1842 Hickory Ln FOUN21-0008 Foundation RepairOWNER:ADDRESS:CITY:STATE:ZIP:
ROSA DOUGLAS W ET AL 12527 TENNY CRAGS RD COLORADO SPRINGS CO 80921
COMPANY:ADDRESS:CITY:STATE:ZIP:
FOUNDATION SYSTEMS,
INC.PO BOX 50545 JACKSONVILLE
BEACH FL 32240
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172020 1452 SELVA MARINA UNIT
12C R/P
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1842 HICKORY LN
FOUNDATION ONLY SINGLE OR
TWO FAMILY FOUNDATION
ONLY
FOUNDATION REPAIR $5400.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $80.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $40.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 12/9/2021
PERMIT NUMBER
FOUN21-0008
ISSUED: 12/9/2021
EXPIRES: 6/7/2022
FOUNDATION ONLY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $124.00
2 of 2Issued Date: 12/9/2021
PERMIT NUMBER
FOUN21-0008
ISSUED: 12/9/2021
EXPIRES: 6/7/2022
FOUNDATION ONLY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $124.00
FOUN21-0008 Address: 1842 HICKORY LN APN: 172020 1452 $124.00
BUILDING $80.00
BUILDING PERMIT 455-0000-322-1000 0 $80.00
BUILDING PLAN REVIEW $40.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $40.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R18239 $124.00
Printed: Thursday, December 9, 2021 10:36 AM
Date Paid: Thursday, December 09, 2021
Paid By: FOUNDATION SYSTEMS, INC.
Pay Method: CREDIT CARD 557708318
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R18239
FOUN21-0008