323 AHERN ST RES17-0276 APP RVW CAPPLs.L�i;yJ� City of Atlantic Beach
ICATION NUMBER
.�'' , Building Department (To be assigned by the Building Department.)
800 Seminole RoadGS — Q4 �
-,- Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax(904)247-5845
J;3 tr +E-mail: building-dept@coab.us Date routed: � 1 \s \�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ---) Ahr Sc- - D- • -nment review required Yes No
4. Buildin• )
Applicant: UL-i ba-i k)Ct *--i.-I e-Of\Wit-C= 4 Plannin & tonin
Tree Administrator
Project: 0 b--) - --,:1\1;"i -t C4)11Si 4C-fl a4 �ubli IA • s
, •ublic Utiliti--
Puublliic Safety
Fire cervices
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: Approved. ['Denied. ❑Not 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
$ Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
'�„ors10 Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address:��3 . "t - .�44-1��r-rl (s /F1 Permit Number: SSI
f's
Legal Description See Attached RE# 169742-000, 169737-0000,169737-0010
Valuation of Work(Replacement Cost)$ 200,000.00Heated/Cooled SF 1836 Non-Heated/Cooled 658
• Class of Work(Circle one : New ddition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): ommerc :I Residential
• If an existing structure,is a fire sprinkler system installed? Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
New Townhome Construction
Florida Product Approval# See Attached for multiple products use product approval form
Property Owner Information
Name: Ahern Project TH LLC Address: 830-13 A1A North#170
City Ponte Vedra Beach State FL Zip 32082 Phone (904)219-5003
E-Mail rjohnston.mec@gmail.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Urban Partners Construction Qualifying Agent: Edmundo Gonzalez
Address 3236 Beach Blvd. City Jacksonville State FL Zip 32207
Office Phone (904)270-2225 Job Site/Contact Number (904)591-7929
State Certification/Registration# CGC 1518379 E-Mail eg@urbanpartnersgroup.com
Architect Name&Phone# Mark Macco(904)249-2724
Engineer's Name&Phone# Bradford Davis(904)739-3655
Workers Compensation Builder Mutual Insurance Co.WCP 104191601
Exempt/Insurer/Lease Employees/Expiration Date
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 the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS,POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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, CON ULT WITH YOUR LENDER •R A► ATTOR ' BEFOR(
RECORD YO NO E F COMMENCEMENT.
•
ignat re of 0 ner or Agent inclu Contractor) (Signature o •ontractor)
Signed and sworn to( r affirmed)before met day of Signe, and sworn to(or affir • before me thisL day of
I ,by I 1 o7 'r 1 , by — r,-„...,fie Cyon-: L."”,to Z
(Signature of Notary) (Signature of Notary)
�d •,, 7AL IA D
.�(,Personally Known Of� Personally Known OR MY CO
�" �'":;,, TALIA DAHLKE MMISSION a GG 094450
[ ]Produced Identificati [ ]Produced Identification , •': F�(PIRE
'�_ MY COMMISSION#GG 094490 Type of Identification: F9�F ._...... . �.. S'April 16.2021
Type of Identification: SF: ;< .. •
:j. EXPRES.Apt ih16-2r21 — =locyndermilers
'F ok F;'•• ' Bonded Thru Notary Public Undzrwr tens
ewau.e.P.e
Legal Description:
A Replat of Lots 2, 4, 6, 8, 10 and 12, Block 2, Plat No. 1 Subdivision "A"
Atlantic Beach, as Recorded in Plat Book 5, Page 69 of the Current Public Records of
the City of Jacksonville, City of Atlantic Beach, Duval County, Florida.
Address RE#:
542 EAST COAST DR RE# 169742-0000
329 AHERN STREET RE# 169737-0000
331 AHERN STREET RE# 169737-0010
AHIER T WNHE S
A =of Tots 2, 4, � 8 10 and 12, Block- 2, Plat NOy # Subdivision.":�Atlantic , as Recorded Plat Sock 5, Page 69 ,of the Current Public Records of
the City of Jacksonvi a City of Atlantic Beach, Dual County, Florida,
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