2277 SEMINOLE RD UNIT D WATER DAMAGE ?i �",,'y e .,
4i _ - ,
s , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ` X ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
RESIDENTIAL ALT /OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -RAAR -862
Job Type: RESIDENTIAL ALTERATION
Description: WATER DAMAGE REPAIRS DUE TO NOVEMBER FLOODS
Estimated Value: $15,642.00
Issue Date: 4/15/2016
Expiration Date: 10/12/2016
PROPERTY ADDRESS:
Address: 2277 SEMINOLE RD UNIT D
RE Number: 168344 -0040
PROPERTY OWNER:
Name: HOOKS, JOHN
Address: 2277 SEMINOLE RD APT D
GENERAL CONTRACTOR INFORMATION:
Name: BEECHWOOD CONTRACTING, INC
Address: 14030 Atlantic BLVD #3414
Phone: 904 - 402 -7258
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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. BUILDING PERMIT APPLICATION - co
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CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach FL 32233
�"- ` R Office: (904)247 -5826 • Fax: (904) 247 -5845
Job Address: 22 SIw, ,note- Rell, O, -f *0 , Permit Number: J6 -poi? - 8-6.1---
Le Description RE#
Valuation of Work (Replacement Cost) $ i5;012- i µ Heated /Cooled SF %1D0 Non- Heated /Cooled
• Class of Work (Circle one): New Addition Alteration epa Move l emo Pool Window /Door
• Use of existing /proposed structure(s) (Circle one): Commercial eside . al
• If an existing structure, is a fire sprinkler system installed? (Circle one): es l`.J 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: 4-0 6e tut/4 r 4.4,1 y .
[4.) 0 ,4,,, F_r_fgr:t"f :a.A K% 1Z,e5: cic4ce NCB -te )fy wAll .C � . 7. 5'011"4- p4;r + t -t-i: w.
Florida Product Approval # FJ,4 for multiple products use product approval form
Property Owner Information
Name: j (-1 kr Address: 2/77 fp►+ :..uIt R-d OA 4- (l
Cit AfJar.4 :c 13c€. L, State a zip 32133 Phone (1o4) 8 b8 - DOC
E -Mail - ..lo11 h 5 - 0 . ► 1 i+vo I301 Sou -k, . ne,+
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required)
WARNING T() 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.
Contractor Information: 11
Name of Company: 3 e e, eh. wo v d Cowl-fat 4 ° Qualifying Agent: Er < L R oko r
Address: J'Nb30 /44-i4K 4-:e. 1B/v i O m+ 3y /y City A .1-c kso.v: ti c State Zip r L 329.2 S"
Office Phone (qpy 1/02 -72 5 Job Site /Contact Number (90 1) 9v l - 2 5 2
State Certification/Registration # CG c 15 42 E -Mail bo ea bet , dog) eor47c. -4: ►N
v�
Architect Name & Phone # Al a
Engineer's Name & Phone # Nq
Worker's Compensation
x emp / Insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a pemit to do the work and installations as indicated. 1 certify that no ork or installation has commenced
pror to the issuance of a permit and that all work will b performed to meet t h e standard o all law r construction in this jurisdiction.
This permit becomes moats and void if work is not comm enced within six (6 months o r i f c onstriction or work is suspended or abandoned for a
period s at any ..me aft -r work is foram •nced. I understand that separate permits must be secured for Electrical Work, Plumbing,
Signs, Wells, Pools, Furnaces, : , filer • Heater , ' ank • ' d Air Conditioners, etc.
Signature of Property 0 er: ‘,
'i _ i,�.i = f (^
� �, Signature of Contractor: 7 '
Befoe , II, 77 0 __ -
this ay of � y j .i 2
ii A Before me thi ,01111 _ Day of r, i
N i P . �- ` ot aiy _ . c: Nota ublic i a
li t _ < - .., _ . . . • r ad ' xamined this application and kno . - . < - • •, 'isid'ns o la and
• rdi ces geiiigst tni d b w rk will be complied with whethe p . • r. r o • • . n i of a permit does not
,rg o g w &i to , r cancel the provisions of any of r f , s,+ a� m� i' ' tla ig construction or the
a ;�c� Fd.
Expires 02114/20 ` rY Commission PP' 086990
w F or c+, Expires 02/14/2010 ' ev. 3/14/16
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NOTICE OF CI MMENCEIVIENT FILE COPY
State of r l o (i 4,1a, County of 1 v A , 1 Tax Folio No.
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: 2
77 S�mSvle_ ..2c1 V �
• A4- fc•�n.�� c Apr �L Fl_ 2 .)
Address of property being improved: 22 7 7 K� vn c+
St�wt n,,IP � ,. - 'Rea/ ; Ft 32223
General description of improvements: �' /� �C _ I I f
�ZCOn ( )t� ?. :7f it � /Wlt)llf (. niZ.LJ
4-;) ['2: P ctd y vat- ( / tut w AC
Owner: Tv Lt,. Peon kJ' Address: 22 77
Owner's interest in site of the improvement:
Fee Simple Titleholder (if other than owner): •
Name:
Contractor: F L o t Fee L ,,,, a C tt +�—
bG 11 �NTfKC�• "
Address: ��� J—VrC .
1 �0 . l4 t 1 u� 4•: t _ 1 , v i,/ t�nc' 74/y
Telephone No.: (b4) 40 — 7 z S 8 Fax No:
Surety (if any) 104:
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 Florid:), 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 OWNER\
i
fp.
ed: f ��j 1t I
� �� � � � �y v/ Date: Z
efore me thi -"Its .. ay o f . / . in the County of Duval, State
Of Florida, h. . ersonally appeared •
Personally Kno • -
Produced Identif or
Notary Public: ft■ -to
•. :,tea ;; 4T i
oya Q Notary Public State of Florida ,
. Shirley L Graham
My Commission FF 086990
Ncain Expires 02 /14/2018
- .�vi City of Atlantic Beach /V / OS r7 �,� /. APPLICATION NUMBER
J Building Department (To be assigned by the Building Department.)
800 Seminole Road ‘ ( yl f 1 �r / a61 _ p 2
Atlantic Beach, Florida 32233 -5445 a
Phone (904) 247 -5826 - Fax (904) 247 -5845
' '! JRI9'' E -mail: building- dept @coab.us Date routed: /z /f
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
(
Property Address: 22. 77 SEmin )// ed Department review required Yes /�o
uilding (/
Applicant: �i e4 W 0011 6/Wrike a r l nnin &Zoning
J Tree Administrator
Project: Wfrri. r d i, -- 2)1( Tv Public Works
Public Utilities
/vD a / g , 1 floa>Q s 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: proved. ❑Denied.
(Circle one.) Comments:
UILDI
PLANNING & ZONING Reviewed by: Date: y` / '� 6
TREE ADMIN. Second Review: ❑Approved as revised. EDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. [1]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09