Loading...
1038 OCEAN BLVD RES24-0035 Permit sf: 1r•, BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY City of Atlantic Beach Building Department PERMIT# FC,3 24-0035 800 Seminole Road, Atlantic Beach, FL 32233 **ALL information required to process `13 91' Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address /033 ©C.-CA/4 B1-1/p.. # c_ • �3c44 . IF'L- 3?*233 RE# 60 Act - Joao Legal Description G-• t4'&S_ �9rt. A1( 4 AT/ - 13sIc_44 I Ai IR L6rr $LIC Zet Valuation of Work(Replacement Cost) $J O OO int, Heated/Cooled SF d Non-Heated/Cooled SF •Class of Work: New EI Addition ❑Alteration CI Repair CI Move ['Demo ❑Pool El Window/Door •Use of existing/proposed structure(s): ❑Commercial 14 Residential •If existing structure, is a fire sprinkler system installed?:❑Yes❑No •Will tree(s)be removed in association with proposed project? ❑Yes (Must submit separate Tree Removal Permit) ❑ No Describe in detail the type of work to be performed: R M o v L © LD 2� FL g 44-c-P n) A-"J 4 Rik '44ca l—[K IE ‘ro R-Li K E Florida Product Approval# ^^ (For multiple products use Product Approval Information Sheet) Property Owner Information Name Tido�1 Ak S A Neru R Phone t7 L1•70 7• /573 Address /O 3 2> at\I b� City Alt, 15c--4{ StateT.L- Zip 3-LZ3 3 Email Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) ri// - Contractor Information Name of Company '- C SO/"L )/4c Phone qb'1.(q 3. 2131S Address 76 OC. 1 A s �, City L i V�-1� , State 'Ft- Zip 3 Z"'Z-3 3 Qualifying Agent ' R6"°500 State Certification/Registration# C-BG 0.21( ( 3 Email CiT ea—F-9REr 04 123 Q.. 1-1.c.-4,11 Job Site Contact Number /z4 Worker's Compensation Insurer KE.t 91r OR Exempt El Expiration Date 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 city/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. 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. �' ; — .c 3- ,kJ (Signature of Owner or Agent) .,p, ( gnature of Contractor) Signed and sworn to(or affirmed)before me this �` u9 day of Signed and sworn to(or affirmed)before me this 1 5 day of u-&1/4f )-y by D nne- i4rt.t.t_r razip ,2 D Z` 'by Signature of Notar /, Signature of Notary k. APAA-r-AV.A.1. 5412-e„,t)-11-4:74‘ [ ] Personally Known OR 40 duced Identificatio [Personally Known OR [ ] Produced Identification Type of Identification: ✓('ice r5 i C.e-i-vs,2 Type of Iden ' ica*T. ., MICHELE E.JOHNSON MY COMMISSION N HH 403056 •r'i . ```` EXPIRES:July 28,2027 i� �•"'• MARIE ELAINE HAMLER -,�'•'-"' %EOF F��.: • '1 Notary Public-State of Florida .'� �' Commission p HH 421634 ,oF� My Comm.Expires Sep 16,2027 / 0 38 r»,vn.i 6.-17.4-Ar r t ‘-- --ri-kohpaz ARe__Licz t — C*Kv.--e. ,- i ov- . Cfk-TL),549fri 1111\ 1=. ---. C .. /AJ cL ( 1,7P-c rat:11 .3 A L3 ? S )4 e".) 4 14-1)Cft-t- 07 — —r I 44 k3e),(S' -g.;>< .? "' / 0 --. ae x ok FA ,)rti ;:04-41v- 1 * 1 08 ) 1 IP 1 i ia ti 1:)1'16 5 47, i)°Cr liNi I 12 I, 014 ' 11.11 / 9..,14-1- I )„.\9--\•\ rm•coc? 1 k------ g / H ...)< b X e 17*--c-K i 4 ' arl ! litr ) / 7 -IL ,V,Xtel< 16 kj() (C'Te 4 v)(ArroD4. Q>eit()1x t A-. - • '# 3 e.`fl's7( i 0 kixti I, yo ST" gC °'S A f)Pciii'VZ If , 1 44 XL/ -- A.f)t.- --- 1 , Sc.A Lt.. /.9. 'LI i 'C r --0401145 o'F f'rr—cSa0 5 0 id Z. 0IL ) //./c cl II • G q , _j 3 1 voar D o hoc4( s 7-4 - oR a. [. (� x It 4 $4s - '� rii x OcA` \i. 4141 1--' o?("> 1 '4 Grftba- g-col0 Ferguson Builders, Inc. Bttikling Contractor-Remodeling&Restoration D I�R� CBCO21113 ifk{ MICHELE E.JOHNSON Greg Ferguson MY COMMISSION#HH 403056 `'f EXPIRES:July 28,2027 904-993-1315 grcgtcrguson I23(o.innail.com 331295 MAP SHOWING BOUNDARY SURVEY OF Tf/E A/oRTH yZ OF Lor BLOCK ,?9 AS SHOWN ON HAP OF 2, ro;Erx/ER wllriv 41-4. OF DT 3 14TL G.c/T/<' fE4CA? AS RECORDED IN PLAT BOOK ( PAGES / OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA CERTIFIED FOR.• TA/a/4-14W / /4 / A/e r'LIR/ • A-/A'S-7- VA//41.0%/ rs/47",/,47/40#4./.0/ 4iJ • V/ /a. / T/TLE b✓c •; %t/L9(/J7 Q/4/ 1/4 LGE>' T/TGe. CO . IP A/O,P7-,z/ o F. E.C. /e • (so'.e/w) 4 3 fo., x -7S DO ' x / .3' ,� X x N NI O• O v J �� o 0 3 5.b, 7d Sri)RY - to R.7. tl• poop • 4.9' GX� —x ` • E4'woo0 [Et • k21; WOOD si n. X woo DECK ,tet M 1 O \ 36•o • N / PA Z $ ¢ 1 ---x �t , .. '.00as ; _ _ _ 'two STORY 3.6' 3 4'G4-14/../ M GR4ME �t/o•/O3$ a.�/[ N 5121 G'D " cS Q 0 , N. C O ✓ • I37' u.0 y /Z•o ' /3 3 ' /\ ='- v_ - _./ O M 0 M ____- 7S o0'To ep...,---;S"49° So 00 Co2A/E,Q 75.. 00 / , ' oc-4/v BoUzEYMO (So',p/tJ) NOT VALID UNLESS EMBOSSED WITH SEAL OF THE UNDERSIGNED. A� /A'TE'g/O,Q ,i,v' E5 4,QE 90°Do'oo" THE PROPERTY SHOWN HEREON APPEARS TO LIE WITHIN FLOOD HAZARD ZONE X AS SCALED FROM FLOOD INSURANCE RATE MAP 000/FOR A7 ai'/T/C 5E,4 LW, . LORIDA, DATED 4 -17-R 9 TRI—STATE LAND SURVEYORS, INC. 8411 BA YMEADOWS WAY SUITE #2, JACKSONVILLE, FLORIDA 32256 (904) 731-7235 LEGEND 1 HEREBY CERTIFY THAT THE ABOVE LANDS WERE SURVEYED UNDER MY a CONC MON RESPONSIBLE SUPERVISION AND DIRECTION, THAT THERE ARE NO • 1RON COR. ENCROACHMENTS EXCEPT AS SHOWN AND THAT THE SURVEY SHOWN (SET AfTN CAP /LS 4;44) HEREON MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH BY -x-FENCE THE FLORIDA BOARD OF LAND SURVEYORS PURSUANT TO SECTION , O IRON COR.(FOUND) 472.027, FLORIDA STATUTES. ® GROSS CUT B.R.L BUILDING RESTRICTION ONE E9u7 EASEMENT LARRY G. EDDY, P.L.S. ND. 4144 R/YI RIGHT AY COY. CO,fRD AREA SCALE ///' 2 O ' .�k iej/ € CENTERLINE A/c AIR CONDITIONING PAD R- ISTE' D,/RVEYOR, A F OF FLORIDA (R) RAO/AL DISTANCE DATE: '"ZS-92- CCNCR£7E IIIII illi.- ''A ^-- -' nnnco AI, Q 9_7 2 7-2