317 AHERN ST RES17-0273 �;S L��;.��, City of Atlantic Beach APPLICATION NUMBER
4s Building Department NOV ' (To be assigned by the Building Department.)
800 Seminole Road �`I 6 2017 n c- -03.13�0 Atlantic Beach, Florida 32233-5445 L S 1 o f 13
Phone(904)247-5826 •• Fax(904)247-5845 _ _ I
"!J;; �.' E-mail: building-dept@coab.us
�� Date routed: I I ` n_
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: v\“n S* Department review required Yes No
(�� 4 B �:in �
Applicant: \ i \0..n Dct_i i S `-bc)5ki I-i_Cil bl 4 ' -ronin. &Zonin)
Tree Administrator
Project: R --,) ✓JyAv\b"L QRS uk_ctll�'1 4 Publics
4 'ublic Utilities
Public Safety
ire 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. VDenied. Not applicable
(Circle one.) Comments:
BUILDING Plans -bo I cw9p- .
PLANNING &ZONING Lasw-kcke, ..p,, Date: I 1-2$-1'1
Reviewed .
TREE ADMIN. Second Review: Xpproved as revised. ❑Denied. ❑Not applicable
A
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by-J`�� j— Date:
/ser--/G00
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
:11,,t �pr�,, City of Atlantic Beach APPLICATION NUMBER
:� ". Building Department (To be assigned by the Building Department.)
,,Y 800 Seminole Road pp _ l
-0 Atlantic Beach, Florida 32233-5445 1� L'S 1 O a�3
Phone(904)247-5826 • Fax(904)247-5845 1 I
`'�o;3 9r E-mail: building-dept@coab.us Date routed: I I ` t ` Il
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 2 r A- t<V\Q \ SA- . Department review required Yes No
(� �r� Bu. in
Applicant: �I \0..n i)0,--1 .1 S C-U[lSk{ tall D') nninc_&Zoninz„)
Tree Administrator
Project: \ L-) /J1(\b1t 2 QRS orlC%tll�1 Crubl_ c`Works
L'PubIic Utilities
Public Safety
re 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. 2Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING I Reviewed by:-01.1.<0--/ ✓�---- -- Date: 17/2 x//r
TREE ADMIN. Second Review: ❑Approved as revised. XDenied. ['Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: ..ti,A0.! L.------ Date: y1'.C//
FIRE SERVICES Third Review: 011 L pproved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: /!/;4—_------- Date: S7-1 iii j
Revised 05/19/2017
0),A -r1r,: City of Atlantic Beach APPLICATION NUMBER
Js ` } Building Department (To be assigned by the Building Department.)
r - 800 Seminole Road V/ (_S ,-}—
0
a93
iii
j.« -0 Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 1�
P-1.0.1.3 9r' E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 2 Pk Li n S - artment review required Yes No
(�� Bw �udin
Applicant: I b Cl.- (
n `►'0-i"k`\L4 S ` flSti �•U* Y') .n &Zoning)
\" Tree Administrator
Project: \ ✓1)1(\��L � nRS ) i.�("fl�.►1 ("Public orks
•
�PUbllc Utilities
Public Safety
ire 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 Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
�..,tvi-,,, City of Atlantic Beach APPLICATION NUMBER
rj �?, Building Department n 7 (To be assigned by the Building Department.)
s 800 Seminole Road NOV 6 2`11 r/ S,9-- a�3
,_ , �� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
A:artiO" E-mail: building-dept@coab.us - - Date routed: gli L t f ` I4
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: kik c(\ SA- • Department review required Yes No
oBuil_d
pp 1
Applicant: Li stn DcLi�i\--i J Czc)S"f i,t nin &Zoning)
Tree Administrator
Project: NU--) ✓rJYr vl pt L 0.-DRSkl Li..Gti Publ c Works )
�Publlc Utilities
Public Safety
ire Services
Review fee $ 9--D Dept Signature Z. t'/\
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:
APPyCATION STATUS
Reviewing Department First Review: Approved. ❑Denied. I 'Not applicable
(Circle one.) Comments:
BUILDING X Ran 413 Icy
PLANNING & ZONING +) L C/Y1�i L✓_ Z/5/(tC
Reviewed by: Date:
TREE ADMIN. Second Review: Approved as revised. ❑Denied. ❑Not applicable
PU ORK Comments:
`
UBLIC UT TI Sce
Z-
-i
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I lApproved as revised. Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
CITY OF ATLANTIC BEACH
14 I � PUBLIC UTILITIES
1200 Sandpiper Lane
ATLANTIC BEACH,FL 32233
(904)270-2535 or(904)247-5874
NEW WATER/SEWER TAP REQUEST
Date: 2/05/18 Project Address: 317 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 17-0273
Water System Development Charge $_1,140.00
Sewer System Development Charge $ 4,050.00 C .
Water Meter Only $_ 185.00
Reclaim Meter Only $
Water Meter Tap $
Sewer Tap $
Cross Connection $ 50.00
Other $
TOTAL $ 5,425.00
APPROVED: Kavle Moore,PE %.
(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
,;;t',..An.„\ Building Permit Application
-. r City of Atlantic Beach
fi
800 Seminole Road,Atlantic Beach, FL 32233
`'';�Y Phone: (904) 247-5826 Fax: (904) 247-5845 }
Job Address: 51-1 , -4 r-' ` A-4-i.v.-74-.6_ 1 -j
$ , FIIPPerrm t Number: 1`*—LI
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): t 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, CONSULT WITH YOUR LEN1t O' 1 ATTORNEY BEFORE
RECOR 0 G YO i R NOT=, O. •OMMENCEMENT A
(Signature of Ow er or Agent incl ..1:Contractor) (Signatur. of Contra .r)
Signed and sworn to(o .ffirmed)before me this Lo day of Sig,ed and sworn to(or aff ed)bef.I me this to day of
I ,vZol-7 , by[..c.►C _Jv1-,r',5.4-on I 1 ,.:DC))--1�11. ECJm•-.tecta f —c'r Z ci/e.-Z
--,_.--- +r"� - /r .2.-.._ r_
(Signature of Notary) (Signature of Notary)
_. .... :V.,F: TALIA
;' `-. DAHLKE
�✓(ersonall Known 0', ................ TALIA DAHLKE Personally Known OR , MY COMMISSION#GG 094490
[�1`e Y
MY COMMISSION#GG 094490 Produced Identification '<` EXPIRES:April 16.2021
[ ]Produced Identificati '�` ��
Type of Identification:
C EXPIRES:April 16.2021 Type of Identification: • Bonded Tru Notary Public Us:Rotel• _
.AGF F;�.. . 1-1 'In •-II�.. �