316 4th St RES22-0012 Interior RemodelOWNER:ADDRESS:CITY:STATE:ZIP:
Krolczyk 316 4th St Atlantic Beach FL 32081
COMPANY:ADDRESS:CITY:STATE:ZIP:
One Call Contracting 121 Paradise Valley Drive Ponte Vedra FL 32081
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169813 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
316 4TH ST RESIDENTIAL ALTERATION
RESIDENTIAL
interior remodel - cabinets,
countertops, repairs $20000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $155.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $77.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.49
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.33
TOTAL: $238.32
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: 1/27/2022
PERMIT NUMBER
RES22-0012
ISSUED: 1/27/2022
EXPIRES: 7/26/2022
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 1/27/2022
PERMIT NUMBER
RES22-0012
ISSUED: 1/27/2022
EXPIRES: 7/26/2022
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $160.82
RES22-0012 Address: 316 4TH ST APN: 169813 0000 $160.82
BUILDING $155.00
BUILDING PERMIT 455-0000-322-1000 0 $155.00
STATE SURCHARGES $5.82
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.49
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.33
TOTAL FEES PAID BY RECEIPT: R18617 $160.82
Printed: Thursday, January 27, 2022 1:08 PM
Date Paid: Thursday, January 27, 2022
Paid By: One Call Contracting
Pay Method: CREDIT CARD 579648988
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R18617
Final Plumbing
Final Electrical
Final HVAC
CC Final
Final Building*
Swimming Pool Steel
Swimming Pool Safety
Electrical Grounding & Bonding
Swimming Pool Final (Bldg)
Swimming Pool Final (PW)
Formed Columns/ Beams*
Masonry Cell Fill
Structural Steel*
OTHER:
OTHER:
OTHER:
OTHER:
OTHER:
Power Pole
Silt Fence
Piers/ Stem Walls
Underground Plumbing
Underground Electric
Foundation/ Footing
Slab**
Retaining Wall Footing
Driveway
Sewer (Building Dept)
Sewer Tap (Utilities Dept)
Rough Electric*
Rough Plumbing/ Top Out*
Rough Mechanical*
House Wrap
Wall Sheathing
Roof Sheathing
Tie-down Framing Connections
Rough Framing
Roofing In Progress
Window/Door In-Progress
Insulation Ceiling
Insulation Wall
Exterior Lath
Stucco Scratch Coat
Exterior Siding In-Progress
Brick Flashing & Ties
Early Power
Gas Rough
Gas Final*
* When all rough electric, plumbing, mechanical are complete but before any work is
covered up.
* When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance. All outlets must be capped and pipe pressurized at a
minimum of 15 lbs.
* For new living space: When all construction work including electrical, plumbing,
mechanical, exterior finish, grading, required paving and landscaping is complete
and the building is ready for occupancy, but before being occupied
Additional inspections may apply to your project if your project
contains these elements:
INSPECTIONS REQUIRED FOR BUILDING PERMITS
To verify compliance with building codes, inspections of the work authorized are required at various points of the construction.
The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
_____________________________________________________
Permit Type
____________________________________________________
Permit No.
__________________________________________________________
Job Address
____________________________________________________
Contractor
POST THIS CARD WITH PERMITS AND PERMIT
DOCUMENTATION IN FRONT OF BUILDING
Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends
Building Department Public Works/Utilities Fire Department
Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789
Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203
* When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all
electrical, plumbing and mechanical work is in place, but before concrete is poured.
* When all structural steel members are in place and all connections are complete,
but before such work is covered or concealed.
** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION
Building Permit Application Updated 10/ 9/18
City of Atlantic Beach Building DepartmentC ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone:)
1 (
904) 247-5826 Email: Building-Dept@coab.us
IS REQUIRED.
Job Address: 3/1/ "-1
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Per
lmit
Number:
Legal Description e 1 4'T 7 /jfi4 4& 7i_ 6.7,
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Valuation of Work(Replacement Cost)$ 2 K Heated/Cooled SF 4111) Non-Heated/Cooled /1)2)(1474W-0/")
Class of Work: New DAddition Alteration Repaiir Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial ®Residential
If an existing structure,is a fire sprinkler system installed?: [Nes No
Will tree(s)be removed in association with proposed project? Yes(must submit separate Tree Removal Permit) No
Describe in detail the type of work to be performed: l ,___ /Gjgrt/ 6.9.4,d,: 4 i Tt,2__ v p'5,
7 A i / 4),<____ , ,ft;4,,,,-/d-- -.5,„ Y/pv t['/i 4 ,q f
Florida Product Approval# /V`¢ for multiple products use product approval form
Property Own,er Information ,/
Name D.9i/ -1/ f 2 4 A /ego, z--FL' / Address 3/6 `1 /4- •57`'
City 9/fr/"i i C— / N4 State Zip...3 -1 3,3 Phone
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Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) A44-
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State Certification/Registration # L(p23i/i E-Mail / ,ti,// -LZ D I. d p4,,--/,_ e 4?-11/
V1ArchitectName& Phone# /"/l; s/!
Engineer's Name&Phone# //1M
Workers Compensation Insurer /1, 'OR Exempt Expiration Date .2--//%412-3
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 regulating
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. 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.
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. c
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
R SULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR P OPERTY. IF YOU INTEND
A._• OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN TT NEY BEFOREi'77 IkORDN . e,a . •OTICE O OMMENCEMENT. I
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ig re of r Agent) Signature of Contractor)
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Produced Identificatio I-Produced Identification f
Type of Identification: O:\/t I-/- ` C.C./A 1 Type of Identification: -At-w-tx L1(_,Q11SA.-