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SEMINOLE RD 2042 CITY OF ATLANTIC BEACH BUILDING AND PLANNING 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE:(904)247-5800 FAX: (904)247-5845 http://ci.atiantic-beach.fl.us September 9,F 2003 To: Jacksonville Electric Authority Property Appraisers Office Bellsouth Communications Atlantic Beach Water Department United States Postal Service Pat Welte, 911 Emergency Coordinator Atlantic Beach Police Department Atlantic Beach City Clerk Office PLEASE BE ADVISED THAT THE FOLLOWING ADDRESSES HAVE BEEN CHANGED: OLD ADDRESS NEWADDRESS 2030 Beach Avenue No longer exists 2032 Seminole Road 80 Beach Cottage Lane 2034 Seminole Road 70 Beach Cottage Lane 2036 Seminole Road 60 Beach Cottage Lane 2038 Seminole Road SO Beach Cottage Lane 2040 Seminole Road 81 Beach Cottage Lane 2042 Seminole Road 71 Beach Cottage Lane 2044 Seminole Road 61 Beach Cottage Lane PLEASE ADJUST YOUR RECORDS ACCORDINGLY. ,Sil,ncerely, Don C. Ford, C.B.0. Building Official CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE: (904)247-5800 FAX: (904)247-5805 SUNCOM: 852-5800 ��J)VLA http://ci.atiantic-beach.fl.us PLAN REVIEW COMMENTS Permit Application #—J'3 "5 Applicant:_QCF-��J GLuQ- nEV Address:_ Project: LJCW MUL-1 ) E-01-n I L-Q Dui er-V�our application is approved o Your permit application has been reviewed and the following items need attention. Please re-submit your application when these items have been completed. Reviewed by Signed Date 3 Contractor Notified Date DEPARTMENT OF PUBLIC WORKS 1200 SANDPIPER LANE ATLANTIC BEACH,FLORIDA 32233-4318 sw TELEPHONE: (904)247-5834 FAX: (904)247-5843 SUNCOM:852-5834 http://ci.atlantic-beach.fl.us PLAN REVIEW COMMENTS FROM THE PUBLIC UTILITIES DEPARTMENT r- Permit Application # "�Z5 Q O'l.) Applicant: ()C-!FJ-ntNJ BL-vb- Address: `E -- 5, -(Y-) 0 LA--� Project: Your application is approved as noted by the Public Utilities Department. Final application approval must come from the Building Department. Li Your permit application has been reviewed by the Public Utilities Department and the following items need attention: Please submit these requirements to the Public Utilities Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions please call (904) 247-5834. Reviewed by o a KI<.aluzniak, Public Utilities Director Date Z " 17 Yl Signature Contractor Notified Date ADDRESS: �j WATER IMPACT FEE WORKSHEET is .FOf1A)0Ge /?,0 - DRAINAGE FIXTURE UNIT FIXTURE TYPE VALUE AS LOAD FIXTURES UNITS Automate clothes washers,commercial 3 Automatic clothes washers,residential 2 Bathroom group consisting of water closet lavatory, Bidet and bathtub or shower 6 3 Bathtub(with or without overhead shower or whidpool attachments) 2 Bidet 2 Combination sink and tray 2 Dental lavatory 1 Dishwashing machine,domestic 2 Drinking fbuntainAcemaker Y2 Floor drains 2 Hose bib I Kitchen sink,domestic 2 Kitchen sink,domestic with food waste grinder andlor dishwasher 2 Laundry tray(1 or 2 compat'nents) 2 Lavatory 1 Shower compartment domestic 2 Sink 2 Urinal 4 Urinal, 1 gallon per flush or less 2 Wash sink(circular or multiple)each set of faucets 2 Water closet,flushometer tank,public or private 4 Water closet private installation 4 Water closet public installation 6 TO NUMBER OF UNITS= I MULTIPLIED X 20 JTOTAL$ &'Fo In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. I. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify tha all information provided with this application is correct. I into, tion Signature of owner: Date: I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that e plans and supportinR data have been or shall be provided as required. Signature of Contractor: I al__� Date: Address and contact information of person to receive all correspondence regarding this application (please print). Name: KLMpe� A MailingAddress: 60 o&,Cb1_N eL�L/io, 6oae_ 5Ln Telephone: .2,46 --1% 3 Fax: '2—Li E-Mail: AS TO OWNER: Sworn to and subscribed before me this io day of 20A5 State of Florida,County of Duval Notary's Signature: oP 0" Cynthia G Bunso My Commission DD130401 M-f;ersonally known Expires Juty 01 2005 Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of _, 20 05. State of Florida,County of Duval Notary's Signature: oy All, Cynthia G Bunso My Commission DD130401 ersonally known U Y__ of�j Expires JutY 01 2006 Produced identification Type of identification produced 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 - http://www.ci.atiantic-beach.fl.us Page 2 Revised 1/14/03 CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (FOR NEW SINGLE FAMILY RESIDENCE AND ' DUPLEX CONSTRUCTION) Date: Job Address: Owner of Property: C_AZL_A�s ISA Address: 6 D 0iff4*3 '?>LJJP- .5ul Te I IST&blln kL. 6bh Telephone: ;W4 1513 Legal Description: Block Number: UJ Q3 Lot Number: 67A 4--14 A -Zoning District: Contractor: QL157t)0 &,Qo State License Number: e'-6r— 0206-L3 Contractor's Address: �>Q 06,9-c-� -81-yO 5LJ I,qr- 136.c4JO� Telephone: 1�6 -'ISJ3 Fax: q111,6_(� - 7T�" Describe proposed use and work to be done: 60 Present use of land or building(s): (7,la V �)V L Valuation of proposed construction: 'KISO oCo k7q- tj,3 i-T, I Is approval of Homeowner's Association or other private entity required? NO If yes, please submit with this application. Will this project involve changes in elevation,site grade or any use of rill material or the removal of any trees? [�,NO. Applicant certifies that no change in site grade or fill material will be used on this project. YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. El NO. Applicant certifies that no trees will be removed for this project. YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,Fl, 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us Page I Revised 1/14/03 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE:(904)247-5800 FAX:(904)247-5805 SUNCOM:852-5800 http://ci.atlantic-beach.fl.us PLAN REVIEW COMMENTS Permit Application # J"?5 --25 1106 Applicant: Address: Project: 17�cq-�J 1 uvc r I I U I A4 Jit-i -Tvf2L c3 Your application is approved o Your permit application has been reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed by Signed Date Contractor Notified Date