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1946 Beachside Ct DWAY24-0006 Application 0 ►p,. BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY ' City' of AtlanticBeach BuildingDepartment ;� � Dp PERMIT# �, w P\\•(2H-000 .) ' ` ,,liT 800 Seminole Road, Atlantic Beach, FL 32233 ry '"'ALL information required to process '' '' ''''- Phone: (904) 247-5826 Email: Building-Depj;@coab.us Job Address 1946 Beachside Court,Atlantic Beach, Fl. 32233 RE# 169542-0592 Legal Description 42-14 09-2S-29E BEACHSIDE LOT 26 BLK 1 Valuation of Work(Replacement Cost) $17500 Heated/Cooled SF N/A Non-Heated/Cooled SF N/A - Class of Work: E New E Addition EAlteration ERepair EMove ['Demo ❑Pool ❑Window/Door - Use of existing/proposed structure(s): ECommercial ❑X Residential - If an existing structure, is a fire sprinkler system installed?: Lilies ©No - Will tree(s)be removed in association with proposed project? ❑Yes(Must submit separate Tree Removal Permit) ❑X No Describe In detail the type of work to be performed: Remove and replace pavers and coping per attached site plan Florida Product Approval# N/A i (For multiple products use Product Approval Information Sheet) Property Owner Information Name Ted Alesch Phone 904-613-6517 Address 1946 Beachside Court City Atlantic Beach State Fl Zip 32233 Email ted@alesch.com Owner or Agent(If Agent, Power,of Attorney or Agency Letter Required) Contractor Information Name of Company Alesch Contracting, Inc. Phone 904-613-6517 Address 1946 Beachside Ct City Atlantic Beach State FL Zip 32233 Qualifying Agent Ted Alesch State Certification/Registration# GC1516326 Email ted@alesch.com Job Site Contact Number 904-613-6517 Worker's Compensation Insurer Insuramerica I WCV0334496 OR Exempt E Expiration Date 06/152024 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 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 YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN F" iiL NCING, •NSULT WITH YOUR LENDER OR AN ATTORNEY B / riot�t I G OUR NOTICE OF COMMENCEMENT. / 1 (Signature of Owner or Agent) A C' J (Signature of Contractor) Signed and sworn to(or affirmed)before me this 3' day of Signed and sworn to(or affirmed)before me( this .� day of 4/bRid ) , .—__by -1& l� �C��'l"l�''f� , 26.7.4l by lt.J) \ect:ti/ds Signature of Notary CUIAAA A 9 Signature of Notary 111\1 (I J Personally Known OR [ J Produced Identification Personally Known OR [ I Produced Identification Type of Identification: Type of Identification.= ,r,..., Amy Divido vl.,.1 Ap, f. - ' - .londa .1.4 My Commasion GG 973026 f mA10 Expires 03/24/2024 .4:'• E e 2e ♦ 4