1502 Beach Ave RES20-0132 Repair ColumnsOWNER:ADDRESS:CITY:STATE:ZIP:
BREMER ROSS L 1502 BEACH AVE ATLANTIC BEACH FL 32233-5736
COMPANY:ADDRESS:CITY:STATE:ZIP:
SUNSHINE COAST
CONSTRUCTION 513 VIKINGS LN ATLANTIC BEACH FL 32233
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171871 0000 MANDALAY
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1502 BEACH AVE RESIDENTIAL ALTERATION
RESIDENTIAL repair columns $2300.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $65.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $101.50
LIST OF CONDITIONS
Roll off container company must be on City approved list . 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: 8/4/2020
PERMIT NUMBER
RES20-0132
ISSUED: 8/4/2020
EXPIRES: 1/31/2021
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 8/4/2020
PERMIT NUMBER
RES20-0132
ISSUED: 8/4/2020
EXPIRES: 1/31/2021
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $101.50
RES20-0132 Address: 1502 BEACH AVE APN: 171871 0000 $101.50
BUILDING $65.00
BUILDING PERMIT 455-0000-322-1000 0 $65.00
BUILDING PLAN REVIEW $32.50
BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R12616 $101.50
Printed: Tuesday, August 04, 2020 3:22 PM
Date Paid: Tuesday, August 04, 2020
Paid By: SUNSHINE COAST CONSTRUCTION
Pay Method: CREDIT CARD 350586863
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R12616
E' Building Permit Application
$ffi - , City of Atlantic Beach Building Departmentt 8OO Seminole Road, Atlantic Beach, FL32233
Ph o ne : ( 9 04) 247 - 5826 E m a i l : Lr U L t il,t,.l i:, ::Ll.ipL (,r, i, i :: Q_l*,,,j :r
Job Address: if ,;Z 1j€k a Avf,,tt,!Permit Number:
Updoted 10/9/18
**A[L INFORMATION
HIGHTIGHTED IN GRAY
IS REQUIRED.
ttL l! t6-br'|"tf qAU1ALAY t"r! erL Atk6i RE# l7ig7i-cor'o
Valuation of Work (Replacement Cost)s 2,3*Heated/Coole asr r / A Non- Heated/ cooled 'u/4
for multiple products use product approval form
Bf a, n Avt-,u t//
3 iz);p|'1sns ?c?,6f ;. ti33Y
o Classof Work: trNew trAddition DAlteration depair EMove EDemo trPool trWindow/Door'./. Use of existing/proposed structure(s): ECommercial B(esidential
r lf an existing structure, is a fire sprinkler system installed?: EYes n{o
Florida Product Approval #Ll 0D
Propertv Owner lnformationffitte Address I {o z
City A'rL4oi,c i5{rA, 1,State / L Zip
Describe in detail the type of work to be performed:
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Owner or Agent (lf Agent, Power of Attorney or Agency Letter Required)
Contractor lnformation
Name of Company lV ^.tt lt,.vI
Add l5 Yil<sulz\ LtTyf
lv.v
i-oAt r a c'v5l 4't' I tG" ''Qualifying Agent 1o;t /llftL /.u,t 4L'rk
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Office Phone
State 6c Job Site Contact ;r*; -7rr ' Cc
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zip 3/ZJj
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Architect Name & Phone #
Engineer's Name & Phone 4 H
Workers Compen sation lnsurer co I {L .!i,OR Exempt n Expiration Date
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, PLUMBIN6, SIGNS,
WEL6, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR CONDITIONERS, etc. NOTICE: ln addition to the requirements of this
permit, there may be additional restrictions applicable to this propefi 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 YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
of Owner or Agent)of Contractor)
u
sig before me this ,'J, -) day of
) ;2's ,ay
n
/,t4ty ),
-1"'L
before me this!/i1 A
(Signature Notary)
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sworn to
;r<,2/.6",,rJ
Notary trn5116 State oi Fbrida
Rushi Panchal
l\,ly Cornmrssron GG 913163
Exprres 09/1 5/2023 ,.s4lioej+v i--.),/^.
",(Jg:.s'.oF Fly .
ALBERT,TORENO
Notary Public - State of Florida
Commission # GG 304g75
My Comm. Expires Jun 9, 2023
rh tary AssnTypeof ldentification: IL) ', i)'] 1".]illt,f ,<'l-trr,'x ,;.
[ ] Personally Known OR
Legal Description
a
of ldentification: