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535 Atlantic Boulevard UTIL18-0008 utility �� CITY OF ATLANTIC BEACH ffab" �' 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 UTILITY SERVICE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: UTIL18-0008 Description: 2-inch potable & 1-inch irrigation meter request Estimated Value: 0 Issue Date: 1/25/2018 Expiration Date: 7/24/2018 PROPERTY ADDRESS: Address: 535 ATLANTIC BLVD 507 RE Number: 170684 0000 PROPERTY OWNER: Name: GATE PETROLEUM COMPANY Address: 9540 SAN JOSE BLVD JACKSONVILLE, FL 32257 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: Scherer Construction of NEFL LLC Address: 2926 Edison Avenue Jacksonville, FL 32254 Phone: PERMIT INFORMATION: Please see attached conditions of approval. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU 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. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. �Sy1,JjJ� City of Atlantic Beach APPLICATION NUMBER Js Building Department (To be assigned by the Building Department.) 800 Seminole Road L0 _ D00¢ Atlantic Beach, Florida 32233-5445 (1 U Phone(904)247-5826 • Fax(904)247-5845 f E-mail: building-dept@coab.us Date routed: I 1 City web-site: http://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: S 3 lin L 6J - Department review required Yes No Buildin Applicant: C16(, �Q �1 U n'l in &Zoning Tree Administrator Project: �l` P0-\6(IrJ� -� ' �l \ i ' q Public Works \p t D / Q � �1 blic Safety �`-1 � l 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 Reviewing Department First Review: ❑Approved. ❑Denied. PNot applicable (Circle one.) Comments: BUILDING PLANNING & ZONING // � Reviewed by: Date: TREE ADMIN. Second Review: [-]Approved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ,sS!�Lir�JCity of Atlantic Beach APPLICATION NUMBER Building Department j (To be assigned by the Building Department.) i` 800 Seminole Road ,^�Q Atlantic Beach, Florida 32233-5445 _I,. �- �- I V 000 Phone(904)247-5826 • Fax(904) 7-58AN 21 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 S- I1 �Gi,fl l�N ' Department review required Yes No Buildin Applicant: C1kk-C- QQAfb`-V u nnin &Zoning 1 r i Tree Administrator Project: Dl` 'A- 1 `l < < ',q cy) Public Works p blic Utilities -Wi 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: APPLIgATION STATUS Reviewing Department First Review: EApproved. []Denied. [-]Not applicable (Circle one.) Comments: BUILDING u PLANNING &ZONING Reviewed by: Date: i Lz / I f TREE ADMIN. Second Review: ❑Approved as revised. []Denied. ❑Not applicable PWO S Comments: LI I S x- 22 -( PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. [-]Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 t ' 4 I t � 11V'v F; ;rte' el ' :. JAN 1 9 2018 City of Atlantic Beach PUBLIC UTILITIES DEPARTMENT 902 Assisi Lane Jacksonville, FL LJ131�'. (904)247-5834 n *-► 71 -4 NEW WATER/SEWER TAP REQUEST �'y. 41 0� Date Service Address _: • -'i. N"C 1 C Number of Units�_ Commercial Residential Multi-Family New Water Tap(s)&Meter(s) Meter Size(s) Z}14�,r-a13k-r- New Irrigation Meter 1 Upgrade Existing Meter from to (size) New Reclaim Water Meter 1_ Size New Connection to City Sewer Applicant Name_ 1T1�T1 r 1'T�T1Lc�Lry fy\ G , Billing Address qS'A0 city .5 O'y", 'O14 V!C i F= State L zip Phone CAOy Email IV i Applicant Sign re -` CITY STAFF USE ONLY Application# ,S�Qr1 jcES cJtn E Esz iSi�wro, Water System Development Charge $ Sewer System Development Charge $ Water Meter Only $ Reclaim Meter Only $ Water Meter Tap $ Sewer Tap $ Cross Connection $ Other $ TOTAL $_ Q!D (Notes) APPROVED Kayle Moore, P.E. CGW\ -.Date Pub!!c Utilities Director or Authorized Signature ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED S'r1i1 f�r yCash Register Receipt City of Atlantic Beach�r R4041 DESCRIPTION ACCOUNTQTY PAID PermitTRAK $50.00 UTIL18-0008 Address: 535 ATLANTIC BLVD 507 APN: 170684 0000 $50.00 PUBLIC UTILITIES $50.00 CROSS CONNECTION 400-0000-343-3701 1 $50.00 TOTAL1 1 1 1 CITY OF ATLANTIC BEACH 800 SEMINOLE RD ATLANTIC BEAC,FL 32233 01j251r2018 11:40;04 CREDIT CARD VISA SALE Card XXXXXMWXX2496 SEQ 6 Batch u; 529 INVOICE 1 Approval Code; 066603 Entry Method: Manual Mode; Online Tax Amount; $0.00 Cust Code: Card Code: M SALE AMOUNT $50,00 CUSTOMER COPY Date Paid: Thursday, January 25, 2018 Paid By: GATE PETROLEUM COMPANY Cashier: BA Pay Method: CREDIT CARD 6 { Printed:Thursday,January 25,2018 11:40 AM 1 of 1 TAAKiT