1911 Sea Oats Dr FOUN22-0003 Foundation Permit FOUNDATION ONLYPERMIT PERMIT NUMBER
FOUN22-0003
CITY OF ATLANTIC BEACH
J v~ 800 SEMINOLE ROAD ISSUED: 6/21/2022
fi'; ATLANTIC BEACH. FL 32233 EXPIRES: 12/18/2022
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.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
FOUNDATION ONLYSINGLE OR
1911 SEA OATS DR TWO FAMILY FOUNDATION FOUNDATION FOOTER ONLY $4500.00
ONLY
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0916 SELVA MARINA UNIT 11
COMPANY: ADDRESS: CITY: STATE: ZIP:
CALL THE SCREEN GUYS 1840 MEALY ST S Atlantic Beach FL 32233
INC
OWNER: ADDRESS: CITY: STATE: ZIP:
KECHIK KEITH GEORGE 48 GOVERNORS WAY BRENTWOOD TN 37027
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II\
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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $75.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $37 50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2 00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date:6/21/2022 1 of 2
esi,,,,,„, Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
,,, r 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
J��
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
IS
L
Job Address: 19 1 1 sem Det kr Dr,4fpa•'/it BCccl1..7aPermit Number: KES442� -0311
Legal Description J(, 4.4 0 R^as-, c?t SELt94 i'idRW4 UN/7 /I RE# SA aa-00/1
Valuation of Work(Replacement Cost)$ y500 Heated/Cooled SF -Heated/Cooled
• Class of Work: ENew ❑Addition ❑Alteration ❑Repair ❑Move EDemo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ElCommercial LkiR!!esidential
• If an existing structure, is a fire sprinkler system installed?: DYes DNo
• Will tree(s)be removed in association with proposed proiect? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed: FD 0T e d
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name rom it 'V&A.) XetI k. Address On JPGR CO4" 0r
City /Man fit acpbeil State FL Zip ,.3.2.433 Phone (4,/f.'6,+?&-7/Q,3
E-Mail tvertt/y1eclii l_t0 ymiii/ •Co-1
Owner or Agen (If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Ca/I Thef,'- .i 't y. Qualifying Agent COI 1 Gt r 1/P�
Address j 4'O /lea/. X,-..1"� JJ City �/�Iic .QCT State fL Zip A.2,22
Office Phone Lott 7' j 3L/'I.S Job Site Contact Number
State Certification/Registration#SCC 11311SI'oe E-Mail, e c 11 fi[4r,eolyui J, car',
Architect Name& Phone#
Engineer's Name& Phone#
Workers Compensation Insurer614112 )41Ssiratl f. c)l11)O,1j ac OR Exempt o Expiration Date /0/ i/210Q
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.
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 LENDER OR AN ATTORNE BEFORE
RECORDINGYOUR OTICE OF COMMENCEMENT.
(.4
(Signature of Owner or Agent) (Signature of Co tractor)
Signed and sworn to(or affirmed)before me this 2! day of Signed and sworn to(or affirmed)before me this 2� day of
JL4C , 2.022 ,by 4..i j ,E1. N ripELSr JotJE ,_022 by /'41C41AEL r)al eL5T
(Signature of Notary) (Signature of Notary)
Michael N Didelot
Comm.lIGG338238 Michael N Didelot
Personally Know !•' 'a. e. Ma 23,2023 Personally Known c. ' `.' Comm•IIGG33i8236
7h
[ Produced Identif _� EX [ I Produced Identifi. .•n , , * E i liu M 23,2423
Type of Identification.-nk,: BOO ThN aron Notary Type of Identification.". �;: ..�