350 Seminole Rd RES21-0277 SidingOWNER:ADDRESS:CITY:STATE:ZIP:
TOUHEY MICHAEL C 350 SEMINOLE RD ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
T H AGRAM, INC 3850 PACKARD DR JACKSONVILLE FL 32246
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170430 0000 SALTAIR SEC 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
350 SEMINOLE RD RESIDENTIAL ALTERATION
RESIDENTIAL HARDIE TRIM $5625.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $80.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $40.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $124.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR 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.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 9/14/2021
PERMIT NUMBER
RES21-0277
ISSUED: 9/14/2021
EXPIRES: 3/13/2022
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 9/14/2021
PERMIT NUMBER
RES21-0277
ISSUED: 9/14/2021
EXPIRES: 3/13/2022
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $124.00
RES21-0277 Address: 350 SEMINOLE RD APN: 170430 0000 $124.00
BUILDING $80.00
BUILDING PERMIT 455-0000-322-1000 0 $80.00
BUILDING PLAN REVIEW $40.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $40.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R17131 $124.00
Printed: Tuesday, September 14, 2021 2:55 PM
Date Paid: Tuesday, September 14, 2021
Paid By: T H AGRAM, INC
Pay Method: CREDIT CARD 512097155
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R17131
Final Plumbing
Final Electrical
Final HVAC
CC Final
Final Building*
Swimming Pool Steel
Swimming Pool Safety
Electrical Grounding & Bonding
Swimming Pool Final (Bldg)
Swimming Pool Final (PW)
Formed Columns/ Beams*
Masonry Cell Fill
Structural Steel*
OTHER:
OTHER:
OTHER:
OTHER:
OTHER:
Power Pole
Silt Fence
Piers/ Stem Walls
Underground Plumbing
Underground Electric
Foundation/ Footing
Slab**
Retaining Wall Footing
Driveway
Sewer (Building Dept)
Sewer Tap (Utilities Dept)
Rough Electric*
Rough Plumbing/ Top Out*
Rough Mechanical*
House Wrap
Wall Sheathing
Roof Sheathing
Tie-down Framing Connections
Rough Framing
Roofing In Progress
Window/Door In-Progress
Insulation Ceiling
Insulation Wall
Exterior Lath
Stucco Scratch Coat
Exterior Siding In-Progress
Brick Flashing & Ties
Early Power
Gas Rough
Gas Final*
* When all rough electric, plumbing, mechanical are complete but before any work is
covered up.
* When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance. All outlets must be capped and pipe pressurized at a
minimum of 15 lbs.
* For new living space: When all construction work including electrical, plumbing,
mechanical, exterior finish, grading, required paving and landscaping is complete
and the building is ready for occupancy, but before being occupied
Additional inspections may apply to your project if your project
contains these elements:
INSPECTIONS REQUIRED FOR BUILDING PERMITS
To verify compliance with building codes, inspections of the work authorized are required at various points of the construction.
The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
_____________________________________________________
Permit Type
____________________________________________________
Permit No.
__________________________________________________________
Job Address
____________________________________________________
Contractor
POST THIS CARD WITH PERMITS AND PERMIT
DOCUMENTATION IN FRONT OF BUILDING
Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends
Building Department Public Works/Utilities Fire Department
Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789
Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203
* When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all
electrical, plumbing and mechanical work is in place, but before concrete is poured.
* When all structural steel members are in place and all connections are complete,
but before such work is covered or concealed.
** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION
i'J''f, Building Permit Application Updated 10/9/18
f!,
l
City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
ccPhone: (
904) 247-5826 Email: Building-Deept@coab.us
JobAddress3 9 S&t1/ isd O(.e AD/Al -Akir 1 c v Permit Number: E .i - O G / 7
Legal Description/0--/.5-A-ZS"2 1 e 56-c- 2 .5'4 LTA i A G01 L6 s RE#/70 41 o -(x9.1.
Valuation of Work(Replacement Cost)$ S, b Z S Heated/Cooled SF Non- Heated/Cooled
Class of Work: New Addition Alteration Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial Nt2esidential
If an existing structure, is a fire sprinkler system installed?: :Wes No
Will tree(s) be removed in association with proposed project? Yes(must submit separate Tree Removal Permit) No
Describe in detail the type of work to be performed:
H(J G-LA- A 146-0 a S SCT e 2.1 o L -1-4... 1/44 /2-t'pc../4 c E-pi/ E- h[ ?
t-+ Ar t - -T ,A it f1.-
Florida Product Approval# F L. 1 3 I % Z for multiple products use product approval form
Property Owner Information
Name fl4I G F9d (.. TO(}-t e 7 Address 335-0 ,16-/e/iso O L& a_ O
City i4TLp7A17i c P & 4-C-11c---4.. State Ft... Zip 3 2 L 3 3 Phone `x'04. Z 5-4. e ' Z 6
E-Mail m K 8 2 2 E (a Lj/*$1/4-/'— . CA,n
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Com any T H• A- 4 AA-44 / //'41 C-• Qualifying Agent /0/1/16 *V f-61"2 V47 N Ci c.
Address 147 Ho G-7 g c.43,TJo M i2 O City ST. o H ht S State TZ- Zip 3 2. LSry
Office Phone /r'04, 66 Z..7 7 27 Job Site Contact Number 90 4 . 6 6 2.. 77 37
State Certification/Registration# Az 1-f — 5\_E-Mail 7-11#49 /ZOA/.I'/D/N y.8 ,41./7•c"0. Ci' .
Architect Name& Phone# 7 COL4WryEngineer's Name& Phone#
Workers Compensation Insurer ` x ErP7 "T OR ExemptX Expiration Date 1 2-/31/ 24r,Zi
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
RECORDI YOUR OT O OMMENCEMENT.
i
ignature of Owner or At f.i . }!-.Contractor)
iiiii
Signed and sworn to(or affirmed),before me this", day of Signed and sworn to(or affirmed)before me this fC) day of
i\01,! by_M\U C 1),- .1.4,1 4'S . 21•2/ , by vvkl fir/ ,o/ L
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01741.7e o -ry)
A. : omission#GG 943250
s-•;o: Expires April 28.2024 t aYP a" VANESSA1.LOVETTF °P'
Bonded Thru Troy Fain Insurance 800.385-7019 Commission#GG 292460
OF Ft,•
ersonally Known Oli+ Personally Known OR 1'ii'
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ExpiresT• -••T p January 17,2023roducedIdentificationProducedIdentificatioFoFFoP,Bonded Thr;Troy Fain insurance 800-385
Type of Identification:V\. `3,\ 1 -. \ Type of Identification: L
NOTICE OF COMMENCEMENT
State of Tax Folio No. I 70 4 ;0 - V 000
County of DUI/A L.
ToWhom 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: /0 — /5 /6 — 2. S— 2 -75
SC- c 2 S46-7/1- 112, 60T 2 6S'
Address of property being improved: 3 Sa •S6'/1/N O(,& /2 /1-7-e-4ACT/G
General description of improvements:• / if 6-ce„ Erp u-r F>Cr6-i21 /'e. 7 g./A! 3 2 L 33
I-E-ecyst c.c'/-1Ft-1 T
Owner: /4(CCM-6-i.... 7-(:)(4E--t E7 Address:35..J.4-1-r/Noce f2 A-TLsf,A(Tf c
Owner's interest in site of the improvement: 0 E4Cf,
Fee Simple Titleholder(if other than owner): 54.Z3 3
Name:
Contractor: (. f't. 44 le-APh, /1-i C , 70ftIfc,q-1/ 0/'LV47/A! G' /C
Address: /47 11/01Y&7 t L ox7Je,' 1 d sr• 9 01-1" ,5> 3 215-`f
Telephone No.: 0`7, 662.7717-
r
6 2. 77 1 / Fax No:
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
specified):
ft
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THIS SPACE FOR RECORDER'S USE ONLY OWNER 0 N0ozi
Doc#2021226049,OR BK 19887 Page 1390, ned: Date: (
Number Pages. 1 fore me this ' I da if
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in the County of Du aWSitc,4Recorded08/30/2021 11:16 AM,
p y ppOEJODYPHILLIPSCLERKCIRCUITCOURTDUVAL
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COUNTY tary Public at Large,State of F,Lo ,C
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