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301 AHERN ST RES17-0269 5.�,v City of Atlantic Beach APPLICATION NUMBER fs~ � Building Department (To be assigned by the Building Department.) 800 Seminole Road - I�,((^^�� i rJ Atlantic Beach, Florida 32233-5445 (t_LS ( � �%-1 �� Phone (904)247 5826 Fax(904) 247 5845 E-mail: buildin -de t coab.us Date routed: 1. I ( S it/- City\-1<;!,,,0109y/ 9 p @ NOVN�V 6 [�� City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 30 l A 0 Sk , De artment review required Yes No uil ing, Applicant: U1_ i ba n P f1.(" -{,s �6-1Sk fad;y� Plan In ng &Zoning Tree Administrator Project: 1�-tom Public- or s � �Irl 171Y1 12. C�(�St��,t�,.;�>�� C blic UtiW i i e� Public Safet Fire Services j 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. enied. ['Not applicable (Circle one.) Comments: BUILDING X r IOIVl5400I4�Q/ PLANNING &ZONING (.4tst✓'h(1)Pi Reviewed by:`J.,l4/G�/ ti,(, Date: 11-2S-1-7 TREE ADMIN. Second Review: Approved as revised. Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES r PUBLIC SAFETY Reviewed b , ,,/11 , , Date: �: v FIRE SERVICES Third Review: F 'Approved as revised. Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ;;;i .v.i City of Atlantic Beach APPLICATION NUMBER Js Building Department (To be assigned by the Building Department.) 800 Seminole Road �s O '^� -,- Atlantic Beach, Florida 32233-5445 KJ Phone(904)247-5826 • Fax(904) 247-5845 �! r J,il� E-mail: building-dept@coab.us Date routed: I t ( S ' 1-4 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3o t_ A n 5} , De•artment review required Yes No p \ :uiI.ing Applicant: U. ( ba.n Pal+ (''s r\sk,(acf A Pla ping &Zoning Tree Administrator Project: VA-6-3 v,)A\1D 0A iL (15-i+,ta,),/ (c____-Pula or blic U iiitf of s Public Safety Fire Services j 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�k `- /1/ Date: 7/1,4// t TREE ADMIN. Second Review: Approved as revised. DiDenied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES / e-----"/"-----.7' PUBLIC SAFETY Reviewed by: ,�"..�✓l v "-----.7' Date: VIM FIRE SERVICES Third Review: /16ipproved as revised. [1Denied. ❑Not applicable Comments: Reviewed by: . �.,..4,/#4. Date: 5,.1�/( Revised 05/19/2017 / �,/ .m-,..V�, City of Atlantic Beach APPLICATION NUMBER • 1 • Building Department (To be assigned by the Building Department.) 800 Seminole Road � '-6s , _ 0 a/ ci -,, Atlantic Beach, Florida 32233-54457. SCG Phone(904)247-5826 • Fax(904) 247-5845 i .P.a,3 �r E-mail: building-dept@coab.us Date routed: 1 1 I S `` 14 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 30 l A Q-( 0 St . De•artment review required Yes No n v =uii. ng Applicant: uba , n PQr�`(V-(S C.�nsrliAL-6 Planning &Zoni— Tree Administrator Project: Yl •t.i,,) ✓J n\1l7M Q, 11S}(i.tC. �blic U dries Public Safety ZFirervices ) 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 lenied. ❑Not applicable (Circle one.) Comments: / 5.1 Mr-rlw.., H--r-- 5 BUILDING ¢ 'S O ( 6-0.-t 1.1‘.•s-4 4 Le. e-1 4.1.....4'r-S `...__ (__)„4„, r t PLANNING &ZONING Reviewed by: � ' Date: 62-42 ‘Ci N 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 (iLu'J?y. City of Atlantic BeachAPPLICATION NUMBER i Building Department (To be assigned by the Building Department.) 800 Seminole Road /� �: "r Atlantic Beach, Florida 32233-5445 Q-6511- O (C Phone(904)247-5826 - Fax(904) 247-5845 NOV 1 6 2017 J;��% E-mail: building-dept@coab.us Date routed: (I I S I i l City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3O t. A hQ-( n S-k- , De artment review required Yes No nn uilding, Applicant: U. i ba n P _(+ -iS el)f- s`[etc f; Pla ning &Zoning Tree Administrator Project: nt.i.,} At,„,)„r>‘1)17M Q.._ (�.S}(i,{a(11 Public ' ores lic Utilities ig Public Safet Fire Services ) Review fee $ ,0 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: APP ICATION STATUS Reviewing Department First Review: FOApproved. ❑Denied. I 'Not applicable (Circle one.) Comments: BUILDING tPlans-'b0 IOjQ/ PLANNING &ZONING -`p Las e,/-F;61e- Reviewed by: , 711' - Date:ZJS( V TREE ADMIN. Second Review: Approved as revised. ❑Denied. ❑Not applicable PU: 1_f_ ✓ ORKS/ Comments: BLIC UTILITIES 2- S= /r PUBLIC SAFET Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 �� ;41'',, �Ts CITY OF ATLANTIC BEACH ��' yr PUBLIC UTILITIES 1200 Sandpiper Lane ATLANTIC BEACH,FL 32233 __--f.);-09'' (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: 2/05/18 Project Address:_301 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 17-0269 Water System Development Charge $ PROPERTY CREDITED FOR SIX Sewer System Development Charge $ EXISTING WATER AND SEWER Water Meter Only $ SERVICES. Reclaim Meter Only $ 1.0 Water Meter Tap $ N a SO G t$ ( - Sewer Tap $ Cross Connection $ 50.00 Other $ TOTAL $ 50.00 APPROVED: Kavle Moore,PE (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLTHES DEPARTMENT BEFORE FEES CAN BE ASSESSED 0..rL` Building Permit Application ;f ' i), City of Atlantic Beach 800 Seminole Road, Atlantic Beach, FL 32233 �` Phone: (904) 247-5826 Fax: (904) 247-5845 3a�73 Job Address: acs 1 Ar-� -i- 5.1-• A+)Gv-1= G b�q � FI Permit Number: V---(-7-S- -� j1v � 41 1 Legal Description See Attached RE# 169742-000,169737-0000,169737-0010 Valuation of Work(Replacement Cost)$ 200,000.00 Heated/Cooled SF 1823 Non-Heated/Cooled 639 • Class of Work(Circle one : New ddition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): N 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 OBT IN FINANCIN , CONSULT WITH YOUR LEND- _ • ' AN ATTORNEY B 0 RE REC DI YO TICE OF COMMENCEMENT./ / .'AL /,L � /�. (Signat a of Owner or Agent including Contractor) �� (Signatu':of Con / or) Signed and sworn to(or affirmed)before me this_Lo-day of Sig ed and sworn to(or affj'med)be ire me this Lr-, day of I I , o1-1 ,by /Z.'uC r.Jc r-, '-Ivn e�vi—I fy C.c)r•-►-1,..,--,da Cror-izc 'e.. ---z---- ,r 2 --,^'—... (Signature of Notary) (Signature of Notary) ?q;9` •,; TALIADAHLKE �F"_4,?... TALIA DAHLKE personally Known OR �% MY COMMISSION#GG 094490 Personally Known OR �i. L: MY COMMISSION#GG 094490 [ ]P oduced Identification -: Ai .\, EXPIRES: ri116.2021 ]Produced Identification '1 o ` EXPIRES:April 16,2021 F,....;,; AP , Bonded' Nu Notary Public Underwriters Type of Identification: =F* Bonded Th .... - .' ,ype of Identification: 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