393 AQUATIC DR RES23-0260 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
Gonzalez Carmen 12028 Northumberland Dr Tampa FL 33626
COMPANY:ADDRESS:CITY:STATE:ZIP:
Bolin Group, Inc.P.O. Box 9419 Fleming Island FL 32006
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171818 5276 AQUATIC GARDENS
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
393 AQUATIC DR RESIDENTIAL SIDING Repair rotted siding, install
Hardi Lap, replace 1 window $6400.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 BUILDING IN-PROGRESS INSPECTION REQUIRED INFORMATIONAL
Notes:
IN-PROGRESS INSPECTIONS ARE REQUIRED FOR EXTERIOR SIDING, WINDOW, AND DOOR INSPECTIONS, AND SHOULD BE SCHEDULED FOR THE FIRST
DAY OF WORK.
2 BUILDING NOTICE OF COMMENCEMENT INFORMATIONAL
Notes:
No inspections may be scheduled until a copy a recorded Notice of Commencement has been submitted to the Building Department
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: 12/11/2023
PERMIT NUMBER
RES23-0260
ISSUED: 12/11/2023
EXPIRES: 6/8/2024
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00
BUILDING PERMIT 455-0000-322-1000 0 $85.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $42.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.66
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $182.16
2 of 2Issued Date: 12/11/2023
PERMIT NUMBER
RES23-0260
ISSUED: 12/11/2023
EXPIRES: 6/8/2024
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USEONLYAI '' City of Atlantic Beach Building Department PERMIT# V-623 —C%Z(O0
Vs," 800 Seminole Road,Atlantic Beach, FL 32233 ALL information required to process
Oft' Phone: (904) 247-5826 Email: Building-Dept@coab.us
JobAddress 39 3 A Q(y,& T t c.. L RE# /7/8/?- 57=7
Legal Description 35)• 11. 11 - 22 • 2_9 eQ,44-rIc- CIO L,8 t S LoT Z2 • $
Valuation of Work(Replacement Cost) 4/47/-0E'• ‘"" Heated/Cooled SF 13 Z ' Non-Heated/Cooled SF -LS'
Class of Work: New Addition Alterationepair EMove ['Demo Pool Window/Door
Use of existing/proposed structure(s): ['Commercial sidential
If anexisting structure,is a firesprinkler system installed?: Yes 1314o
Will tree(s)beremoved in association with proposed project? Dyes(Must submit separate Tree Removal Permit) ' Imo - - t ^
Describe indetail the type ofwork to be performed:
tl
2-F-i°'/1 . .¢-oT7 > $iviN . 2 STo'r`r( F arT 'eSive), iwJSTAI. - .'"°""0447-4 L.e/
f2Ei4-00c__E / '-c- "e>•" C Z- STo,iy (# . .T SrME s zE
Florida Product Approval# cL-4' t 4•I <=1.4. I For multiple products use ProductApproval Information Sheet)
Property Owner Information Name aAl2A '— — Phone 4o If• ,<o . o2-1E
Address t Zc Z No L-T HL_. City 7'd'--tPA- State GL Zip 33& z1
Email GJ q /20e sir c-Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information Name of Company t•--t t!J c- Phone 90'4.2-1C"4.I t
Address --?`" ou 94i 5ftyCitsc .s,D State r-t- Zip 32-.004D
Qualifying Agent W I t.t,t A''`-t/ 6.2 State Certification/Registration#
Email 69 i . s'4-K_-t o.- 140 e- • C A--I JobSiteContact Number A 4'4+41 1 -
Worker's Compensation Insurer ORExempt Expiration Date c//3/Zo z-S'—
Architect's Name Email Phone
Engineer's Name Email Phone
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 thisjurisdiction.I understandthat aseparate permit must be securedforELECTRICAL WORK, PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
NOTICE:In addition to the requirements ofthis permit, there may be additional restrictions applicable to this property that may
befoundinthepublicrecords ofthis county, and there may be additionalpermits requiredfrom other governmentalentities
such as water management districts, state agencies,orfederal agencies.
OWNER'S AFFIDAVIT:Icertify thatallthe foregoing information is accurateandthat allwork will bedone incompliancewith allapplicable
laws regulating construction and zoning.
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE
FOR IMPROVEMENTS TOYOUR PROPERTY.IFYOU INTEND TO OBTAIN FINANCING,CONSt1L3WITH YOUR LENDER OR AN
ATTORNEY BEFORE-RECORDING YOUR NOTICE OF COMMENCEMENT..
i ignature ofOwner orAgent)Signature of Contractor)Zyt)
Signed and sworn to(or affirmed)before me this ZS day of Signed and sworn to(oraffirmed)before me this Z day of
NDVEfl113ER , 2023 byJVeana. Pitt-math Moue ti,beS ,,2o2'S y WI1\am- o v•
Signature of Notary Signature of Notary Z ( .
4 Personally Know OR [ ] Produced Identification Personally Known OR [b6 Produced Identifi do
Type of Identification: Type of Identification: F L i,L ex? 8 -r
Notary Public State of Florida F• ' =Cornmbdon0NH270885
limns Lee Pittman A Ems luneI,2029
M Commission HH 32411$j IIII yExpires 10/23/2026
By Mike Jones at 3:20 pm, Dec 08, 2023
REVIEWED FOR CODE COMPLIANCE
By Toni Gindlesperger at 1:44 pm, Dec 08, 2023By Mike Jones at 3:14 pm, Dec 08, 202350.00
By Toni Gindlesperger at 1:44 pm, Dec 08, 2023By Mike Jones at 3:16 pm, Dec 08, 2023