1021 ATLANTIC BLVD # 1003 ELECTRIC CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-800
Job Type: ELECTRIC ONLY
Description: ELEC FOR SIGN UNIT 1003
Estimated Value:
Issue Date: 4/16/2015
Expiration Date: 10/13/2015
PROPERTY ADDRESS:
Address: 1021 ATLANTIC BLVD
RE Number: 177602-0040
PROPERTY OWNER:
Name: EQUITY ONE ATLANTIC VILLAGE,
Address: 16 NE MIAMI GARDENS DR ATTN: TREASURY DEPT
GENERAL CONTRACTOR INFORMATION:
Name: ALLBRIGHT MANAGEMENT PROFESSIONALS INC
Address: 7818 Professional PL
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Sign $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
; i 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
SIGN PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
TOB INFORMATION:
Job ID: 15-SIGN-772
Job Type: SIGN PERMIT
Description: SIGN-ELEC 47 SQ FT UNIT 1003
Estimated Value: $1,895.00
Issue Date: 4/16/2015
Expiration Date: 10/13/2015
PROPERTY ADDRESS:
Address: 1021 ATLANTIC BLVD
RE Number: 177602-0040
PROPERTY OWNER:
Name: EQUITY ONE ATLANTIC VILLAGE,
Address: 16 NE MIAMI GARDENS DR ATTN: TREASURY DEPT
GENERAL CONTRACTOR INFORMATION:
Name: ALLBRIGHT MANAGEMENT PROFESSIONALS INC
Address: 7818 Professional PL
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Sign Erection $65.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY HI ACCORDANCE WITH ALL CIT' OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDDHG CODES.
City of Atlantic Beach APPLICATION IVUMBER
< \) Building Department (rn be a fined br t 9uirding Depanment)
800 Seminole
RRoad _ 7z
Atlantic Beach, Florida 32233-5945
Phone(904)247-5829 Fax(9M)247 584fi
Nyy., •:. E-mail: building-dept@coab.us Date routed: Z
Cityweb-site htd//N'K'N'-coab.uS
1
01403
1_z_ A� ez [�t-
Fire
-
Property Address: 4 / 7� /Vnt review required Yes No
,�
Applicant: /dray.hT__An� do
/ istrator
Project: __ _� �� /J L_�__ ks
ties
ty
es
Review fee $ Dept Signature
Other Agency Review orPermit Required Review or Receipt
Of Permit Verified B Date
Flonda Dept of Environmental Protection
Flonda Dept.of Transportation J
St. Johns River Water ManaganenI District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.
r APPLICATION STATUS
Reviewing Depadment First Review: Approved r]Oenied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed by: ./�_� _ Date: y 2
TREE ADMIN.
Second Review: QApproved as revised. QDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
_—_ _ Date:
FIRE SERVICES Third Review: QApproved as revised. []Denied.Comments: i
- Reviewed by: Date: II
Msed 07/27/10
City of Atlantic®each APPLICATION IVUMBER
,:. /` Building DepartmenF (ic be asci netl b
II
300 tics Beat Road /� yt gtclding Depa b e�;
J�� Atlantic Beach, Florida 32233-5945 S/bbn 7 4
Phone(904)247.5626 Fax(904)24'7684.5 - —
E-mail: building-dept@coab.us Defer routetl: t
Cityweb-site: http://w. ..b.us
Property Addreps: d _ZRnfit ikj De men& review required Ye No
Applicant:
uildin g o __
Administrator - --
Project: Public Works ---`--""
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
tmB Date
Flontla Dept.of Environmental Protection of Peit Verified
Florida Dept.of Than tion
St.Johns River Water Management Distnct
Any Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other
APPLICATION STATUS
R
—�,-J�7—pproved - - -
eviewing Deparcmen¢ First Rent .
(Circle one.) Oomments: LJAs: Denied.
UILDIN
PLANNING$ZONING
TREE ADMINReviewed by:_ I "
. _-- _ JD
Second Review: QApproved as revised. QDe ed PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
--- -- _
FIRE SERVICES i hind Review: -
Approved as revised. QDenied.
Comments:
Reviewed by:
Date:
•ised 07/27110 --------------
FILE COPY
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 1003 Atlantic Boulevard,Atlantic Beach FL 32233 Permit Number: 6 I 72
Legal Description 38-2S-29E14.040 CAS TRO Y FEARER GRANT Parcel# 177602-0040
oe oor o q, t, q, i
Valuation of Work$ 189S-M Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): ew Addition Alteration Repair Move Demolition poolispa window/door
Use of existlng/pr=powd structure(s)((circle one): Commercial Residential
Han existing struMure,is a fire sprm er system costa a one): Yes o NIA
Florida ProductApproval#N/A
For multiple proodducts use product approval form
Describe in detail the type of work to be performed: 1 N SWILATI04 pF �BUILVI.J& $1�
'Chlstn►r+Et_ L.el'f?EZ_StGnIe.JZ titex,ls LED iL4LLtFAixwna4
Property Owner Information:
No E UITY ONE ATLANTIC VILLAGE INC Address 1600 NE MIAMI GARDENS DR
city North Miami Beach State FL •p p( e 33179
E- 1r
Contractor Information:
Company Name:Allbright Management Professionals Inc Qualifying Agent:Francis Leo Mmmv N
Address:7818 Professional Place City Tampa State F—Zip 33637
Office Phone 813-980-0300 x 110 Job Site/Contact Number 813-476-9278 Fax#813-980-0321
State Certification/Registration# 12000680
Architect Name&Phone#N/A
Engineer's Name&Phone#NIA /
Fee Simple Title Holder Name and Address A
Bonding Company Name and Address
Mortgage Lender Name and Address M1,6t
App/(ration is hereby made m obtain a permit w do the work and insudbehioms as ladicoled /certify(hat no work or instn/lnRon has co„oomrced prior m rhe
usnnnceo npermit nndthalu/l work will Aeper nrnred ro mrsl thestnndnrds ofall/mw regx(nhug mutructlan in rhisJurlsdictlon. Thsparmltbecomesnu//
android, rmrk i, ratmmnwwe dwNhmn ix(6 months.orlJconstruetien or urork/s susyemfed or nbnndonMfornP% od ofsb/6)monthr nt any rima nQer
work is oanmrencad. l understand that separate permiis must be seured for Etworkv work,Plumbing Slgns, Wells,Pena, Pomacrs,Bailers,Heaferx,
Tanks and Ab Condidoners,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 YOU NOTICE OF
COMMENCEMENT.
/bereb ccrt�lhat/ltawmaelandexaminedtbls licationarrdkrwwrkasanretobetmeandeormet. A(lpmWslom oflawsandordinnnmipwrniogthis
Type of work will be complied wish whether s ci ad herein nr tud. The gmming ofa permit floes rro!presume(o give authority to Woja or em,cel t/re
provisions ofanyotherfe&ml,state,orlo lalvregu/a Ragconsftaionortdaperformanceofmm(mction.
FILE COPY
SignmumofOwna SiSn.iun ofCmtncwr ��"
Print Name nt Name
Swom to and subsaib be re nii, S1.m m and
this
_b,DayoF 20 this yof
Notary Public Z ///�� � aG• luu
k,
" LISSE7}EG.&lM TY4Revised0116.10
MVCOMMIs G#I hilae UO �e _ #1}MY Fydh JOIN AUIIIXA
?` a` EXPIRES:Febms 24,W16 MY P/kM.115510Rl FFOM19S
~ .ah ' 6utleaibp Molary PWtr Mremayea ♦,.
EXPIRES:August 11,2017
.��� PottltslM6ug1M0M76mkea
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH FILE COPY
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845
JoB ADDRESS: IMS rATbA k1`=, VWP. A?ZAnX A&W .5 233 PERMIT#/S.4/G -?7
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS�h VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑i Underground up Pole
!_iResidential(Main)Service
I-0-100 amps i 101-150amps :151-200anrps ❑ amps #of Meters
❑Commercial(Main) Service
C0-100 amps 101-150amps 1;151-200amps amps CCT Service amps
Conductor Type Size
❑Multi-Family(Main) Service
L0-100 amps _'.101-150amps ❑151-200amps C amps #of Unit Meters
_]Temporary Pole ,J amps
SERVICE UPGRADE n amps 'i;' CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
L 100 amps '150amps 11200amps ❑ amps CCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUH.D-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICALPI;OJECTS
❑Swimming Pool JySign L:Smoke Detectors_Qty ❑Transformers KVA ❑Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
C Replace Burnt/Darnaged Meter Can ❑SafetyInspection ❑Panel Change C'-0H to UG
Other:
'emit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I M1ereby certify that I have
and this application and know the same to be true and cored. All provisions of laws and ordinances governing this work will be complied with whether
peci fled or not The permit does not give authority to violate the provisions ofany other state or local law regulation construction or the performance of
momaetlon. r
'roperty Owners Name EmurMQJE ArLAmrc V 4wi1 (L_wc. phone Number
:lectdcalCompany QMFfzO Office PhoncA5-9AO.63WFaxArs-I C1-O31l
'o.Address: lab1 �FErfi1G.Nr!_�j'ZpG� 1 City-MAGA Stater Zip
icense Holder (Print): M Ill State Certification/Registration# fill CDD& 0
fotarized Signature of License Holder
Sworn and subscribed before a day of /11AWeve 201/
OIA
SignatureofNotarPublic I
H EXPIPES:AYpa111,Pa17
imarrok"Nftim"
FILE COPY F-i
Fee]
EQUITYONEINC
February 26,2015
Owner: Equity One (Florida Portfolio) Inc., a Florida corporation
1600 NE Miami Gardens Drive
N. Miami Beach, FL 33179
RE: BusblaInsurance Agency
1003 Atlantic Blvd.
Atlantic Beach, FL 32233
To Whom It May Concern:
This letter serves as confirmation that Equity One (Florida Portfolio) Inc., a Florida corporation
hereby authorizes: Ampro &their authorized agents to secure permits for installation of a facade sign,
provided said work meets all building code requirements.
Please be advised the property owner(s)approve sign offset.
Should you have any questions, please contact Property Manager, Kevin Hollenbeck, of our Jacksonville
o4oueft
29 2222.
T
X
K , Vice President of Construction
AAgent for: Equity One(Florida Portfolio) Inc., a Florida corporation
STATE OF FL IDA
COUNTY OF
Individual
Before me, this day of.4,15, Ken Choquette, personally appeared and executed the foregoing
instrumen and acknowledged be ore me the same was executed for the purposes therein expressed.
NOTARYSTAMP:
Signature bf Notary ZAn, C I la
�5� _ I�y � �•r� My commission expires: /�"`
Print Notary ame C�c� Identification Method: personally known
_Produced I.D.—Type:
v'yj�y U11E17E11WRA
EXPIRES:
x IRES:FSION YE24,2016
MThwNdgNbI¢UM
Equity One Inc. 1 1600 NE Miami Gardens Drive I North Miami Beach,FL 33179 1 Main 305.947.1664 1 Fax 305.947.1734 1 vvvnv.equityone.net
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