815 PLAZA RESO23-0027 DECK -' ''/-4 Building Permit Application Updated 10/9/18
2`, City of Atlantic Beach Building Department **ALL INFORMATION
`�, r v 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
`'';li
IS REQUIRED.
GPhone: (904) 247-5826 Email: Building-Dept@coab.us �j 2 Q
d
Job Address: O I 5- ?/(,- R 3
A Z A. Permit Number: ..5O Z -bZ 7
Legal Description So-ed) 17 -z 5-21e.
NOVA AL lL�-S�/'"ir 1 112V CLI' / RE# 1 71/<
NValuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled
• Class of Work: Aew ❑Addition ❑Alteration DRepair ❑Move ❑Demo ❑Pool DWindow/Door
• Use of existing/proposed structure(s): ❑Commercial p'Residential
• If an existing structure,is a fire sprinkler system installed?: DYes JeNo
• Will tree(s)be removed in association with proposed proiect? ❑Yes(must submit separate Tree Removal Permit) Olo
Describe in detail the type of work to be performed: 12-r"Nt> 4 Qt_ b j?e_-<:_ie t`I6--r 2.0 QLA4'- (-,.) ►`r L,
-c u rvci 1 ev.,-,(
Florida,Product Approval# for multiple products use product approval form
Property Owner Information
Name IPEre . -IC. OP-' Address FSI> RAza
City LA ,--t- ,C, ac-4.1.- State -- . Zip 32Z33. Phone Z02- ({Zr 71 'S-a
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of CompanyC NtS IN4 E Ck-TE12G-J2.AQualifying Agent Jo -44 A"� -G LV -r-
Address QU41414-�r=sT, C C `/ S C C-^-) City 1 AC/(SD'V&► .- State R_ Zip S 2 Z 3,
Office Phone cfr--/ '7 C '7 7's`j Job Site Contact Number
State Certification/Registration# E-Mail ?(,EA c. 51= P6C.-y✓1A/L • Lam,
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer /9_,AFT-( orf- OR Exempt❑ Expiration Date I ///24
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 ATTORNEY BEFORE
RECORDING YO ' TICE OF COMMENCEMENT.Alr w
(Signature of Owner or Agent) (Signature of Contractor)
5-ever>, 5cLw-rCervLII.v G
Si ned and sworn to(or affirmed)before me this q day of Si ed and sworn to(or affirmed)before me this J day of
0(03, •. 3.e ' . 4 a)l , r (l 2 , .- 6 . .. . ' : i a I
' ."tom 44 ' _. - .,/ ' . �'- -
ign t re .
uDlfct _of Florida t •f
Jessica A Dolquist Notary Public State of Floida
p. My Commission HH 142217 P ' Jessica A uist
d Expkes Oti/14/2°25 ersonall Known OR • ) My Commission HH 142217
[ ]Personally Known OR bra [ Y +�� zi
Expires 06/14/2025
[ roduced Identificatio [ ]Produced Identificatio O .
Type of Identification: i:3(.._. Type of Identification:
MAP SHOWING BOUNDARY SURVEY OF
LOT Zel- BLOCK / Aq SHO!NO N MAP OF
20 Y4 c. P4uY) (/J/ 7- U
AS RECORDED IN PLAT BOOK '30 PAGES GO•64 24 OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA
CERTIFIED FOR: ,J,•/E-TLf /g • 721Y co"—; PEOPL6-C Fi25T C____e/''M()^// 1 ^J
p YA On/.. i/✓ - pa 4 . a 0 G/ '- ', .
`• Ci t Q.v,, L,Gvez., .,-c,1 _ 10 i C (Ad 7TALL.f J
/1 \\
(z_ /�
4 g5 ° Z,o 'oz:'6- Sobs ' ir
O.rD.Z. 1 .I O
r -r x /
0.l -- r- o • Uri C. ES .� Lo• "--- z3
%O k s).-..
? 1,
ti, N ¢q.7• / 6 lr zs
i0•G 4.--iz —�t-
y
, //o p/54-t-
O 10 L. / i./�. /S- S' o�
N
NI 1\3 i .. •
S73. ZS •
Tg COIL. _
,J 95 ' 57 ' z.7 '.kJ. ea. LS
PL_ 4 z4 S7- ( o " 2_/,/)
THE PROPERTY SHOWN HEREON APPEARS TO LIE WITHIN FLOOD HAZARD ZONE X AS SCALL D FROM FLOOD
INSfIRA NCF RATE MAP 0/)0/ FOR THE CITY OF4rc_. /-4,c4FLORIDA, DATED ¢ /7 9' AND
-I 12
•
od e►>5 4-rrAcN w 1-rit
3//STQ1 N 55 5C o kiS
►iv Q tc
(� - R-3r) se:co
L
<Zir / �Z�i Ai rAcf+F):•• I ff`
- Jv ISIS ,A',I I> „6"
�eE zX(,„ yi,oe1,-) & 4
SC'GUtc 1--11-7 44 SOIS7-
14 N‘__&--e.s Lv 'r y//L i4c 5
E1/1" Jvi47S eirrroclit2P �X�S
U^' G e-eto42cJSI-"Cr"
e//( AG-5
3e.,3,4t areAc.ri1'r AT I /ro^)
CE✓��2A�'� Ac4-e51—/-r-44---
\-?-4"r-Test--7-(e
^'IT(4---
24"rTest- res ANi�Joitr
2S ,
C C r
� C
------ -.i—.._-_.. - ----- L.----- -------- n
e Lim Pds-c 5 5 c 4 1 fu cop)c et` L,1'd 10 cc,"—2- "kz-v-'' .-O 1675
SA E, I ij u " ijpG-c'R-l,OCX- - 2(co L G AG-c 2 aeA Qp c,as-rc N)c:, ((.0" Ddu
Cc,fore 2- W 1' CdtjcAl4571►t^ 460 o L u(b GGA (.ocKS
Z)(1.0 10151-4 I t9"o GC rJ 114kikekkrees
1 i 1
i . 0 ,-
-,-;\--,-,-/›.,..c/7, „ __ ___ , ____,
z'
--. r /7. / '
7 9 .,-
7 /
7,_
_. •
/ilt�,r /7 f' //7#/ //7/iii/