377 12th STTREET FNCE20-0110 Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION '
7800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us T
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Job Address: 511 12_ h �-�- , Permit Number:
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Legal Description L'34 3$ l4iiC T!f-w r P it, oP La1 -31,Lv/Nr;Nos:-C r - 4y RE#
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Valuation of Work(Replacement Cost)$ ,CO Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition DAlteration LdRepair ❑Move ❑Demo ❑Pool Ci Window/Door
• Use of existing/proposed structure(s): ❑Commercial G?Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes I No
• Will tree(s)be removed in association with proposed oroiect?❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed:
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Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Gv -r-Ovn3 0 NI Address 3-11 1 .7 64 5TQL L 7"--
City
City ty(, dr,'c. State FL Zip 3 33 Phone 90(1 g.Sj , 9.k5
E-Mail L.() t LLiy;1-n7b417Sem,irc , C- a,t
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company 1\recrrva...rm r c? (`r1F Qualifying Agent Ly Verrr\9-i •
Address -+ o (' ()Us C+ City c>;cc- t I C State c s Zip 3Z701
Office Phone g0k-3/41 00$8`Z Job Site Contact Number
State Certification/Registration# $12`6 I )2q E-Mail S1 1 Ver r-10 n -le nCe a e)c3ma_i 1.CCM
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer FI or\ C,ck Ck-4 rv5 OR Exempt❑ Expiration Date ICS 12c 2.i(
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 NOTICE OF COMMENCEMENT. •
(Signature of Owner or Agent) • (Sign-at:we-of-•ntractor)
Signed and sworn to(or affirmed)before me this 12 day of Signed and sworn to(or affirmed) before me this 12- day of
QC , • by iN \ c.rn —Tcirrk bCOb>°r 77c,20741k L4NtC,� 1\ier nevoam
a in
ignature • •fa y'Signature of Notary)
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' y►�' Notary Public State of Fiona' .� Notary Public Stats of Florida
F(]Personally Known OR f' ; Deana Garcia Personally Known OR ? Deana Garcia
[ ]Produced Identificatio N i/ MY commission V 29+4" [ ]Produced Identification 1 t mM commission GG 294444
E Expires 09/25/2021 Expires 09/25/2021
Type of Identification: e"' Type of Identification: u"`
MAP OF SURVE
LOT 38, AND THAT PORTION OF LOT 39 LYING NORTHERLY 0
SOUTHERLY LINE OF LOT 4, AS PROJECTED IN A SOUTHEAST
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ct BOOK 23, PAGE 4, CURRENT PUBLIC RECORDS OF DUVAL CO
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- gn Envelope ID:4564F111-1456-4BDA-AE60-FDE78870DC11
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rD R 0 P it s A L
Silverman Fence Company
4698 Dusk Court
Jacksonville, Florida 32207
(904) 730-0882
Fax : (904) 730-5142
Please Contact: Lynda orDeanawww.Silvermanfences.com Date: 9/17%2020
C:3toneer's name Mane Phone: work phone:
Tomson 853-6985
--__
Pat essl Gty. S•aee: cm
377 12th St
tn:to'laticn 4gdres5:('Dine:a+n)
Or Subd,r s,an tarn:
fr.B.Ce woe Material List Fence Diagram Key: Fence lee Ec,stilns rence building cr house Cate_O nIfivs
to be rr°cted 'me \ •
Bowe on Scare You must
s-.adtr °°' 15-sections pull permit
X S:rkaeo ,,.rrrearirr.
_ 5:ace ale.el 17-posts
C',an t:nh 1•6'J0.•e. K ir[C•,pre.c; We Parricipale
PVC nyt P T Pine
s
An.ininent 2-y r e-lx l/1 1L.
��wood board width r :nLI ZL1 h,‘1 t T
Style:
+t•:g'�ri�on haCIL C�a..blt. '1
Description `•Si j--Y.1j p•i.},l'e 10
Total Linea- fence 1
Footoce /feign:
4f• 3 y J (enamor 6n Mance Program of
Concrete.ports / ei,.Benet 8asiness Bureau
6' x Haul Off axisting
Y Take down existing )
III included its L,+ 1 i
Gates Tim estimate a^, - 17jC y
--- erohssgnnaav Pro,.Ord W: .,.,e1C21
Ty:•P Quantity twctn Howe
. Kimball
Specifications Cash!Check= $5629.00
,-� Fnitnr.slope°r Credit= $5797.87 . x• Thank You •
Be leve:a[lap r.W rgfsCr r a cn-,f..::. a:+r.,s lair —"'fin gllik:(-(.
Straightaaossra s stnculKr I '--. �
Special work to bea t..x t .
performed b Xn Permit Responsible,/ 'c r.eii'Su; rte' ' F' .1 ( elle. r
P y HOA approval •• I_. •••'- t" 1.
customer: „ ug3> ,'•a.......
. copy WSW-Vey
Survey received We hereby purpose to furnish lobos and materials-complete in accordance with the about sperlfkaflrms,for the sum of
dear line S with payment to be mode upon completion. CASH,CHECK or CREDIT as payment_All work to be guaranteed for one(1)yea-,
.. of personals labor and workmanship only. NO warranty on Pressure Treated Pine or Cypress lumber for warping,twisting,splitting or any change of
_ tushes c;Sines lumber shape or otherwise. I understand All limber is rough sown and may tory in dimension and/or shape.Silverman Fence is not •
tstaie a souse use orgy responsible for underground obstructions such as pourer lines,irrigation,gas or sprinkler lines of any kind,pipes for welts,etc...Nor is
Silverman Fence responsible to repair any such lines if damaged during project installation. All materials rennin property of Silueiman Fence
2_1y,_;-N 1l_f Co until paid in fulL Any special order items such as lrinyl or aluminum wd1 have a 25%restocking charge if the order has been placed and/or
1 the cancellation of the order is passed a 24 hour time frame from acceptance.Siluemian Fence is not responsible for shipping delays on any
LC/z ordered items. All properties are Located by Central Locate Service through the Stow of Florida. Underground utilities,electrical lines,phone, I
:able and gas is totaled. Please be aware your yard will be spray painted or marked Fully licensed and insured. All jobs and contracts
ore bound per our current insurance coverages. r ,
The above prices,specifications and conditions are hereby accepted. You(Siluerman Fence)are authorized to do the work as specified aboue.
I agree if paying with a charge card:I understand this incurs a 3%added charge as listed about and I wilt not dispute any charges at proiect
completion for balances paid in full. Payments wilt be made in full as outlined above(COD)at completion.
9/17/2020 (—oocw
ra..e
Accepted: Date: Signature: igµteMak. --
tae36ialarwa
rARED BY AND RETURN TO:
A.Robison,Esquire(DFD)
Fisher,Tousey,Leas&Ball,P.A. ,
One Independent Drive,Suite 2600 _
Jacksonville,Florida 32202
•
TRUSTEE'S DEED
THIS INDENTURE, made to be effective as of the tc k- day of Ciu\ ,2006,
between KATHRYN H. ARNETT, as Trustee of The Sarah P. Rourke Living Trust, whose
address is 1355 Moores Mill Road,Atlanta, Georgia 30327,party of the first part, and WILLIAM
THEODORE TOMSON and ANNE BOTTCHER TOMSON, whose address is 3305 Patriots
Lane,Norristown, Pennsylvania 19403, party of the second part.
WITNESSETH:
That the said party of the first part, in consideration of the sum of TEN AND NO/100
DOLLARS ($10.00), the receipt whereof is hereby acknowledged, has granted, bargained, and
conveyed to the said party of the second part, its successors and assigns forever, the following
described lands, situate, lying and being in Duval County, Florida, to wit:
Lot 38 and part of Lot 39, lying Northeasterly of the extension
Southeasterly of the Southerly line of Lot 4, to its intersection with
the West right of way line of 12th Street, all in Block 1, of SELVA
MARINA,UNIT 1,according to plat recorded in Plat Book 23,page
4, of the current public records of Duval County, Florida.
Real Property Parcel ID No.: 171920-0000
The party of the first part hereby certifies that the above-described property does not
constitute her constitutional homestead as made and provided by the laws of the state of Florida.
Subject to covenants,restrictions and easements of record and taxes assessed subsequent to
December 31, 2005; provided, however, this reference will not serve to reimpose any such
covenants, restrictions or easements.
And the party of the first part does hereby fully warrant the title to said land,and will defend
the same against the lawful claims of all persons whomsoever, claiming by, through or under the
party of the first part, but not otherwise.