Permit 161 16th St CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000171 Date 2/19/10
Property Address . . . . . . 161 16TH ST
Application type description RESIDENTIAL ADDITION/ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 40000
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Application desc
remodel bath
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Owner Contractor
------------------------ ------------------------
AYERS CORNELIUS CONSTRUCTION CO.
161 16TH STREET 71 19TH STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 249-9706
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
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Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 250 . 00 Plan Check Fee 125 . 00
Issue Date . . . . Valuation . . . . 40000
Expiration Date . . 8/18/10
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Special Notes and Comments
NEED RECORDED NOC PRIOR TO FIRST
INSPECTION
*2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2007 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 250 . 00 250 . 00 . 00 . 00
Plan Check Total 125 . 00 125 . 00 . 00 . 00
Grand Total 375 . 00 375 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
fI
City of Atlantic Beach
Building Deparftnent APPLICATION NUMBER
800 Seminole Road (TO be assigned by the Building DepartmerrL)
Atlantic Beach,Florida 32233-544,5
Phone(904)247-5826 - Fax(904)247-5W
r0j pi It E-mail. buJ1dlng-dePt@coab.us
City web-site: http:tAvww.coab.us Date roxufttgd. 7
APPLICATION REVIEW AND TRACKING FORM
Property Address: /z" Depa-560111
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Planning&Zoning
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Public Utilities
Public Safety
Fire 3IS
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Other Agency Review Or Permit Required Review R***W
Florkla DepL of Errif Of Permit
Flonda Dept of Translmrtetjon
SL Johns RWw Water Management District
Army Corps of Engineers
E*Mon of Hotels and Restaurants
Division of Alcolxft Bemages-- fob-a=
Other
tReviewing:Depa APPLICATION
in EpCpproved-
,:�:7!ltment 17
(Circle one.) C=0Mf=mnts:
PLANNING&ZONING
Reviewed by. �ate.
TREE ADMIN.
Second Review [--]Approved as revised. F-IDven
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third ROVIOW.- EIAPProved as revised. F]Denied.
Comments:
Reviewed by: Date:
Reviwd 05f14109
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 10- ill TF-F-1
OFFICE:(9D4)247-5826 0 FAX NO.:(904)247-5845
VWM.COAB.US
BUILDING PERMIT APPLICATION DUVAL COUNTY
74IZ4PP_�,DIDRESSIN 715d 77 1A-PQ;,F
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*�*:IUEGAL �W%ASS�Ok 14U
LOT-BLOCK SUB DIVISION(f)fj�" 6ROVP_ N IT El NEW BUILDING 13 DEMOLITION 91<ESIDENTIAL
""7 kftl ' 13 ADDITION 13 CONVERTING USE 11 COMMERCIAL
CRIFTIOW MRKW�'W 'k
'0152 LTERATION 0 ACCESSORY BLDG. 81,FIRE
REPAIR OPOOL/SPA 1:3 YES Q-11A
0 MOVE 0 OTHER 13 No
WTOS,.Ml�r FROFERTYOVVNERL*10�09 WMW-w PONTRACTOR�W*,*' "'11 W'-!_VMS'*_,WAf Mil-TECT-7 ENGIN E ER'
9.NAME: 15.COMPANY NAME: 23.COMPANY NAME:
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6P-STRVcTI0i1J
16.NAME 24.LICENSEE NAME:
ft)Ak6PP-E_T GPjJF_"ll
10.ADDRESS: 17.STATE OF I-LORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
C-5--lP 4ff9t,'1
18.ADDRESS: 26.ADDRESS:
An' 13co VL l 130)C .35-:n�q'a
ANJil FL, 5 7-
11.QW4CE PHONE: 12.FAX NO.: 19.OFFIC 0 27.OFFICE PHONE:
2Afpf- 2.-Zjo 2A4q
13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE:
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14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS:
Am
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31.NAME: 33.NAME: 35.NAME:
32.ADDRESS: 34.ADDYE-S&S 36.AODRESS:
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 laws regulating Construction in this
jurisdiction. This permit becomes null and void if work is not commenced within six(6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
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.I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
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.
'qEN 'ig NT i�T
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:::Digned:r'4LJ A.1 Date- b Signed: Date: IQ
Before a this of 2010 in the county of Before me this_4Lo dayof 2010 in the county of
Duval,State of FI ride,Tersonally appeared Duval,State of Florida,has personally appeared f -
�4 'R� &C&KQ -1 AW-5 __ �Z_k1,4aC,,Q42,Fr (�04PA)FL/u-c.
herin by himself/Vself an6 affirms that all statements and declarations le herin by himself/herself and affirms that all statements and declarations are
true and accurate. true and accurate.
Notary Public at Large,State of County of No!pry Public at Large,State of County of
loop
D Personally Known Personally Known
1P Produced Iderl ion-PtDL h-64 7V-S El Produced Identification-
Notary Signal 4 00 1 Notary Signat C=
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M C S AKS GORMAN
Bldg Permit Application 2010 CB MY com SION#DD643668
EXPIRES:May 2SHE PE rrS FOR ADDM EXPIRES nuary 25,21011
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REVIEWED FOR CODE COMPLIANCE
CITY OF ATLANTIC BEACH
SEE PERMITS FOR ADDITIONAL
REQUIREMENTS AND CONDITIONS. rh ic�
REVIEWED BY: DATE: �2