,'/--GAO.(n,
Architect Name & Phone#
Engineer's Name & Phone#
Worker's Compensation
Exempt / Insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indi - d. I certify that no work or installation has commenced
pnor to the issuance ofua permit and that all work will be performed to meet t - - .ndards of all laws regulating construction in this jurisdiction.
This permit becomes null and void if work is not commenced within s' months, or if construction or work is suspended
Work,Plumbing,
Signs, Wells,Pools,Furnaces,Boilers,Heaters, 'n nd • ' onditioners,etc. r //�
Signature of Property Owner: "/ 1 Signature of Contractor:41161 ,_ k./r
Before me /� `
this .2- Day of /1) 0, Before me this c71- Day
Day of /t/h .or -)
Notary Public:Cj' ,772-52-70:7,,, yi:: ROYAL GATES DEAREN III Rotary Public:eh «,,,
w s:= Commission#FF 190928 ..t% '= • e• S DEAREN III
.r tm
��.,A�€ Expires May 20,2019 , � ; Commission#FF 190928
I hereby cert that I have read and extif p,. lii ',•..rfast$t919 )' e same to be true and correct 4,'^-/' s.. '4fetl : ,39,a3649
ordinances governing this type of wo t ..11 by con taw Unfit-whetherspecified herein or not. The gr l Ir. . ' 61'i 04'ihok.eooaes•ro,o
presume to give authority to violate or cancel the provisions of any other federal, state, or local law regu ating cons ruc ton .r -
performance of construction.
Rev. 3/14/16
OFFICE COPY
Doc # 2017106953, OR BK 17974 Page 1428, Number Pageo: 2, Recorded
05/08/2017 at 04:19 PM, Ronnie Fussell CLERK CIRCUIT COURT D;JVAL COUNTY
RECORDING $18.50 DEED DOC ST $0.70
Prepared by and Return to:
Lawrence V.Ansbacher,Esq.
Ansbacher&Schneider,P.A.
5150 Geffen Road,Guiding 100 RECEIVED
Jacksonvile, Fiends 32256
WARRANTY QEED MAY 1 6 j
1 Grantor's name and address is:
Cloister10-90,LLC, Building Department
a Florida limited Ilablitty company
5150 Belfort Rd.,Bldg 100 City of Atlantic Beach, FL
Jacksonville,FL 32256
2. Grantee's name and address Is:
Risa L. Herman
2622 Ridgefield Ct.
Jacksonville,FL 32257
The terms Grantor and Grantee shall be non-gender specific, singular or plural, as the
context permits or requires, and include hors, personal representatives, successors or
assigns where applicable and permitted.
3. The real property('Property')conveyed hereby is described as follows:
U.i418 of The Cloister Condominium,a Condomintin according to the Deciaretion of Condominium
thereof,rsarded in 011kdal Records Book 3876,Page(s)450,of the Public Records d Duval
County,Florida,and any amendments thereto,together Mb its undivided share in the common
elements.
together with all tenements, heredltarrents, easements and
appurtenances belonging to or benefiting such property.
The Property Appraiser's Parcel Identification Number is 170237-0048.
4. Grantor for good and valuable consideration plus the sum of 510.00 the receipt whereof
is hereby acknowledged, hereby conveys, remises and quit-claims to Grantee any
interest of Grantor to the Property.
5. Grantor fully warrants title to the Property and will defend the same against the lawful
claims of all persons whomsoever, except for (i) taxes subsequent to December 31,
2016, and(ti)covenants, reservations, restrictions and easements of record, if any, with
reference hereto not serving to reimpose the same.
Note: This Decd represents the dish ibution of unencumbered real property of Grantor to the sole Member
of Grantor,being the Grantee, Therefore,no documentary stamp taxes are duc ori this Deed.
170225 17.05.01 Warranty Deed into R,u Herman.doe:
Last rsv :17/05/133 3:19 PM
OFFICE COPY
Executed as of May -6,2017
181 Witness: Clois :r10-10, LLC,
a F.rida limited liability company
Print Name
2nd Witness: (/,)Q�yryla_ aZr{i-c :;0 By:
Print Name: ` M a r&,N—� c� .awrence V.Ansbacher, its Manager
State of Florida
County of Duval
The foregoing instrument was witnessed by and acknowledged before me this $ day of May,
2017 by Lawrence V. Ansbacher as M nager of Cloisterl0-10, LLC, a Florida limited liability
company, on behalf of the company(t, who is personally known to me or( )who has produced
(Florida Driver's License)as identification.
Notary Public, State of Florida ' DUKA
My Commission Expires:
MY COMMISSION Si OO 037367
Pli�-��wt
6aidVAR:, Odober 10.2020
Naery Pvello UnO�wAMa
170225 17.05.01 Warranty Deed into Rise Herrnan.docx -2-
Doc # 2017103545, OR BK 17969 Page 1962, Number Pages: 1, Recorded
05/03/2017 at 04 :17 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
l NOTICE OF COMMENCEMENT
Permit No.1rSC)/7'Cr/0 Tax Folio No.
State of Florida.County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legal description of pro erty and address if availab e :
�( 3'1 --c�c-�r•g 1 p -� ' - age iIre- CIL)* P• ( -td I1, Uh'�- f
2. General Description of improvements: 014 31(�o-�,
I Q>zeIfc,cL me�( G S 0voA..
3. Owner Information:
a)Name and Address: IA-1- ).L eery-)C.,., /0 /p 5/- a fL e 04 ,ci 3 9,a,3'3
b)Interest in property: Qg4 So, a( fh„-r. U4%l C/
c)Name and address of simple titleholder(if other than owner):
4. Contractor Information: ''ff
a)Name and Address: i-400-%Z.e....; �'; 4-t ;,� -17o T
w foes SO( 2 X LGCr 11;✓moi I4/4.it, GF vt,2 R
b)PhoneNumber: eipq. ,,-.9.q,6,- tS 1 '
3aa 1 to se.,di-aa)
5. Surety Information:
'6/4 .Po Name and Address:
b)Phone Number:
c)Amount of Bond:$
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13(1)(a)7.Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to himself/herself.Owner designates of to receive
a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes.
a)Name and Address:
b)Phone Number of person or entity designated by owner:
9 Expiration date of Notice of Commencement(The expiration date is one(1)year from the date of Recording unless a
different date is specified: . Stir (3 ,...9.c>r
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF TIIE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART
I, SECTION 713.13, FLORID• • STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOU' PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB S ' BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING.
CONSULT WITH O LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTI E 'Alt
OMMENCEMENT.
S •. • e.'mor • mer's Authorized Officer/Director/Partner/Manager Si netory's Printed Name&Title/Office
The fore oing instrument was acknowledged before me this a day of h'1,..1 ,20 /),by
�,?
C � �c
l 'r-ns for
ite of Person) (Authority T)pe,i.e.Officer/ ey) 'amc of Party Instrument was Executed for)
i
,, AT 7s. DEA9N III N A PL IC,
STATE OF FLORIDA
_• 6Conrs. Print Name: we/ / C44,--0-,5- 014
., -•4 °:'t-!.rExpiies hAay 10.2019
ti ':e'.
,•ill InWtY08001E64010
' J;h-ersonally Known
0 Identification/Type:
Verification pursuant to Section 92.525,Florida Statutes. Under penalties of perjury,I declare that I have read the
foregoing and that the facts stated in it arc true to the best of my knowledge and belief
Signature of Natural Person Signing Above
Revised 10/1/2009
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