831 Amberjack Ln RES19-0362 COAB Permit Form with Conditions - RenewedOWNER:ADDRESS:CITY:STATE:ZIP:
RANDOLPH BASSEL L 831 AMBERJACK LN ATLANTIC BEACH FL 32233-4224
COMPANY:ADDRESS:CITY:STATE:ZIP:
THE HOME DEPOT 9208 Florida Palm Drive TAMPA FL 33619
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171183 0000 ROYAL PALMS UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
831 AMBERJACK LN RESIDENTIAL ALTERATION
RESIDENTIAL Replace 2 windows $1150.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $60.00
BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $94.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $30.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $188.00
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: 6/16/2023
PERMIT NUMBER
RES19-0362
ISSUED: 6/16/2023
EXPIRES: 12/13/2023
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 6/16/2023
PERMIT NUMBER
RES19-0362
ISSUED: 6/16/2023
EXPIRES: 12/13/2023
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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
Replace 2 windows
831 AMBERJACK LN
THE HOME DEPOT
RES19-0362
r„.,-,
11,-:!.../,,, City of Atlantic Beach APPLICATION NUMBER
Building Department To be assigned by the Building Department.)
t-,, - \
800 Seminole Road
rEC
III—0 2 (p4,w Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 le'( ?0, (l52:01119'''".2:01119''' E-mail: building-dept@coab.us Date routed: t
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 78 ( b.tt gc,LL . ,De;. tment review required Ye No
7
euildin
Applicant:l I JI IY, tip } Planning &Zoning
fn
i Tree Administrator
f
Project: 1 0—e-- '- (n,!lb>03 Public Works
Public Utilities
Public Safety
Fire 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: [ pproved. Denied. Not applicable
Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date: /4-I 7-1 9
b/
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
Call Tim for Fick Up 727-837-8400 i r.-/ P/7
l0y -2 .'—i, Building Permit Application Updated 10/9/18
is City of Atlantic Beach Building Department ALL INFORMATION
t-#
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Fax: (904) 247-5845 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: B31 Amberjack Lane Permit Number: F--LS 1 -D3(e,r).
Legal Description 30-60-17-2S-29E Royal Palms Unit 1 Lot 29 BIk 4 RE# 171183-0000
Valuation of Work(Replacement Cost) $ 1,150.00 Heated/Cooled SF Non-Heated/Cooled
Class of Work: )New Addition inAlteration Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): OCommercial ®Residential OFFICE COPY'
If an existing structure, is a fire sprinkler system installed?: EYes ONo
Will tree(s) be removed in association with proposed project?DYes(must submit separate Tree Removal Permit) no -
Describe in detail the type of work to be performed:
Replace 2 windows size for sizer, -
fi
iii-.. -,
Florida Product Apprdval # 1491 1.4 for multiple products use product approval form
Property Owner Information
Name Fredenca Randolph Address 831 Amberjack Lane
City Atlantic Beach State FL zip 32233 Phone (904) 329-0172
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) n/a
Contractor Information Z .
Name of Company The Home Depot Qualifying Agent Arthur Francis
c(.Address'9204 Florida Palm Dr City Tampa State FL Zip 33619 L)Office Phone (727) 637-8400 •Job Site Contact Number LI i\State Certification/Registration# CGC061641 E-Mail tim.omalley@expeditepermit.com. U .:: • ,
Architect Name& Phone#d x J Z I
Engineer's Name&Phone# 1 r N Q C)
Workers Compensation Insurer r2^'
R;t'Z'F-P N t.S)ti.re ,.y (,o OR Exempt o Expiration Date 3 t c _,
t'' 0 0Applicationisherebymadetoobtainapermittodotheworkandinstallationsasindicated. I certify that no work or installttjoL.Ji Z
FI
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regtt
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construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,S'I- a c •WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: Inytl.p t6 t e' " mt!", •
permit,there may be additional restrictions applicable to this property that may be found in the.publlc-•ret&o..this ct u ,;,T_ >
rtheremaybeadditionalpermitsrequiredfromothergovernmentalentitiessuchaswatermanagementdistricts,state a e I t$
federal agencies,
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OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done`fit bmplian a !x a
applicable laws regulating construction and zoning. Iia u
W U N
OWL uWARNINGTOOWNER: YOUR FAILURE TO RECORD A NOTICE OF COMIVIENCE1VTENT MYYr t
LIRESULTINYOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. IF YOU IMPEND'CX
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECQR,DING YOUR NOTIC •F COMMENCEMENT.
tivl
Signature of Owner or Agent)— j Signature of C ntractor
IV/ 3 Signed a d sworn to (o affirmed)before me this / day of Signed and sworn to (or affirmed)before me this day of
e)/•—•,.4,-- , d-al v-by /`-ice`-
02.U[Q ,by l r Wv[u• Fra.u5
NOTARY PUBLIC 0.1 •;', TIMOTHY R.O'MALLEY
fak •,: MY COMMISSION#GG 117135STATEOFFLORIDAGe
PersonallyKnown C• EXPIRES:August 7,2021 'Comm#GG229591 1 Personally Known OR Fo,; Bonded Th u Notary Public UnderwritersProducedIdentificati."'•- ' Expires 6/18/2022 Produced Identification . "
r.,........F LJ....+4i.-.44.....
OFFICE COPY
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
Project Name: av1
Permit #0..C/9
Project Address: 83 t -141 a SCk
As required by Florida Statute 553.842 and Florida Administrative Code Rule 9B-72,please provide the information and product approval number(s)for the building components listed below as applicable to the building construction project for the permit number listed above. You should contactyourproductsupplierifyoudonotknowtheproductapprovalnumberforanyoftheapplicablelistedproducts. Information regarding statewideproductapprovalmaybeobtainedat: wwwfloridabuildirw.oro.
Category/Subcategoryb . Manufacturer 4 Product Description J Limitation of Use State# Local #A. EXTERIOR DOORS
1. Swinging
2. Sliding —
3. Sectional
4. Roll up
5. Automatic
1
6.Other
B. WINDOWS
1. Single hung
2. Horizontal slider
3. Casement
4. Double hung
i
5. Fixed
6. Awning
L_._____7. Pass-through
8. Projected r
9.Mullion 1
10. Wind breaker
11. Dual action
d
1
1
Other
Category/Subcategory Manufacturer Product Description imitation of Use State# Local#
H. NEW EXTERIOR
ENVELOPE PRODUCTS
2.
In addition to completing the above list of manufacturers, product description and State approval number for the products used on this project, theContractorshallmaintainonthejobsiteandavailabletotheInspector, a legible copy of each manufacturer's printed specifications and installationinstructionsalongwiththisProductApprovalSheet.
I certify that this product approval list is true and correct to the best of my knowledge. I further certify that use of different components other than the ones
listed in this document must be approved by the Building Official.
cv-Q
Contractor Name) (Print Name)
SignaZ)
Company Name: - Vis_.d'Sr-
Mailing Address: 2
City: --TG---\D-Tc State: F--z- Zip Code: 33C t `1
Telephone Number: ( 'IJ 7) (9 3 7- e./ w Fax Number: (
Cell Phone Number: (E-mail Address:
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