1757 Seminole Rd ACC19-0042 COAB Permit Form with Conditions - RenewedOWNER:ADDRESS:CITY:STATE:ZIP:
MULL TIMOTHY B 1757 SEMINOLE RD ATLANTIC BEACH FL 32233-5832
COMPANY:ADDRESS:CITY:STATE:ZIP:
RANDY & RAY'S LLC 10631 SQUIRES CT JACKSONVILLE FL 32257
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169637 0500 OCEAN GROVE UNIT 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1757 SEMINOLE RD
RESIDENTIAL OTHER SINGLE OR
TWO FAMILY RESIDENTIAL
OTHER
WOODEN DECK - renewal 10
-23-23 $28375.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
2 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list (Advanced Disposal, Realco Recycling, Shapells, Inc., Republic Services, Donovan Dumpsters,
Phillips Containers, JDog/Dennis Junk Removal, All American Roll Off, WCA Waste Corporation). 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: 6/17/2019
PERMIT NUMBER
ACC19-0042
ISSUED: 6/17/2019
EXPIRES: 4/20/2024
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $195.00
BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $110.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $97.50
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.39
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.93
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $50.00
TOTAL: $484.82
3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
4 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking must be removed from job site by Contractor.
2 of 2Issued Date: 6/17/2019
PERMIT NUMBER
ACC19-0042
ISSUED: 6/17/2019
EXPIRES: 4/20/2024
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
City of Atlantic Beach APPLICATION NUMBER
jsQ Building Department To be assigned by the Building Department.)
800 Seminole Road 7
r Atlantic Beach, Florida 32233-5445 Roc C—
Phone(904)247-5826 • Fax(904)247-5845
Date routed:E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: S ev c( Nth De ent review required Ye No
Applicant: Pio ` S annin &Zonin
Tree Administrator
Project: C2 C-1 C _ 5 ublic Works
Iic 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
v
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. ODenied. Not applicable
Circle one.) Comments: oc"B:U:I:L:DIN
PLANNING &ZONING
Reviewed by:Date: $ .a 2-%ky9
TREE ADMIN.
Second Review: Approved as revised. Denie . 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
City of Atlantic Beach APPLICATION NUMBER
s r Building Department To be assigned by the Building Department.)
n
800 Seminole Road
Atlantic Beach, Florida 32233-5445 4z
Phone(904)247-5826 • Fax(904)247-5845
Date routed:E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: l 1Z EMTtraC21 P, De ent review required Yes No
Applicant: Rtoo annin &Zonin
Tree Administrator
Project: c2n _ublic Works
lic 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 n ,
Florida Dept. of Transportation vvSt.Johns River Water Management District
Army Corps of Engineers v
v
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:
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
City of Atlantic Beach APPLICATION NUMBER
Building Department To be assigned by the Building Department.)
800 Seminole Road 44Y
j s Atlantic Beach, Florida 32233-54 1s 4 Z
Phone(904)247-5826 . Fax(904) -5845
E-mail: building-dept@coab.us Date routed: s
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: DqpartWent review required Yes No
Applicant:I S annin &Zonin
Tree Administrator
Project: C2n 1 =e K ublic Works
lic 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
v .St. Johns River Water Management District
Army Corps of Engineers V
y
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: proved. Denied. Not applicable
Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by:Date: i
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
1 IVJ;r City of Atlantic Beach APPLICATION NUMBER
s Building Department To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 e C l C 4 L
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ( S 7 .,r c( Deps't[tLnent review required Yes No
Applicant:1' f rj IR A i S wrannirl Zonin
Tree Administrator
Project: ,fy (2)n c L)E-0(< Pubiic Works
PcElic Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required
Review or Receipt
Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation Vv .St. Johns River Water Management District
Army Corps of Engineers
y
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: []Approved. Denied. MeNot applicable
Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: rim/ ate: ,s-/7—fig
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 05/119/20117
OFFICE COPY
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
11 r
Phone: (904) 247-5826 Email: Building-Dept@coab.us
IS REQUIRED.
nom ' Q
Job Address: 1115 1 `J,F_fP'N1M LMO L-1E (-9 Permit Number: l 0 U
Legal Description Vu'r14 %/Z (9F L01-ys O eIGAiu Gf101/E u.nJ-C-1 7— RE#
Valuation of Work(Replacement Cost)$ 31 OU Heated/Cooled SF Non- Heated/Cooled
Class of Work: New Addition Alteration []Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial Residential
If an existing structure, is a fire sprinkler system installed?: Yes No
Will trees be removed in association with proposed ro'ect? Yes must submit separate Tree Removal.Permit ONO
Describe in detail the type of work to be performed: 1k r.P LAer -4, "PAA _W00*0 '360, r&)
T-UV b A GC 2D yw 5 I8 0 less9 jj +
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name 1''PNW ti? AT fu ti,LC Address 11 67 SF,WV r,J0L 9
City L A CA61-v Statef--L Zip 32233 Phone X03 ay4 96(16-
E-Mail 3G,Ft'c.A-V!A*\ Ial° C9.V7,J,J (--I k;—%
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company 'ZkAj5'\ } Q A X15 LLC_ Qualifying Agent rA NJ`1
Address to(.3 '5oLA.La-ra s I N City '5Acy1sQNVGu.X State rL- Zip 39al57
Office Phone 401A 170 6-800 Job Site Contact Number 104 5710146'613
State Certification/Registration# E-Mail. D4ND y ND,eA 5 G.,NLe4 ,G.7wv,
Architect Name& Phone#
Engineer's Name&Phone#LU
Workers Compensation Insurer 15 Oil')Y6A-e - P AOL-1 OR Exempt p Expiration Date N
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or instdla4crljio
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the lawsuctig 2
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBIN I
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS,etc. NOTICE: In addition to the requirer@r> Qtra N
10
permit,there may be additional restrictions applicable to this property that may be found in the public records of this cWnQ, c8 Q
there may be additional permits required from other governmental entities such as water management districts,staterrye9 c
federal agencies. O 0 Q
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in complian4i a 1 H
Z
applicable laws regulating construction and zoning. O ELL 2EW
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT wfI> YM LC Co
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU WtEwtU
TO OBTAIN FINANCING, CONSULT WITH YOUR LE ER OR TTORNEY BEFORE Ir w
R ORDING YOUR NOTICE OF COMMENCEME . Ir
LU w
c r , Y
Signature of Owner or Agent) Sig ntractor)
Signed and sworn to(or affirmed)before me this 13 day of Signed and sworn to(or affirmed) before me this day of
by o.-e,e me:. -- ?\ by
sral!maPun2!IQnd NeloN rW1 P•P 8 ;;o"=°+;. (Signature of Notary)
HENRY R.PROCTOR Signature of Notary)
OZOZ'Ol»Q aO:S3MIdX3 •:
MY COMMISSION#GG 027339
a; :
6EUZ0 00#NOISSINNOO AA
io EXPIRES:December 10,2020 NO10ONd T!AMN3H
I' L.,
EXPIRES:
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Produced Identification
MAP SHOWING BOUNDARY SURVEY OF
THE SOUTH 1/2 OF LOT 45, OCEAN GROVE UNIT NO. 2, AS RECORDED IN PLAT BOOK 20, PAGE 20,
OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
HAROLD D. WELLS AND VELDA C. WELLS
ATLANTIC HOME MORTGAGE COMPANY
ADVANCED TITLE RESEARCH SERVICES, INC.
STEWART TITLE GUARANTY COMPANY
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