321 AHERN ST RES17-0275 -S�:L�i;.�f, City of Atlantic Beach APPLICATION NUMBER
J�r Building Department (To be assigned by the Building Department.)
>. 800 Seminole Road r (J e s t q - Qv� S
�� Atlantic Beach, Florida 32233-5445 1�
Phone(904)247-5826 • Fax(904)247-5845 1
0.219 - V E-mail: building-dept@coab.us Date routed: l 1 `ts ' il-
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: sa\ frc\tt S S* . Deppent review required Yes No
uild.
Applicant: U-i Vx Da1-'-f S cc`s flStf 40—,D!1 tannin &Zonin
Tree Administrator
Project: \Lt4 LDinivQ C-O(1S-:f t t_ */\ '--• . Wor
Public Utilitie
Public _ -
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:, / 1.��/ Date: VAZ/it
TREE ADMIN. Second Review: ❑Approved as revised. „Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: I.�...,i, 1-------4,----- Date: Y/2/4
FIRE SERVICES Third Review: Approved as revised. ❑Denied. [Not applicable
Comments:
Reviewed by: /�....4, �/L.--/ Date: WIV IT
Revised 05/19/2017
"s-.Eyrie City of Atlantic Beach APPLICATION NUMBER
J r � Building Department (To be assigned by the Building Department.)
I 800 Seminole Road NOV 1 6 2017 (Les t'+ - Qv4 qS
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904) 247-5845
•Pto 3iO• E-mail: building-dept@coab.us Date routed: ` 11,s I L�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: \ fes. `t( c S$ . _Dep�.tr ent review required Yes No
uil. i•
Applicant: a,V_ CLn Da-( ( 0,0 nSif,AL- lannin• &Zonin.
Tree Administrator
Project: nQ td%0MYDent COnSt:14.C*)ZA works
Public Utilitie
Public
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. I enied. Not applicable
(Circle one.) Comments: (-
BUILDING nos -400 Iw,,
PLANNING & ZONINGlv►
41) se "c 11-2Y-11
Reviewed • Date:
TREE ADMIN. Second Review: IvApproved as revised. nDenied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed byG,2_ )6(.440., Date: /-2 "/4,
FIRE SERVICES Third Review: Approved as revised. ❑Denied. Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
-11..A��;. City of Atlantic Beach APPLICATION NUMBER
Irl.
d ,t� Building Department (To be assigned by the Building Department.)
V 800 Seminole Road (/__e 5 k 1- - Q d S
,, Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 i
�;1 9%Date routed:' E-mail: building-dept@coab.us ts ` k�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: sa\ 1\ L{ \ 5i- De. . . 'sent review required Yes No
: • ••,.
Applicant: kilI ban Dal- c'LLS CO nSi(ilc--k.M Tannin• &tonin•
Tree Administrator
Project: f\Q (\‘fl.D t_ C'.-iDt1SVIA_ -b/1 • wor
Public Utilitie
Publi
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. El 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
0-A re, City of Atlantic Beach APPLICATION NUMBER
4V _, Building Department NOVC (To be assigned by the Building Department.)
800 Seminole Road ,w ' u � (LE-s t q - Qv4S
u V Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 _
E-mail: buildin de t coab.us Date routed: t i k m 1.
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Sa\ h J ° Dement review required Yes No
uil
Applicant: a(OCln Da (- -« Cts nSi(L.t %(-;m nninq &Zonin
Tree Administrator
Project: 1.L,+,) `tV‘(tDr t_ Q_Ons-k1tl(A).bil was?
CH.11.____Iblic Utilitie
Public
ire Services
Review fee $ i2 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:
APPL CATION STATUS
Reviewing Department First Review: Approved. Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING * F is- -\ o IOgQ,
PLANNING & ZONING LIA9PI r- C,I f--- Reviewed by: /46 1-"i /(''''t---- Date: 2-Htp
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. Not applicable
PU:„ore ORKS Comments:
•UBLIC UTILITIES
2— c— 'r
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I 'Approved as revised. Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
J '�' CITY OF ATLANTIC BEACH
jS\
-J-9.219'r'
PUBLIC UTILITIES
1200 Sandpiper Lane
,�, J l i l f, ATLANTIC BEACH,FL 32233
(904)270-2535 or(904)247-5874
NEW WATER/SEWER TAP REQUEST
Date: 2/05/18 Project Address: 321 Ahem 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 17-0275
Water System Development Charge $ 1,140.00
Sewer System Development Charge $ 4,050.00 ioe(,,) S.V 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 '-44
(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
......,,v,„,,\ Building Permit Application
J t • sd
¢ ' City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
•It';at)r Phone: (904) 247-5826 Fax: (904)247-5845
Job Address: .3" 1 . ►•—►2.—r . 4—./-�1-�� � ��
r'rl-. 2c-G G) PermitPeNumber: �����V r n�
Legal Description See Attached RE# 169742-000, 169737-0000,169737-0010
Valuation of Work(Replacement Cost)$ 200,000.00Heated/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): 1 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 LEND•R O' a N ATTORNE :EFORE
RECORDI Y• " NOT COMMENCEMENT./
-
/L_//. iii/..,61,<_.
(Signatu - of Qw er or Agent including-contractor) (Sig-:lure of Cont.:tor)
Signed and sworn to(or ffirmed)before me this day of Si:ned and sworn to(o' . firmed)be ore me this l.o day of
I 1 ,ezO 1-7 , by R:•G.iC .Jc 'r-. -f'r 7 1 1 iot' , by Jr-r-,i._.r—,dv Conry ti/e_z__
-.• - s--,- -/ V �_ Jam!
(Signature of Notary) (Signature of Notary)
Personally Known ;?, F'.;P: rs TALIA DAHLKE Personally Known OR riq: ' TALIA DAHLKE
Produced Identifica gjt MY COMMISSION#GG 094490 l 1 Produced Identification : ; /. MY COMMISSION#GG 094490
Type of Identification: EXPIRES:Apnl 16 2021 o Type of Identification: =? L.�`�zs EXPIRES:A�nl 10.2021
"4:0,;?:," Bonded Thru Notary Public Underwriters ° Bonded 7h i Notary Public Underwr ters
oar ,