815 ATLANTIC BLVD COMM23-0055 COAB Permit Form with Conditions NEW PERMIT 1-9-24OWNER:ADDRESS:CITY:STATE:ZIP:
NORMANDY BOULEVARD
LLC 8650-12 OLD KINGS RD S JACKSONVILLE FL 32217
COMPANY:ADDRESS:CITY:STATE:ZIP:
SEATEK HORIZON, LLC
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
177653 0060 SECTION LAND
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
815 ATLANTIC BLVD COMMERCIAL ALTERATION
COMMERCIAL
TENANT BUILDOUT -
FLORIDA JUICE AND BOWL $30000.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 ZONING ZONING NOTES INFORMATIONAL
Notes:
Must submit separate sign permit prior to any new signage being installed.
Must obtain business tax license prior to opening.
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: 12/1/2023
PERMIT NUMBER
COMM23-0055
ISSUED: 12/1/2023
EXPIRES: 5/29/2024
COMMERCIAL 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 $59.00
BUILDING PERMIT 455-0000-322-1000 0 $205.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $102.50
FIRE DEPARTMENT FEE 45500002080800 0 $150.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.61
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.08
ZONING REVIEW COMMERCIAL AND INDUSTRIAL USES 001-0000-329-1003 0 $350.00
TOTAL: $874.19
2 ZONING MINIMUM TREE REQUIREMENTS PRIOR TO CO
Notes:
New trees must meet following minimum tree sizes at time of planting and must be on the city's approved tree list in Chapter 23 of the code.
- Palms must have 8 foot clear trunk height
- Oaks must have 4" caliper and 12' height
- All other trees must have 2" caliper and 10' height
2 of 2Issued Date: 12/1/2023
PERMIT NUMBER
COMM23-0055
ISSUED: 12/1/2023
EXPIRES: 5/29/2024
COMMERCIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
11,,vi BUILDING PERMIT APPLICATION l AL •
S r ,\ FOR INTERNAL OFFICE USE ONLY
City of Atlantic Beach Building Departmentc c-PERMIT#Q(y O1 z__CUC.
800 Seminole RoadAtlantic BeachFL 32233
ALL information required to process
3'"
V
Phone: (904) 247-5826, Email: Building-Dept@, coab.us
Job Address g/5-4-7-L9NT t C /3L UD RE# ) 77h5-3-oo(0 o
Legal Description .2 5. 9 a , 3 3 i3 OE.c4 S i a J `/ r F RR lER li 124NT pr RECD 0/R i1 /-/ 7r/
Valuation of Work(Replacement Cost) 3 Q,600 Heated/Cooled SF 2/D 0 Non-Heated/Cooled SF
Class of Work: New Addition Q'Alteration ERepair Move Demo Pool Window/Door
Use of existing/proposed structure(s): gtommercial Residential • If existing structure, is a fire sprinkler system installed?:Yes g7 No
Will tree(s)be removed in association with proposed project? Yes (Must submit separate Tree Removal Permit) [iNo
Describe in detail the type of work to be performed:
1=-1A Jo (C .
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Florida Product Approval# For multiple products use Product Approval Information Sheet)
Property Owner Information Name TS 6_ PZF_IL71 Phone nj 0-993-—/- 90/
Address 8(,sv OiCD k//0jrs j20 Cityc.)IrA-(rSONV/CIE State FL Zip 7 2//7
Email pld fIdWA2 DP T c.igi Gty ,
t wner or Agent(If Agent, Power of Attorney or Agency Letter Required) th.i vi
Contractor Information Name of Company SE4 T,=K 1}1)2 2 vti' .:.c C Phone 10,4 c3 6 oc',
Address 1 vs-4rc4N r Ic d[.9 City 4/1.AA+1 iC g F 4C 1L State GL Zip 12 ??
Qualifying Agent (Ay;h c MG L4ruit State Certification/Registration# c gc/z S 4.73 a
Email 5€09-rEKfribmc s IMAIL,roNi Job Site Contact Number goo 616 in $
Worker's Compensation Insurer OR Exempt Q Expiration Date •) /- ZvZ c
Architect's Name )ast N C,4N,viar Email ,)1}SO4 t?c,1NNW,aap.CCS Phone .p4-d47.49O
Engineer's Name A•LEXPio F12 (pkWt CoAu L7/ivu- Email Phone 909-20_ 6,o/0
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 city/county, and there may be additional permits required from other governmental entities such as water
management districts,state agencies, orfederal 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 YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
of Owner or Agent) Sigre octor)
Q.k,
Si ned and sworn to(or affirmed)before me this ir- day pt q-,,,, , /i241yr-Signature
nd sworn to(or affirmed)before me this U ,
Mdaynof
c lZv..t JZL1 by Dc vA:eQ j. e'kT rl- by j9.v,C'S t `C l".e
Signature r /J 61 Signature k (t.g Notary J g tary 1.•-
Personally Known OR V.] Produced Identification/ Personally Known 11012 )Produced Identification
Ty e of Identification: FG P L `•f /2 Type of Identification: / I) L el 6 12.43
YP".. •:
ERJOLADURMISHI
I
Commission#HH 270865 p'°p£"..F ERJOLA DURMISHI
FoP Expires June 4,2026 Commission#HH 270865
telc:_*:P Expires June 4,2026a;
TERMINATION OF BUILDING PERMIT BY PROPERTY OWNER
I D 4, i i`L 13 L u a-r am the owner of
6l c 4Tj,9N) TIC FL UP,, 4TLgn1?'c &C-RC1c 31237 and have
contracted with FAC,-cctir coNsTRurriGti.i.0 E.VE o?M FNrLLC for
improvements on the above property, under Building Permit C Om m123 - 00,5' 5—
I have terminated my contract with the above contractor, before completion of the project, and
wish to transfer the Building Permit to 5 EAT E..K 1-102/z.oN 2.-i c
I understand that financial and contractual issues may still apply and are civil matters between
the owner(s) and contractor(s) and we agree to hold the City of Atlantic Beach harmless in
those matters.
Details(Optional)
A copy of this form will be sent to the original contractor.
Property Owners Named'r el `Rt--tC/ Phone Number 1.17(:;*--738g
Address gi 1`- T- -/t/ J ;z7-1--) 7_____________i--
l
Signature of Property OwnerDate /7g7:2-7/'g :2-7/'
Before me this
c`
day of a-"(-- 9 20 .29
Signature of Notary Public SL 94,1 ,
acr"""s,"": ERJOLADURMISHI
Commission#HH 270865f
Expires June 4,2026
Izr%
AGREEMENT TO ACCEPT TRANSFER
40;>;cOF UNCOMPLETEDBUILDINGPERMIT
This agreement and a new Permit Application are required
to transfer an uncompleted building permit.
J 4m F S '1Ac L e r o f Phone 2/ C-3 6 00/-6
Address /0/ S- 47-4 NT C /3.2- ti
Email 5E97- EK/4on ESQ MAiL . c.oM
State Certification/Registration # Cec. 12 c'9-731 understand that Building
Permit COMM 2. 3 ()DC's- was started by another contractor and is currently
uncompleted.
I agree to, after reviewing the approved plans and the unfinished as-built construction, to
submitting a Revision Form and revised construction drawings to the Building Department to
correct any deviation between the approved plans and as-built construction, where found.
I understand that, based on the current inspection record, I am responsible for the Code
compliance of the finished project.
Details (Optional)
9 alh/A .".."?. ...„,_
State of Florida
County of Duval
The foregoing instrument was acknowledged before me this S day of ,-- dinL... - 020 2—y
by la Q 5 ,ej, hL e,C roj who personally appeared before me
and acknowledged that he/she/they signed the instrument voluntarily for the purpose expressed in it.
ei3h b
Signature of Notary Public
I Personally Known OR ERJOLA DURMISHI
Produced Identification
pY.
Commission#HH 270865
FLTypeofIdentification: L L ex? Z N.'.; Expires June 4,2026