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323 AHERN ST RES17-0276 �L �,vr��, City of Atlantic Beach APPLICATION NUMBER �s ,. f Building Department (To be assigned by the Building Department.) a 800 Seminole Road S l — 04119 zr Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 \ 1 7� ;3r; E-mail: building-dept@coab.us Date routed: l l \S `3 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: '-- Ah39-4r Sk-- - D- . .invent review required Yes No 4_ Buildin. Applicant: �;-�tv i b0-) 0C /-( 0-UNS-k-i�lC,�f1�� 1 Plannin &Zo rnn Tree Administrator Project: 0 Q.r-� -\- -,-,-)(\"•bf ty -Ons a_c_- 04 -ubli rMMO , 'ublic Utiliti Public Safety Fire S Nices 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. fNot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by../ _ 1.---------A„----- Date: Z1.1t-//6' TREE ADMIN. Second Review: Approved as revised. ,Jenied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: _. ,,,/f l //*/ " Date: `A/i f FIRE SERVICES Third Review: XApproved as revised. ❑Denied. Not applicable Comments: Reviewed by:�.�. L ,----------" Date: ,f7.706 Revised 05/19/2017 �:11./7/-.41 City of Atlantic Beach APPLICATION NUMBER J4 P" ' ‘ Building Department NOV ' c 7 (To be assigned by the Building Department.) 800 Seminole Road t7 I V-G S l I- - 04-119 ��.. �. Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 ` �Ptat !)? E-mail: building-dept@coab.us Date routed: ` kS ` k3 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3:.\-' A' - r' St- - D- • -iment review required Yes No 4 Buildin• = Applicant: 0,-1 130-1) 0CL1'4 0-0-N5-k i iA_Gii Lly\ 4 Plannin• &Zonin• Tree Administrator Project: 0 V Zflf\-t i bm-vi itc-60✓\ Eublissfailill rUblic Utiliti.____All Public Safet _- kiElagallEIMIIIII 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. I Denied. fNot applicable (Circle one.) Comments: II_ BUILDING PIcoS '60 lai , PLANNING & ZONING 40 315Q4C..ke' Reviewed by / Date: I I-20- 11 TREE ADMIN. Second Review: Approved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES _ / r PUBLIC SAFETY Reviewed b.: ,,i _ _ _;:'/,,,,,, Date:/_ ri, FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 �51..�,��fCity of Atlantic Beach APPLICATION NUMBER rs •� Building Department (To be assigned by the Building Department.) r _ _; 800 Seminole Road 4119 �: ;� Atlantic Beach, Florida 32233-5445 S l O \:,..t, Phone(904)247-5826 • Fax(904)247-5845 A. o;t �� E-mail: building-dept@coab.us Date routed: l � \ � City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: -3 -'1 A V\12,481- a • Depa ment review required Yes No Buildin Applicant: U-1 ban 004-4-I\k-(S e-CYNSA i a_(,_ij Plannin &Zonin Tree Administrator Project: jl e..W A.--,,:(\lll b frit_ CbM-Vi— M-Vi44ctl al) ubli s ublic Lib iti Public Safety ..!ree-vices 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 IReviewed 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 City of Atlantic Beach APPLICATION NUMBER (pwrit, S, Building Department (To be assigned by the Building Department.) 800 Seminole Road !_S l _ g si - , Atlantic Beach, Florida 32233-5445 NOV 16 2017 V-G 04-Th Phone(904)247-5826 • Fax(904)247-5845 01119 E-mail: building-dept@coab.us Date routed: ` k s \ k3 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: r'3-: ANAP-'M SV - D ment review required Yes No Buildin Applicant: U-1 bAr 00-- ( 0-um i ik {i,:y\(Planning Z& Tree Administrator Project: '0 --,) `\ % lNV.t irY\-t_ 6r' but lI ublic [c�rks �" ublic Utiliti Public Safety...) Fires Vice Review fee $ 50 Dept Signature 4Cfri —,-1/V 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: VlApproved. Denied. ❑Not applicable (Circle one.) Comments: BUILDING X Plans+to [01x9, PLANNING & ZONING k Laseskicke, Reviewed by: _ L': ki"----- Date: 2411(r TREE ADMIN. Second Review: Approved as revised. ❑Denied. Not applicable PU'+#WORKS Comments: 'UBLIC UTILITIES 2- s -1r PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 t, CITY OF ATLANTIC BEACH PUBLIC UTILITIES 1200 Sandpiper Lane ATLANTIC BEACH, FL 32233 J'�l fir- (904) 270-2535 or (904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: 2/05/18 Project Address: 323 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 X Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# RES 17-0276 Water System Development Charge $ 1,140.00 Sewer System Development Charge $ 4 050.00 Water Meter Only $_ 185.00_ u C Reclaim Meter Only $ Water Meter Tap $ Sewer Tap $ Cross Connection $ 50.00 Other $ TOTAL $ 5,425.00 APPROVED: Kayle Moore, PE (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED 4 Building Permit Application City of Atlantic Beach ` 800 Seminole Road,Atlantic Beach, FL 32233 -ost' ` Phone: (904) 247-5826 Fax: (904)247-5845 • - V--Esl--_ - (a Job Address:.----5 ,AM,e-.e--r-t .5' A4,4-1 r-4.r4._ r i F Permit Number: 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): I ommerc :I Residential • If an existing structure,is a fire sprinkler system installe.? 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: Ahem 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 SR A► ATTOR BrBEFOR( RECOR YO NO E F COMMENCEMENT. f 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 affirm before me thisl.o day of 1 t Z CSI 7,by 1Z'c:14...Jot-,- --vr-► I 1 , 'I1 ,by r'-o.-- _ - G4:1-,Z 6 te---Z _— _ ---�__ —L �--, (Signature of Notary) (Signature of Notary) '. "(ALIA DAHLKE Xj Personally Known OR Personally KnoEton OR `: ��1'7.'' TALIA DAHLKE MY COMMISSION#GG 09 Produced Idenai •'�= COMM 4450 [ j Produced Identificati�ri [ 1 ' Iii. •,. MY COMMISSION#GG 094490 . ''', ,-c.;c° S:April 16.2021 Type of : ° F ..,... ... ' rs Type of Identification: = : ,��•. r Yp _ .,. ndenmte .. °o:a; .' Bonded Thru Notary Public Underwriteqs a 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