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225 2ND ST - WINDOW & DOOR ;:=Lyi' ,�7 f CITY OF ATLANTIC BEACH 0.4 " 'F''s 800 SEMINOLE ROAD T310 ' ATLANTIC BEACH, FL 32233 !P INSPECTION PHONE LINE 247-5814 RESIDENTIAL -ALTERATION RESIDENTIAL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RES17-0165 Description: replace 2 windows &door Estimated Value: 0 Issue Date: 9/18/2017 Expiration Date: 3/17/2018 PROPERTY ADDRESS: Address: 225 2ND ST RE Number: 170197 0000 PROPERTY OWNER: Name: SCHRYVER PATRICIA BETH Address: 225 2ND ST ATLANTIC BEACH, FL 32233-5204 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: OSBORN BUILDERS LLC Address: 2157 POINCIANA RD 2157 POINCIANA RD NEPTUNE BEACH, FL 32266 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. rr1_\,��r�., City of Atlantic Beach APPLICATION NUMBER �f "_ ` Building Department (To be assigned by the Building Department.) � �.-. 2 800 Seminole Road -E;$49- 0 (U S -C Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 • Fax(904)247-5845 D'/O�//II pros.)>?� Email: building dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: «3 s a n `� • Department review required YrNo p y Building '' '' // Planning &Zoning Gs�Dotn gU.��6PrS ti-i___ ,1�� Tree Administrator LQ Project: ( a W t n II S 4 A)r 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: [ Approved. 1 IDenied. I INot applicable (Circle one.) Comments: N0 ha i SS v€ to i 1 i+ v n 41 -h! Las j gc o Phe-- BUILDING F L ,pfd S hee-- a s ore -rill ov+ Cx2), 7 ha4ir, /70)". PLANNING & ZONING Reviewed by: rn Date: 9 '/ 4/72 TREE ADMIN. Second Review: (Approved as revised. (Denied. I INot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ['Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 �� )CfrfII li. (./ \�' OFFICE ����'g Permit Applicati _ ;� �:, City of Atlantic Beach Eii SEP 5 2017 i1 v 800 Seminole Road,Atlantic Beach, FL 32233 U 1 I LJ 5 J,���Phho-ne: (904)247-5826 Fax: (904)247-5845 [� r(/� Job Address: c2I � 4/-2.6 t Q Permit Number:_ {mus i_f 0 w� .i Legal Description 5-7-61 /6-25-2-9E 4itrv/c CQ Z1 L3)k0.1 RE# 1 7b)R-7" 0000 Valuation of Work(Replacement Cost)$ . 1.,01 'D.Oc) Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Dea o Pool ndow/boar • Use of existing/proposed structure(s)(Circle one): Commercial Residential • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes CID N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: i2de/ a ,,,,,;,,lr. A.4,,d,w ole-01Az con), w'AA, A ru b Florida Product Approval# ' Q/-r1^ for multiple products use product approval form Property Owner Information / c Name: /�`r�i�` S�iry►eu- Address:62'� &').47 4,c Bi..�t / 322a? City At/Aril-rt. Bee4a, State f:"..- Zip 52.233 Phone r `SOL f 62'3-02_1 2 f E-Mail r/5hr MrilvxMZ k'/+.nl - Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Contractor Information �1 Name of Company: .5/30eN 1.///.4.X/2.5L2- Qualifying Agent: DR Qualifying OS.b�r.--L Address,�J 5-4,4,,,,,,,,,,,,„, ,e„,,,( City/yofrr,�&ft State Zip 32ZL G Office Phone09)2L1'j-07?2 Job Site/Contact Number (.40N)4i4 0 '173`7 State Certification/Registration# CSC 15135-0‘, E-Mail C6600241.8I)1 L.,V.EZ$ gLL. ,Ore .n/E7 Architect Name& Phone# Engineer's Name&Phone# Workers Compensation ',6,1 r-- _ Exempt/Insurer/Lease Employees/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 regulationg 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. 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. ♦ : 0 N a LL c N 2 (Signature of Owner-7r A:' including Contractor) } g a LL P (Signature of Contractor) Z � o Z dayof Signed and sworn to(or affirmed)before me this` da o `), F Signed and sworn to(or affirmed)before me this29"t g Q 0 a o c 1-KkySt .2C1—I ,by QC C) 3.SOn r v-er . �0.'] ,by z L: 0• l N Heather Mooney c P t.?.' C' E E �6•,.,,°4 State of Florida b (Signature of Notary) (Signature of Notary) . �, • zi My Comm}ss}on Expires 02/0112021 m ; �''a^°` Commission No.GG 68713 ;gym.. .e.0 r El-4; , [ 1 Pe onally Known OR [ }Personally Known OR ' [ roduced Identification <)Produced Identifica / '. ; s,�' • Type of Identification: h0(160 k7(14er5 Li c P1 C. Type of Identification: ti L,e Kb- ' �0. r IC_ , J , NOTICE OF CONIIMENCRIVIF,NT .,ay /, Doc##2017247290,OR BK 18166 Page 1687, State of rCAa Number Pages:1 / 7 Di 1 7—(}d o O �f �� Recorded 10/30/2017 02:27 PM, County of RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL'1 J: COUNTY a To Whom It May Concern: RECORDING $10.00 - t (7 The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: 5- 6, /6ra25dQ18 Address of property being improved: g aS • 4 Pti 6 h-da FL, General description of improvements: #f/ oZ 11a4,-ei ur- .- C% ' d j Df 21 Owner: !"P►' GM 5h rive®' Address:,Q j1 &1-,4}14,,,k / 3 22 Owner's interest in site of the improvement: Owe e,r/C'€44107 Fee Simple Titleholder(if other than owner): Name: y� Contractor: 174vrei DS/AM a Dos -6-3 1 d0.1 reS LI-C Address: oft Sj /90/u 4vizA Ret2 , /VeriitYze, & J FA- Q :,pr‘Telephone No.: (101)%66 I73-1 Fax No: Ma 9),p111 Surety(if any) Address: Amount of Bond$ 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 the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OW Signe`t E I Date: 6-c/-34-0-(511 Heater Mooney Before me this 2.9- c3(1Stl 20i1 in the County of Duval,State State of Florida Of Florida,has personally appeared R2t%T SC,i CA 3• a/lr1"I X b My Commission Expires 02/01 Notary Public at Large, State of Florida,County of Duval. ,0; " 1 No.GG 68713 My commission expires: 02 01 1 26 21 Personally Known: or QrOd c-e64 %ioricta Dr ix scc-€4, SP ‘(11(3r511— 1) ,Isl uij *---t.-%- 'Oz cv 6 tt Z i /7/ . $ Q I 1. ...cs N 's ----ln"'"-""*-a'bft'----,__.__- _ _1,...../ , . . tit W 1 il--- ., . ii- i l' --..k .. : .X. \\I . - 3 0 ,,, . I:: 4 ;...4, th .h -,, , -4 it, e ,,- -- k . . ,� i t�, tl: A 1.43 .r. 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