Loading...
1127 Atlantic Blvd Carpot for Legion 2014CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003774 Date 2/10/14 Property Address . . . . . . 1127 ATLANTIC BLVD Application type description COMMERCIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2380 ---------------------------------------- Application desc COMMERCIAL CARPORT IN FENCE -------------------------------------- Owner Contractor _ _ _ ------------------------ RTS DEWITT B TILDEN MEMEORIAL POST CAROLINA C TTOHWY INC #316 INC. AMERICAN LEGION 2465 CTT NC 39837 1127 ATLANTIC BLVD ATLANTIC BEACH FL 322332516 (888) 242-5022 Structure Information 000 000 Occupancy Type . . . . . . ASSEMBLY ----------------- Permit . . . . . . COMMERCIAL ALTERATION/OTHER Additional desc . 32.50 Permit Fee 65.00 Plan Check Fee 2380 Issue Date Valuation Expiration Date . . 8/09/14 ------------------------------------ Special Notes and Comments Avoid damage to underground water/sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247-5834. If on-site storage is required, a post construction topographic survey documenting proper construction will be required. 2010 FLORIDA BUILDING CODE, FLORIDA FIRE PREVENTION CODE 2008 NATIONAL ELECTRIC CODE APPROVED AS NOTED. SWALES FROM NEW CANOPY TO EXISTING RETENTION AREA REQUIRED PER RICK CARPER, PUBLIC WORKS DIRECTOR. ----- --------------------------------- STATE DCA SURCHARGE 2.00 Other Fees ENG REV COMMERCIAL BLDG 25.00 STATE DBPR SURCHARGE 2.00 UTIL REV COMMERCIAL BLDG 25.00 ------------------ ______ ----- Fee summary Charged Paid Credited Due _-------------------- ------ --00 Permit Fee Total 65.00 65.00 .nn PERMIT ISPAWA0NQi1(Mk1' �a1RDANCE WITWA6,0ITY OF ATI -19 FIFEACH ORDINANEAPAND THE FLORIBR 0 BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003774 Other Fee Total 54.00 54.00 Grand Total 151.50 151.50 Page 2 Date 2/10/14 .00 .00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. t FIIILLEL COPY i Carolina Carports Inc:',., 187 Cardinal Ridge Trail Dobson, NC 27017 1-800-670-4262 November 26, 2013 To whom it may concern, This letter is to authorize Joe Nolan to pull a permit for Carolina Carports Inc. and Michael Johnson for the city of Atlantic Beach, Florida. License # CBC1254822 Exp 8/31/14. Address: 1127 Atlantic Blvd. Atlantic Beach, Fl. 32233 Thank you, Michael Johnson CCI County: 9W+q- State: Notary Signature:2 NOTARY PUNIC my Burry County, NC . C CWCWffln W ,*ros M -t - s I4 s n M 1* -9 :c7'V PObEXr D 4*61o3,CL ! I AMEXIGAN _E610ti A iA NIP _ t 7 UAM 6LYD. � ATLANTIC. VA4*, R L t 1 RAT U�o �(� ' R vii .. c a�s�a c� j f!A �i s, I4 s n M 1* -9 :c7'V PObEXr D 4*61o3,CL ! I AMEXIGAN _E610ti A iA rarrsaerssaeevs _ t 7 UAM 6LYD. � ATLANTIC. VA4*, R L t 1 RAT U�o �(� , wu ww ss rr, reo�.uw w uw O nw w+r. " s 0 m 4000004 City of Atlantic Beach Building Department 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 • Fax (904) 247-5845 E-mail: building-dept@coab.us City web -site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: 1 12-1 Pte- QYtk%(_'1 a V d Applicant: oyr Project: Review fee $ iED ent review re uired Yes No uildin anning & Zoning Tree Administra Public orks Public Utilities Pu i e y Fire Services Dept Signature Review or Receipt Date Other Agency Review or Permit Required of Permit Verified B 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: APPI ICATInN STATUS Reviewing Department Revised First Review: pproved. ❑Denied. (Circle one.) Comments: G't � OAC rJelCALtPo � b S� _/ to' &m �s//'e. DING ',04we�& ANNING & ZONING Reviewed by Date: !O P Second Review: ❑Approved as revised. ❑Denied. TREE ADMIN. RKS e Comments: ITIES PUBLIC SAFETY Reviewed by: Date: Third Review: ❑Approved as revised. []Denied. FIRE SERVICES Comments: Reviewed by: ate: Date-.- Revised 05/14/09 `� BUILDING PERMIT APPLICATIONI �� DEC 4 2 13 CITY OF ATLANTIC BEACH 11L1 800 Seminole Road, Atlantic Beach, FL 3223 By Office (904) 247-5826 Fax (904) 247-5845 Job Address: 0-7 kTL&N T i<G /4 L V�Permit Number: 9 Legal Description Parcel # Floor Area of Tq--.Ft-. S q, Ft - Valuation of Work $ Proposed Work heated/cooled non-heated/cooled -7 3 S Class of Work (circle one):1 Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial Residential If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No /A Florida Product Approval # a G 5`? 6 R a lWaYlgei a k b 7a Z Al 10 167120�L For multiple products use product approval form Describe in detail the type of work to be performed: �� L ��a R'R� `� Nuc_` r� ax" 1: RQ� Property Owner Information: City A'i'c.AWrZ' _- Bj A -G k E -Mail or Fax # (Optional) AaSc 3L/P Address: 1( 9 p7-" WT Z,--, gl; ap. State FL Zip 4 -Ag 3 3 Phone Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: )I a +A�",, Address: 187 (, j r . Office Phone 70 if ILC A Jo State Certification/Registration # Architect Name & Phone # Engineer's Name & Phone # Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Qualifying Agent: City D&BSQ ni State Nd Zip 2 l at" er Fax # 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 laws regulating construction in this jurisdiction. This permit becomes null and void tf work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks and Air Conditioners, etc. 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. I here b certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether sped ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of a t r f e 1, at to l law regulating construction or the performance of construction. t &4� Signature of Owner Signature of Contractor Print Name TdS� d�lF �. %1�C ,/..71 ................................... Print Name TASC Fl{ L`- A bLA N .................................................................................................................................................................................... ............. Before me this Day of , 20 N t PU.' it.P JENNIFER WALKER .''': MY COMMISSION 0 FF 01140 a: •= EXPIRES: April 24, 2017 .. Bonded Thru Notary Public Nrul®hi 119t§ Before me this Day of JENNIFER WALKER MY COMMISSION A FF 011480 EXPIRES: April 24, 2RZV1S 01.26.10 Bonded Thru Notary Public UnderwWa > _ �,.�,�,�,, s aarwe ,wl D wrrt v ^muwanr •a a4 ruw tia A �• -y�� �% �•M0,7 1. j • -21Nvuv ".twig ?i m".,v Lill hi w 4�� o 1 *r, of es � t s H c a 9 g W � ga �• g pq:- - .g� iii• L C t Midi 6 m Q a ,0 .. FK ��•� n `k CL rt SS a hi �,-, 4,40- - E 0 Z n O cn i -+ mmmm - lame, m O z mo c�an omcM e^'on G n nmx prim m L. y D>n mmcC OZ Ci O zm O D 'ZZo Tmn � Z T D O woo Z1 z O mZ Imil �mm O:EZ C::; D zE< mm �m'm =zm "' m z mc0� zL� ➢ z C (n tam T G - n rn I N i c c6'tsG m O N x c z C P � e P C' �m C cn F i -n- plp rorn3 rn o r. r, n z 'a ? D 4 - � a�F V Cpl vm; ~ �m> tbtl0 "I2a G pTp Z G) 2 fn o c S D z O in 0 mDZ 00 A c o o m m n 0 70; C { ' � z V tr Q 0 O S N N +zC 1 m c t r p S D _'s E M m > m n� m m m 2 u � m m c m n _ r 70 m z Nm0 D z m A b } `s = fzn N � a Z O ?' P I a m0fn Zm O O fa cn Gsm o G C p N tfn 2)A a w mO �z O x�m Om O 0 2 I T I � . z c m 0 6) A n CD ' C. rES 0 En z u m m ^1 r. c Tr v l zD oo -D+D mr Z n O cn i -+ mmmm - lame, m O z mo c�an omcM e^'on G n nmx prim m L. y D>n mmcC OZ Ci O zm O D 'ZZo Tmn � Z T D O woo Z1 z O mZ Imil �mm O:EZ C::; D zE< mm �m'm =zm "' m z mc0� zL� ➢ z C (n tam T G - n rn I N c6'tsG m n m !oco P � e P �m m cn 3_n i �d plp rorn3 rn O m U 'a ? 4 - � a�F V Cpl vm; �m> tbtl0 "I2a m nom 2 fn o c S D z O Z` in 0 mDZ 00 A c o o m m n 0 70; C { ' � z V tr Q 0 O S y 1 m c t r p S D _'s E M m > m n� m m m 2 u � m m Dz zz� rn _ r 70 m z Nm0 D z m A b } `s = fzn N � a Z O ?' P m m0fn Zm O fa cn Gsm o G N tfn 2)A a w mO �z O x�m Om O 0 2 I T I � . z m 0 6) A CD ' N . cZ--+ yy m z maZ���Koc z > ?N _ NT -i02 a T n �- T p II Z 0". TGnDO O f, 50mN O ao ilCn jQQQb Z xmm� �AmN O ��mV oi. saN m Vzo z�pZO o[;m pz= DT G P D mA S Tn OD ~ AnoN, o 0Dysm mm m_Ta Q4 pZ>QF Ac Cp00 ° aII O � mZ. 3 m m D r n D X 0 O D M Z a Z T cn "{ D zz� : 0 0 cn z v O m r n D T O � U) m D cn 1m },0 Iro tm z m z 0 a r m O z ilia A I, f� g l 9 A F p mfh �pp� a p qq iS � S q Ri� C 4 i [ , i 0 m y L ,• s 0 i fF Q�� z z 1m },0 Iro tm z m z 0 a r m O z ilia A I, f� ;Fg S 9 A F jm m all € , i 0 y � � p ,• s Q�� z z Y� A I, f� RJR ` S 9 A F jm m all € , i f� n 9 D jm m p € D i 0 � � p ,• s Da ggg ;M0 �. 10 SIN Imo m Wit 3 E£ 1. f$ J iI jilt ���_ 9gk. mm a A 3` if! "11,11 t Dm � � it hm E fr m ;m AIN m =. m i�Im j/€ z� 1Z ! _ m € IG) fi Jill go m1 >a- off' �0 1� ; �R a �. 4m mm , g m r m� D �OZ O Z. 1 0 55; m 1 aL �r y €g r=ZQ n� m R•o „as � ggqqB Y i 11 m `�♦ sg �� ��g j S O 3 O.G) nT t g Y oDj4: E T� DAmD m N=�g s 00°3 !! fn xzm :. 1 op om 715 1 � .0lom iii // _ jpm g!!ii Q grx0 =z MZ s mo ;c z O LUM M rn z n 0 Z 0 X Z n gm z M 0 > U) m 0 0 z F Rj 4: D -{r Cl1 T 1 mm Dm IM Om lz OM s _' If at z 1= C) mo n r c Ce99"te offer P.d. Box 1263 Carolina. Toll Free: 187 Cardura! Ridge Tr. Local: W) 670-4262 Dotson, NC 27017 C OrtS. Fax: (336) 367-6400 Fm ii. cci@ccitmgA (336) 367-6410 Website: www.caroti j4 Fu: (36) 367-341 l rracarporWnc'com jj jC • FLS - CBC1254822 DEALER S Dealer Phone No. 3 CUSTOMER NAME " � � �'%5�b: ZW-M ADDRESS . jC�n� r'� fy� � Y %!t��--STATE TAX oho (Where Delivetrd) PHONE: WORK (22y ) ,� 3 HOME ZIP �--__� OTHER {�) UNIT SIZE W L. l i?t, LQ 4 COLOR Tpp vim' 12 ❑ All Orders C.O.D. S. h. ,SIDES TRIM s L,_/_,_�.1 �Ie 3 e te55 l Price t la �5 Tax NaM F AM—Ea l F3 SF[uR3 �R THA ISI lt(KiF LEN�iTH e I' Installation Type Cement ❑ Power Available yes ❑ No ❑ Boxed Eave ❑ Vertical ❑ Ground U Asphalt . ❑ Umertified 17 Certified subtotal D �U 5 tux Down Payaw Bdbrt "ax 3*W, Total Additional Labor CMM at� ►ation a 3dO ,�lv Other ❑ This purchase agreement (the "Agreement") is made by and behveen Carolina Carports, Inc, ("CCI"), a North Carolina corporation; "d Buyer agrees, after being fully educated about CCTe various products including the fourteen 14 des gauge, and certified units, to bay, and CCI agrees to sell, pursuant to the terms listed in this Agreement, the item e described above. buyer has read and understands the terms of this Agreement, including the terms and conditions contained on the reverse side of this document, which terms are expressly incorporated herein by reference, as well as any and all relevant warranty information, and agrees to be bound by some. Customer: CCI: Email By: Authorized Dealer How did you hear about C.C.I?: ❑ C.C.I. Event o C.0 -L REP 173 Word of Mouth = -Other ❑ Website c3 TV Ad ❑ PaperlMagazine Carolina Carports Inc. 187 Cardinal Ridge Trail Dobson, NC 27017 1-800-670-4262 November 26, 2013 To whom it may concern, This letter is to authorize Joe Nolan to pull a permit for Carolina Carports Inc. and Michael Johnson for the city of Atlantic Beach, Florida. License # CBC1254822 Exp 8/31/14. Address: 1127 Atlantic Blvd. Atlantic Beach, Fl. 32233 Thank you, Michael Johnson I mmi t McMw m NOTARY PI18llC Suny County, MC My Cw mis W EVIM t L s 6 � 8" 'sib �e �� ➢� F��C Cg"gp� ��H m I'eG ; d r� _•' _ Q € �l R y t . i viii :�a §� E�^¢�¢ � aid �§ �� �• � � n i a s N g c Sw.s. !- � t � .'�y � -_ _ ..- �:: = •i..i Jii1i..7rFrs�a I,Di3i i 6'3:V "' :• 4 ',aM - � (CII9E.2'.' ;i M. 4M:. E- lz Six r—AN-.E&ION i� i 4tP y�OMARMTtats I iL V, AT !A1iiic BLVD.,, ATtANTK- BEPU}, F t. I'eG ; d r� _•' _ Q roY Y,l/ dM Yu, wnwnW. rt nn. a m.. w -++ea R y t . i viii • .. _.�• .�I.� . !- � t � .'�y � -_ _ ..- �:: = •i..i Jii1i..7rFrs�a I,Di3i i 6'3:V "' :• 4 ',aM - � (CII9E.2'.' ;i M. 4M:. E- • ? Six r—AN-.E&ION i� i 4tP y�OMARMTtats I iL V, AT !A1iiic BLVD.,, ATtANTK- BEPU}, F t. I'eG ; d r� _•' _ Q roY Y,l/ dM Yu, wnwnW. rt nn. a m.. w -++ea R �� �.� 7. ,�' AOL, dL d .>T •jiit a6- E'8" °&E^ ► V G F r ,�; E R71 eE:E � � a §E'� ?N.. _ ._..� � y � �, ,;, ➢ Wit: � � e •'.: !► i • I �8 � i� � 6 � g' Cy ' - D yil .Z 1Yi' �' d - • � Is' .. �°fd • •� — � Z t. lY 8<� >' � &7356 aY a z ....: ._.f ..1.•..ck�'r.' e '•i AmMiON s l � .� i}� � !`L7 q`LWT'L BLVD.•, ATL41.ITtL BEAC!},FL r[,rr;.��l fp"'ow'f rw+r.n�ru, rwrmui.n ss�w ai+a, w-.+oo � Dec 10 13 03:13p Dewitt B Tilden Post 316 BU] Job Address: 10-7 A-ri-&n-' i r -C Legal !Description k1go Valuation of Work S �-3 3'O:.'Ea Pra 904-249-2058 �.�D�INP'PERMIT APPLICATION tY QQ{ F ATLANTIC BEACH embole Road, Atlantic Beach, FL 32233 6e(*247-5826 Fax(904)247-5845 Class of Work (circle one): Addition Use of existing/proposed structures)circle one If an existing structure, is a fire sprinider syste>i Florida Product Approval #' t .5"14 A 1 1 o d For multiple products use product approva Describe in detail the type of work to be perfoi p.1 Permit Number: '' 11 i Parcel # ed Work heated/cooled non-heated/cooled 7 3 ,5� !Alteration Repair Move Demolition pool/spa window/door I Commercial Residential ins)Wled? (Circle one) !Yes No lA r ned: t'N.4 7' y Property Owner Information: .0000�1 Name: A +'z e IQX G r+ W L"!Z6- o N J0 eSr 3 Address: City State. p 33 3 Ph ne' E -Mail or Fax 4 (Optional} Contractor Information: CONTRACTOR J 1ktjjL ADDIS: Company Name: I}Ra t E! N N.e-+A PPA?T i y ; Address: !d 7 Q � rin$ Agent: 4� �� �,Rs. �C T . City Dz. 6 �� State Nd Zip 2 1 ai Office Phone t z i -4- 70 - S6 CA Job 9iV (t6ntaet Number .. 1~ax # State Certification/Registration # {` Architect Name & Phone # Engineer's Name & Phone # . Fee Simple Title Holder Name and Address Bonding Company Name and Address - Mortgage Lender Name and Address - tlpplication is hereby made to obtm'n a permit to do the work apd installations as indicated I cert fy that no work or installation has commenced prior to t!:, issuance ofa permit and that all work will be performed to ntee! the standards of all laws regulating construction in thisjurisdiction_ This permit becomes n1,11 and void f work is not commenced within six (6) months, or if ' utruction or work u suspended or abandoned for o errod of six r6) months at any time ante work is commenced. I understand that separate permits must secured for Eleeirlcal Work, Plu»ebuig, Signs, yYdls, Pools, Furnaces, Boilers, Hearers, Tanks and AirCondltionem etc I; WARNING TO OWNER: YII UUi iAILURE TO; RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IlY' 'END! TO OBTAIN; FINANCING CONSULT WITH YOUR LENDER OR AN ATTOI NEV BEFORE RECORDING YOiJR NOTICE OF COMMENCEMENT., I hereby certify that I have read and examined thisapplication a know the same to; be true and correct. .111 provisions of laws and ordinances governing tilt type of work will be complied with whether spec: led herein or no The granting of a permit does not presume to give authority to violate or cancel t1; provisions of an oth r f e 4 at 1 �Jy1 law regulating cor�strudlion; or the performance of construction. Ir Signature of Ownert49301040�A4�� Signature of Contracto Print Name 7'&S lt f lk L, t�sc ,. _ !. PrintName* M Lkr4el J"o �r< - _._... .— Before me Before me this Day of ,20 f this Day of.20 �i I 1 W COMmmo f FF 0114M rl u, .z�t� 126.10 iiiatio1WYP 1 1 ,11 ,111.1 lv CW goo 0 City of Atlantic Beach Building Department 800 Seminole Road -- �� Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 • Fax (904) 247-5845 r%Dill, E-mail: building-dept@coab.us City web -site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: 1 1 2� A -H Q n -ti (f ay Applicant: Project: GOh )ry- r (71. C a. C Department review required Yes No Buildin Hing & Zoning Tree Adminis ra or ublic Wor Pubic 1 u is a ety Fire Services Review fee $ Dept Signature nthar Ananry Raviaw nr Parmit Required in strict bacco Review or Receipt Date of Permit Verified By ICATION STATUS )proved. Reviewed by: - - 'tea TREE ADMIN. Second Review: Approved as revised. ❑Denied. P B I -C WORKS Comments: c., PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: FIRE SERVICES Third Review: []Approved as revised. [—]Denied' Comments: Reviewed by: Revised 05/14/09 Date: 12 12,0p > C dl�l uw"-w Date: Date: Comp. By: RLC Date: 12/9/2013 Public Works Department City of Atlantic Beach Permit No: 07-821 Address: 1127 Atlantic Blvd - American Legion Reauired Storaae Volume Criteria: Section 24-66 of the City of Atlantic Beach's Zoning, Subdivsion, and Land Development Regulations requires that the difference between the pre- and postdevelopment volume of stormwawter runoff be stored on site. Volume of Runoff is defined as follows: V = CAR/12 Where: V = Volume of Runoff C = Coefficient of Runoff A = Area of lot in square feet R= 25 -yr / 24 -hr rainfall depth (9.3 -inches for Atlantic Beach) Predevelopment Runoff Volume: Lot Area (A) = 89,730 ft2 Runoff Coefficient Lot Area Added impervious provided with permit, still need total impervious Description (ft) Area Lot Area Description (ft) (ft) "C" Wtd "C" Impervious 2,626 89,730 1.00 0.03 Pervious 87,104 89,730 0.20 0.19 Runoff Coefficient (C) = 0.22 Runoff Volume V = 0.22 x 89,730 x V = 15,536 ft3 Postdevelopment Runoff Volume: Lot Area (A) = 89,730 ft2 Runoff Coefficient Area Lot Area Description (ft) (ft) "C" Wtd "C" Impervious 3,364 89,730 1.00 0.04 Pervious 86,366 89,730 0.20 0.19 Runoff Coefficient (C) = 0.23 Runoff Volume V = 0.23 x 89,730 x V = 15,994 ft3 9.3 / 12 9.3 / 12 Required Storage Volume DV = Postdevelopment Runoff Volume - Predevelopment Runoff Volume DV = 15,994 - 15,536 DV = 458 ft3 Retention (2) 1127 Atlantic -onsite Retention.As 12/9/2013 City of Atlantic Beach �s Building Department -� 800 Seminole Road j r Atlantic Beach, Florida 32233-5445 t' Phone (904) 247-5826 • Fax (904) 247-5845 E-mail: building-dept@coab.us City web -site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: �� ��� �`� 13yA C Applicant: C I an Project: m ` DatlMent review required Yes No anning & Zon Tree Administrator 21 ih rks ublic Utilities Public Safety Fire Services Review fee Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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 Revised 05/14/09 []Denied. Reviewing Department First Review: ��/ (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: Date. ' Second Review: ❑Approved as revised. ❑Denied. TREE ADMIN. L WO Comments: TI I ES P LIC F Reviewed by: Date: Third Review: ❑Approved as revised. ❑Denied. FIRE SERVICES Comments: Reviewed by: Date: Revised 05/14/09 rsy�wr, City of Atlantic Beach Building Department J� 800 Seminole Road Atlantic Beach, Florida 32233 5445 Phone (904) 247-5826 - Fax (904) 247-5845 i•�,;t��r E-mail: building-dept@coab.us City web -site: http://www.coab.us vqA q APPLICATION NUMBER (To be assigned by the Building Department.) Date routed: 12-1 APPLICATION REVIEW AND TRACKING FORM Property Address: 1 < Applicant: ,O -r-- Project: GDry-)�o i ( lack ryDnY+ Review fee $ nDement review re uired Ye No & Zonin Tree Administrator 'PuEli Works Public Utilities Public Safety Fire Services Dept Signature Review or Receipt Date Other Agency Review or Permit Required of Permit Verified B 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: A It-ATIr1A1 CTATI IC Revised 05/14/09 VApproved. ❑Denied. Reviewing Department First Review: (Circle one.) Comments: N BUILDING �'� � ,�y dna �C]�i2 /�/1 PLANNING & ZONING Reviewed by: Date: 2-11-1 Second Review: ❑Approved as revised. ❑Deni TREE ADMIN. CEDBILIC WORK Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: Third Review: ❑Approved as revised. [-]Denied. FIRE SERVICES Comments: Reviewed by: Date: Revised 05/14/09 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 1 L,17 R'Tt-#tNt ZG. fi L vD - Permit Number: Legal Description Parcel # Floor Area of Sa.Ft. Sq.Ft Valuation of Work $ 9 - Proposed Work heated/cooled non-heated/cooled--7 3 S Class of Work (circle one): Ae3 Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)circle one): Commercial Residential If an existing structure, is a fire sprinMr system installed? (Circle one): Yes No /A Florida Product Approval # FL f. 5 't /. R a lWa46L,01 A k b 7 a,1 k1 la ta"i1,2a4 �L For multiple products use product approval form Describe in detail the type of work to be performed: r l"' "L e -RA PRr y Nsj'D,` r 1> << RQL� Property Owner Information: Name: A 11 f QZ C R Al t. (,-Ea � P 6S i" ,.316 Address: it 9 7 AI -4 R 1yT Z. City A V LAjUrr,:: k StateFL Zip 3 -1A3 3 Phone E -Mail or Fax # (Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: e-1*A L ^'1$ G l -R P&A Address: JWA7 t�' 7-A. Office Phone 5`0 c ' 70 , it ;k -G A Job State Certification/Registration # Architect Name & Phone # Engineer's Name & Phone # Fee Simple Title Holder Name and Address_ Bonding Company Name and Address Mortgage Lender Name and Address !U� - Qualifying Agent: City De 15,5 d W Contact Number Fax # Nt` Zip 21 el 7 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 laws regulating construction in this jurisdiction. This permit becomes null and void :f work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrics Work, Plumbing, Signs, Wells, Pools, urnaces, Boilers, Heaters, Tanks and Air Conditioners, eta 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. I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the V isions of a t r f e 1, at to l law regulating construction or the performance of construction. Signature of Owner Signature of Contractor Print Name '�S .�1F......._��...... `- ..................................... Print Name TesF JOR L`. 1,6 LA Jll Before me this7—Day of Before me this Day of JENNIFER WALKER N — JENNIFER WA ER MY COMMISSION N FF 0114 *'� r MY COMMISSION 1 FF 011480 EXPIRES: APdl24, 2019. 1 EXPIRES: April 24.2RZVis 01.26.10 Baled Tlru Notuy Publb WWWW"i �SitF:t\• Bonded Thro Rg" Pubk UnderwAters