848 AMBERJACK LN - PERMIT ACC17-0057 City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road 4-
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 A
E-mail: building-dept@coab.us Date routed: D
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: A rq 04, 6u_ CA -Departme _t review required Yes No
uildin
Applicant: AWN
Tree dministrator
Project: �_Do C'P U b ri__cW o)�rk_
_s >
( Pub&,UtPI*tiga:__)
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:
APPLICATION STATUS
Reviewing Department First Review: 10�pproved. FlDenied. E]Not applicable
(Circle one.) Comments:
BUILDING
Reviewed by�'X�� Date:
TREE ADMIN. Second Review: [-]Approved as revised. F]Denied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05119/2017
Building Permit Application
_6�d�ted 5/5,/�,!
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FIL 32233 OCT 2 7 2017
Phone: (904)247-5826 Fax:(904)247-5845
Job Address: 8416
Permit Number: .41T
Legal Descriptio I KfS LI) a llj -TS ON
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Valuation of W(rk(Replacement Cost)$ *7_a co —Heated/Coolled SF "Is — _I —+I I
0 -Non-Heated/Cooled_
Class o Work(Circle one):QNDew Addition Alteration Repair Move Demo Pool Window/Door
• Use of x1sting/proposed structure(s)(Circle one): Commercial QEeideDntia
• If an ex sting structure,is a fire sprinkler system installed?(Circle one): Yes No(�N:1A)
• Submit Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
escribe in deta I the type ot work to be performed:
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Pro er Own r Information
Name: CA Address: 01
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E-Mail Phone
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State Certificatioli/Registration#_ E-Mail
Architect Name Phone#
Engineer's Name ne#
r mpensation
Exempt/insurer/Lease Employees/Expiration Date
Application-i's h.er by made to obtain a permit to do the work and installations as indicated.I certify that no work or
commenced prio installation has
c t t. . I to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
ons ruc ion in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, F UIRNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
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OWNER'S AFFIDA�IT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
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applicable laws r 9 ulating construction and zoning.
WARNING T OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN Y UR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
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TO OBTAIN INANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
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(Signature of Notary)
1P
JENNIFER JOHNSTON
My COMMISSION#GG 042984
]Personally Kno n OR EXPIRES:October 27,2020
Produced Idel Bonded T hru Notary Public underwdters I Personally Known OR
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Type of Identification: -I , �qs ki I cluced Identification
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City of Atlantic Beach
Building Department APPLICATION NUMBER
y
800 Seminole Road (To be assigned�by the Building Department.)
5. AUG
Atlantic Beach, Florida 32233- 3 IF, C__
Phone(904)247-5826 - Fax(9t),1247-5845 0 2017 1
t r
E-mail: building-dept@coab.us BY,
Date FFrouted:
City web-site: hftp://www.coab.us 6/3_0/�7_
APPLICATION REVIEW AND TRACKING FORM
Property Addre
SS: Z40-C; De artment review required Yes
uildin
Applicant: 0 P-P S f--(1�-_ anning &
Project: C.> Tree Administrator
2000 7", tA En I U
ublic 0tilitie
Public Safety
Fire Services
Rdvidw fee
Deot;si 4�
,9
Other Agency Review or Permit Required Review or Receipt
Florida Dept. of Environmental Protection of Permit Verified B Date
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: DApproved. WDenied.
(Circle one.) Comments: ONot applicable
BUILDING
PLANNING &ZONING Reviewed by:
TREE ADMIN. Second Review: DApproved as revised. OlDenied. E]Not applicable
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ElDenied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,Fl,32233
Office(904)247-5826 Fax(904)247-5845
Job Address:
Permit Number:
Legal Description L6T llf-il
Parcel#
Valuation of Work$If 2-0 00 q. t
— 1142-49 proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition Pool/spa window/door
Use of existing/proposed structureQ) circle one): Commercial Residential
If an existing structure,is a fire sprm=system installed?(Circle one): Yes No N/A
Florida Product Approval#
For multiple products use`proVuc_t app—rov—aTFo—rm
Describe in detail the type of work to be performed: k')OL)a(sbed
Property Owner Information:
Name: a,�LLV%�,Ya Address:
City AW-1:21 Vt� EW&CA —State,-45Zip
F�hone2,>q,J_
E-Mail or Fax#(Optional
Contractor Information:
Company Name: Tuff Shed,Inc. —Qualifying A ent:
City Orlan o State FL
Address: 8524 ff—Colonial Drive
Office Phone 407-282-2444 Zip 32817
—Job Site/Contact Number Fax 40'/-384-2999
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder N
Bonding Company Name and Address
Mortgage Lender Name and Address
A hereby made a ob am 0 e m to d he work ndns n as no,
a n, a a ' 'a" 'o 5 ,s�d r"y,hot no Ovor�or installation has commencedprior to the
e 0 0 a' ca ce '
Eli' "s p bep n ed nee he andard w ng ,,,ruc�� thisjurisdiction. Thispermil becomes null
s e o' er n nd'ha ork a a
s v c o 'a w w a
e o or 's . 9'd L abandon or(Weriod ofsaj.6) fter
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coin "c' un r"._ Par., p r, ;s m." u f
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T.ak s C.d d d ha e e b ed E a o'k,P _ .g,Sgus, i months at any time a
k I Aw , ec. Ms,Pools, urnaces,Boileis,Heaters,
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 FINANCINGI�ONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO I
COMMENCEMENT. R NOTICE OF
I hereby certify that I this
lype o work wh P1.e licaiion and know 1hesame to be frue and correct. Allprovi , s vson rdinances governing this
any 0 it, y rd
f I IlbeA !
provisions of ci einornot The granting ofa permit does not resu;ne 41utho 0 vo or c, c
i to construc on or the performance o consiruclion. to violate or cancel the
#�ffede 1i
b
Signature of
Signature of Contractor
Print Name
Print Name Tom Saurey
Sworjj to and re me
this_ct— ay o Sworn to and subscribed before me
20 n
this ;hDaof July
2016
Notary Public
Revised 0 1.26.10
ISMAELVALDEZ
NOTARY PUBLIC
STATE OF COLORADO
Notary ID 20154037801
My Commission Expires 09/23/2019
MAP SHOWING BOUNE-ARy SURVEY OF.
LOT 22-D. AQUATIC GARDENS, AS RECC� )RDED IN PLAT BOOK 38,. PAGES
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DEMM a'WOW FEWC CERTIFIED TO:
STEVEN GUINN
SWA'O'P" BANK --TITLE'TNIV COMPANY
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IONAC ROME f
ARO EAD TITLE & ESCROW, INC.
y meet$ the
th*:,F'-;'-Board of I_
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ec arid.S'�
D U R D E N 'll't7ld Chapter
NJ 5JI 7 Flc6 di I i trative
SURVEYING AND�MA41NG, INC.
Jackson", 3'211
,2._S W'-'N _ 54
(904) - 4 91 r
LICENSED BUSINESS NO. 6696 SIGNED
TIVS SURVEY NOT VAUD uNLESS THIS WORK C;-mULK NUMBER:
PRINT IS I i:MBOSSED"TH THE SEAL OF TME ABOVE SME,. B-8179
CITY OF ATLANTIC BEACH
DEPARTMENT OF PUBLIC WORKS
1200 Sandpiper Lane
Atlantic Beach,FL 32233-4318
TELEPHONE:(904)247-5834
FAX:(904)247-5843
www.coab.us
CONTRACTOR: DATE: 8-31-17
Tuff Shed, Inc. PERMIT#ACC 17-0053
8524 E. Colonial Drive ADDRESS: 405 Aquatic Drive
Orlando, FL 32817 Atlantic Beach,FL 32233
Email: tuffshed(apermit-it.com
PERMIT APPLICATION FOR 8' x 12' SHED
Your permit application has been denied by the Public Works Department for the reasons listed below. Please submit
this information at your earliest convenience in order that we may approve your application. If you have any questions,
please contact Scott Williams, Interim Public Works Director at 904-247-5834 or email swilliams@coab.us.
PUBLIC WORKS CORRECTION ITEMS:
(Submit thefollowing information to the Public Works Department)
0 Documentation shows impervious areas are over the 50%allowed by City code.
PUBLIC WORKS CONDITIONS OF APPROVAL:
(Thefollowing comments will be printed on yourpermit as Conditions ofApproval)
• All runoff must remain on-site during construction.
• Full right-of-way restoration, including sod, is required.
cc: Toni Gindlesperger,Building Department
Jennifer Johnston,Building Department