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305 AHERN ST RES17-0264 s-=yirjr City of Atlantic Beach APPLICATION NUMBER ,0.)-- Building Department (To be assigned by the Building Department.) J ...: 800 Seminole Road V L-St--} _ OYt' / •-• �� Atlantic Beach, Florida 32233-5445 Phone(904)247 5826 Fax(904)247 5845 `t .(5 I t1 'AJ;il9r E-mail: building-dept@coab.us Date routed: ` City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 05 NA c S--k- • Deyartment review required Yes No Buildi Applicant: al t an pal-kw..{,. CAD Il5-.11,tcita) tannin &Zonin Tree Administrator Project: T\ Lir) ,ti 1\V1O 0-01\=\4 LIC. iOf) e- is Works Public Utilities 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: ❑Approved. [Denied. ❑Not applicable (Circle one.) Comments: / " BUILDING PLANNING &ZONING Reviewed by�-.�+-•/ t.../-:,e------------ ../-:, Date: 2/1Z/lir TREE ADMIN. Second Review: ❑Approved as revised. enied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by:,��•4/(//L Date:/45. FIRE SERVICES Third Review: ]Approved as revised. I (Denied. ❑Not applicable Comments: 07 _ • Reviewed by: iL�/ ---- Date: y21//ir Revised 05/19/2017 (---r/LA_Iij�J City of Atlantic Beach APPLICATION NUMBER � Building Department (To be assigned by the Building Department.) v 800 Seminole Road NOV 1 6 2017 ,� , Atlantic Beach, Florida 32233-5445 (7.5t1- — C) bcf Phone(904)247-5826 • Fax(904)247-5845 I t l is (i^ 01119' E-mail: building-dept@coab.us "' - Date routed: T City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 0S AAVA n Si • De artment review required Yes No B uildi a Applicant: Lk,1 b CLn pa,(1-N24-.S e_:Dr S (uCti I g 1_1 ning &Zonin Tree Administrator Project: 'f\ Q),a -- ,,,o1-\hb COiNSV tkC ior) ��u6T Worker Putie Public Safety Fire Service 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: q BUILDING Plans -fob Ict yJQ/ PLANNING & ZONING Law-Rale, I 1-��-l� Reviewed by Date: I TREE ADMIN. Second Review: %/Approved as revised. Denied. I 1Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES r 7.--,2 7ifff PUBLIC SAFETY Reviewed Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 !.r .r,J• City of Atlantic Beach APPLICATION NUMBER Js Building Department (To be assigned by the Building Department.) 800 Seminole Road ba _ a4,ct Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 t L is l �Lro4 E-mail: building-dept@coab.us Date routed: l City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM PropertyAddress: OS A•hk,( n . D tment review required Yes No Buil. ,• _ Applicant: u ( \a(1 Pct_(-44.4Liia) Tanning &Zoning, Tree Administrator Project: IN e.).-) LoiNsv itcAia \ is ork LAC Utilitie 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: ❑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 4 R viewed by: Date: FIRE SERVICES Thir iew: NN roved as revised. Denied. I 'Not applicable Comments: Reviewed by: Date: 5 65- Revised 05/19/2017 - 5l.:.�,y:4„ City of Atlantic Beach APPLICATION NUMBER �S ., ? Building Department (To be assigned by the Building Department.) .1, 800 Seminole Road -‘-',..1. -7 --c' Atlantic Beach, Florida 32233-5445 O 6 2��7 E.SI"� – r�� :� Phone(904)247-5826 - Fax(904)247-5845 l l i.S it/ \0,110. E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: °5- Ah @. n Si - Department review required Yes No Buildi Applicant: a(\an 4)a.i-k -I C'-Dr S {L cki tannin &Zonir—ii. Tree Administrator Project: 'f\ Q L, .t)Il Korvu_ 'Lo11Sv r�iv-ko.r) is Work- CPublic Utilitie Public Safety Fire Service Review fee $ r Dept Signature 7 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 * Plans -ho Ivy, w dim - , PLANNING &ZONING Reviewed by: '-+- Date: Z 'S--Ar. TREE ADMIN. Second Review: ❑Approved as revised. Denied. I 'Not applicable PUB ORKS Comments: P BLIC UTILITIES 2_—S- /of PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 (---- STs CITY OF ATLANTIC BEACH 1 - r) PUBLIC UTILITIES j/ 1200 Sandpiper Lane ,� /i. ATLANTIC BEACH,FL 32233 (904)270-2535 or(904)247-5874 NEW WATER/SEWER TAP REQUEST Date: 2/05/18 Project Address: 305 Ahern Street No. of Units: 1 Commercial Residential 1 Multi-Family New Water Tap(s)&Meter(s) Meter Size(s) 3/4" New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaim Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# RES 17-0264 Water System Development Charge $ PROPERTY CREDITED FOR SIX Sewer System Development Charge $ EXISTING WATER AND SEWER Water Meter Only $ SERVICES. Reclaim Meter Only $ I l Water Meter Tap $ AJ o SD C 5 �„2 b. Sewer Tap $ Cross Connection $ 50.00 Other $ TOTAL $ 50.00 APPROVED: Kavle Moore,PE )61. (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED 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 rs'rLrr . * Building Permit Application y Ff City of Atlantic Beach 800 Seminole Road,Atlantic Beach, FL 32233 yrs}r Phone: (904) 247-5826 Fax: (904) 247-5845 Job Address: 305 ,o.►-,er-n 5►-•' - s ++L gyp/ PermitNumber: '+ - 03' 1C9 Legal Description See Attached RE# 169742-000,169737-0000,169737-0010 Valuation of Work(Replacement Cost)$ 200,000.00 Heated/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 :1 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 NANCIN , CO SULT WITH YOUR LEND • !f' AN ATTO. 1 EY BEFORE RECORD;' G U20 •TI OF COMMENCEMENT. ‘40,- (Signatu r-of Owner or Agen . uding Contractor) ('ignature of C, tractor) Signed and swo n to(or affirmed)before me thisto day of Signed and sworn o or affirmed) •efore me this Lc day of I I >t 7 , by R.'c:K —Az>hin.l-ar i 1 I ,- by CCimur-ncJD G'or'ye (Signature of Notary) (Signature of Notary) vrrrrirrr.rw�� ^,: TALIADAHLKE KPersonallyKnown OR " Xv Personally Known OF F' "P:ou•. • II. '•,: MY COMMISSION#GG 094490 TALIADAHLKE [ ]Produced Identificati n3� -u • [ ]Produced Identification m MY COMMISSION#GG 094490 .i��. EXPIRES:April 16 2021 ,H. Type of Identification: %sfo y' Bondcd Thru Notary Public 1.1' ena tars Type of Identification: �� Bonded Thu Notary Public Underwriters