1089 ATLANTIC BLVD -APPLICATION ~ BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
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800 Seminole Road,Atlantic Beach, FL 32233 ,
Office (904)247-5826 Fax(904)247-5845 l
09 ,44- — Op
Job Address:
�`�SIVA. Permit Number:
Legal Description 3�—� q F �.��7 (� -
1 Floor Are of 1 �'`S��a��r arcel# % 7 7�,l C —0000
Valuation of Work$1)(60ly,13,CO Proposed Work he ted/cooled no rt
non-heated/cooled
Class of Work(circle one): . New Addition Alteration Repair Move Demolition ooU
Use of existing/proposed structure(s)(circle one): Commercial Residential p spa window/door
If an existing strucure,is a structure, sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product appi ,V
Describe in detail the type of work to be performed:
Property Owner Information: lid >
Name: htt 1-ni)e tfs 1 he-. . Address: .20 G t� v
City yi u(l(� State .Zi r 9041- �L�CU
E-Mail or Fax#(Optional) p Phone )99\-9/012)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name:
Address: Qualifying Agent:
Office Phone City State Zip
State Certification/Registration# Job Site/Contact Number Fax#
Architect Name&Phone# S#; -SL. /.J:creh: rl� (77o) �! S.---7z/00 Engineer's Name&Phone# r
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certi that no work or installation has commenced prior to the
issuance ofa permit and that all work will be per formed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if 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 0 %, ' : YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY ' : ET ti 4 I UR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOItIN ►:I ' a' OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATT ' B FORE RECORDING YO'[.TR NOTICE OF
CO M CEMENT.
I hereby certify that I have read, . •xamin d is a plication and know the same to be true and correct. All provisions of laws and or Hance overning this
type of work will be complied v' etrein or not. The granting of a permit d.• n. presume to : ve authority • viola -'.r cancel the
9rovisions of any other feder,,- .cal aw - gulating construction or the performance of co z on.
�i ature of 0 ,
gn �� i / Signature o •T1'.'a•'•r ' % / ��
Tint Name 4�:= !.A;�/ �}( ` -
( L � J.14- Print Na - Jerome Jos-:f C•, avino
3efo e Before
its Day o e_,---- 20 this 1 , Day of Oc...,-1
iota In_.: «., , ..• ' ! .� „ . �, ' .20 15
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y Pub i `.� EXPIRES:March 23,2019 y 1C �' VA _
gr ;�'' Bonded Thal Notary Publ c Urdernritera *'l • YVON -. I t
�., r __ Commission# F20.11'.325
' '' A Expires July 24 . Re me• 01.26.10
•4 R�;, Band.Thu.Troy on i -nos 800386.7019
j y Jr N
y, J CITY OF ATLANTIC BEACH
`� 800 SEMINOLE ROAD
r ATLANTIC BEACH, FL 32233
(904) 247-5800
NOTICE
THE 5TH EDITION OF
THE FLORIDA BUILDING CODE
TAKES EFFECT
JUNE 30, 2015
ALL BUILDING PERMITS, APPLIED FOR, ON OR
AFTER JUNE 30, WILL BE REVIEWED AND
INSPECTED UNDER THE FBC, 5TH EDITION.
BUILDING PERMITS APPLIED FOR BEFORE JUNE
30, WILL BE REVIEWED AND INSPECTED UNDER
THE CURRENT 2010 FBC.
DO NOT WRITE BELOW- OFFICE USE ONLY
Applicable Codes: 2010 FLORIDA BUILDING CODE
Review Result (circle one):
Approved Disapproved Approved w/ Conditions
Review Initials/Date: .1: 4), tZto t
Development Size
Habitable Space 80(40'0 Non-Habitable
Impervious area
Miscellaneous Information
Occupancy Group t.A. )(A.n — 5- I ' -R
Type of Construction
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required `(
Flood Zone rl,
Conditions/Comments:
t4�∎1 o-.1' Se-Pp ?.,eis ?At..dz•■.)
cg- e- t40
I
i LCj\ rJ
J 800 Seminole Road
J Atlantic Beach,Florida 32233
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Telephone(904)247-5800
FAX(904)247-5805
Construction Site Management Plan Compliance
A construction site management plan conforming to Atlantic Beach City Code Sec 6-18
has been approved as a part of this building permit. The Construction site management
plan was approved based upon the following information.
1. Parking plan—parking plan showing how site will be accessed and all onsite
and abutting street parking areas.
2.
3. Location of construction trailers, loading/unloading area and material storage
area.
4. Location of chemical toilet area.(chemical toilets must be kept out of City
right-of-way and not further than 15 feet from structure under construction)
5. Location of dumpster. Dumpster must be from an approved waste company
(in accordance with Chapter 16 City Code)as of 2009 the permitted
dumpsters are Advanced Disposal,Realco Recycling, and
Shappells. Dumpsters will have tarp covers or rigid covers on windy days.
Dumpsters must be removed prior to issuance of Certificate of Occupancy.
6. Traffic control plan, showing access with dimensions,area to be stabilized,
narrative on phasing of construction with adequate parking and delivery of
materials.
7. Site cleanliness. Contractor must have the entire construction site cleaned by
Friday of each week. This means removal of scrap lumber, concrete remnants
and other such construction debris including cans,metal,plastic and paper.
8. Erosion and Sediment Control. Contractor must maintain all elements of the
approved Erosion & Sediment Control Plan(silt fence,catch basin filters, etc.)
until sod or other stabilization has been placed and approved by Public Works.
9. Other activities,where special conditions are identified by the Building
Official.
Failure to comply with the Construction Site Management
Ordinance may result in a Stop Work Order being issued in
accordance with City Code Sec. 6-17 (3)
Revised 5/2009