Permit 1917 W Sevilla Blvd CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000592 Date 6/02/10
Property Address . . . . . . 1917 W SEVILLA BLVD
Application type description RESIDENTIAL ADDITION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2300
----------------------------------------------------------------------------
Application desc
EXTEND DECKING IN REAR
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
CUMMING INCORE BUILDING CORP
1917 SEVILLA BLVD.W. 12567 SWEETWATER LANE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32218
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50
Issue Date . . . . valuation . . . . 2300
Expiration Date . . 11/29/10
----------------------------------------------------------------------------
Special Notes and Comments
HEIGHT OF DECK NOT SHOWN; IF 30" OR MORE ABOVE GRADE, MUST
BE SET BACK 51 FROM REAR AND SIDE LOT LINES .
*2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2007 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
HEIGHT OF DECK NOT SHOWN; IF 3011 OR MORE ABOVE GRADE, MUST
BE SET BACK 51 FROM REAR & SIDE LOT LINES .
Roll off container company must be on City approved list
and container cannot be placed on City right-of-way.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 65 . 00 65 . 00 . 00 . 00
Plan Check Total 32 . 50 32 . 50 . 00 . 00
Grand Total 97 . 50 97 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERma APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 917 �St\) I U-A 13(V,0 UJ JE Sj- —Permit Number: 10 9c�,
Legal Description LOT 10 �Evlccp� Parcel 9 C 6T 10
P loor Area ot Sq S q.Ft-
Valuation of Work$_()_1,'�)00 —Proposed Work be, non-heated/cooled '/60 S?
Class of Work(circle one): New ddition Alteration Repair Move Demolition poolispa window/door
Use of existing/pro osed structureQ) (ceirne).: Comm ial Rieisiden%ti
If an existing strueflure,is a fire sprinkler system installed? (Circle one). 0 Qj/jA
Florida Product Approval# \[Ez03W UsQi60 P-,T-
For multiple products use product approval form
Describe in detail the type of work to be p rflormed:
17��E�- OPP W k�j
Property Owner Information:
Name: &. )PC�- CQMVxt�-r, 3R, Address: \9)_� 56(0009 t>L_U0, W-ES7-
City—A-MPt-1v--kC 3&PIcH StatefL-Zip Phone 603 -!5 F5/5-
E-Mail or Fax 4(Optional
Contractor Information:
Company Name: 0� C-S�P-C- CSW-('Qualifying Agent: ��t c�kegn 4AF-+�4t)T,�o rj
Address: N qf city sky-- 1W
� Lutonoc L -State FC - Zip 32-2te
OfficePhone Job Site/Contact Number S"�,,E Fax# '76 -25 Ce 13-0
State Certification/Registration# Q_'18 C 1 2-6 Is 2�57
Architect Name&Phone# ryt
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address Jptc_�z C L I-)c-ts
Bonding Company Name and Address
Mortgage Lender Name and Address
4 '� h d r d th work and n a �ns a nd�,c or installation has commencedprior to the
icat'o is e yma e tain a ermit t 0 e i sta' ' s i ,
d to m7,t an ar a' w thisjurisdiction. Ais permit becomes null
f k s aWeriod of sixj6)months at any time after
re to 0' 0 p e or e st 0
d h k w m
ix P6 m ths, or cton r 0,
p
ssuance o a er, an 'a'w w i s e
d n
c.
r, f
t i _its_ t OZ or Ejc c ul
C ) on
and"''d fok s not commence I
W" is co" c "st t t S,
T k en ed nd and a P a e pe be e d ells,Pools, urnaces,Boileis,Heaters,
Ir Con fifton rs, te
ank a dA e e _
WARNING TO OWNER: YOUR FAILURE TO RECO A NOTICE-OF
TW11"' ORWAM
COMMENCEMENT MAY RESULT IN YOUR PAYING I �� .1 S
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN F CLN H
YOUR LENDER OR AN ATTORNEY BEFORE RECORD
COMMENCEAffNT. t
Ihere cer!ify that I have read and examined this application and know the same to be true andcorrect. Allpr "f*rwg a?td,or&nmwr& ng this
1�work will be co�nplied with whether s ci ed herein or not. The granting o ot res e to nce,the
,fL JT f a permit does not pres give authority to violate or c
provisions ofany otherfederal,state, or loca regulating construction or the peFfib�mance ofconstruction.
Signature of Owner Signature of Contractor
t-j
Print Name Print Name
............. .......... .............................................................
Swon-1 tq and subscribed before i3ac Swom e
tliis/,09�D��Of -71� O-A-, ti"is 16
Ejj=])VMMCE
A
.4"LLI a X%_:�"jEtV%,jrj
ubj* '01 0. Public __
SEE PERMUS FOR ADDMONAL
&"�#0 0 Notary Public State of Florida REQUlREMENTWqdQ0NMnWS.
Linda Carol Adlin
F, My Commission DD888156
OF"d; Expires 07/11/2013 REWEWED BY.
DATE:
MAY-07-2010 06:49 Frorri:Tl:l'::;I
Boundary
Survey
14 WI I
SET I.P.ICAP 1,12- 3 t I I�q A:AF I
I AMIM 1,PAITF OP PI AT L8416 135
Ik— N 89'Wl U"V� 11 I.W
I LIT in
n�
E C K
4 BUILDING
411911 U-)T 9
�1, z
2 1'
5ET I.R.ICAP 11"
LLWU�
SE7 I R.�.
I R9F 1.;q
q:P
7LVILLA[30ULCVARD WEs*r
50.0'RADIUS
5001
rQUND r.K
NAll A I)rK
rRC —0
I' - 36 HItLL)VAAh 0,.v,.ipj
OR A C 141T.VVIIIAlknill.PIVARDWPAT LIRAI I LN 5.).L�
PH SCALE ATLANTIC BIACH,FLORIDA 33233 APPROVU,C.0 ii,
f\EFURNISHE-0j
I Al';I Vil I lAkrh 11',H411 1141 In Of IM M,Ml 11,rlV�QW IA 1131 eCU It 1'3QC L*,C PLOIC WaVdl W
N.M.
nA'31.1 n$7 ni"ARINC;!; I��MMN'Ilk"n Hfewapp aa,4,A,wn TresmM lire Of LLX 10,IMling J WIng Of Iq 89-56"ll 11
Ut I ji�: jS-S ISLC C�4,,7PljAlI-,K4r.MT% %F jm,�t4 edr
r'onvryon 11,paliNv 11014
TARGET
IJRVEYINC,-PVC
QeeMyN me!
First A me-rican Whison ReWr/Corp MLTOPS"
Titic In surfincIr Cuizipany
%W H Vlz Y QK�i k.K I I 1(;A F
ntin aijiirffin L11%
ll.�CALVJ'_�%Ll W C.0�l It
1.0 U�:"�1411 T Ul BLIPIIIIPIJL
rk-i,rin
'�"1".11 1.r:11 p-13.� rnr ;0 _j
In, liml�,I� r,r.,C: ,1.11:", f,
j,Fjr
rry ;4AA�jmTrrrrnrNcr ��l
IrTlt:l
rq5Ms
'T,I.,
..........
!;I HVI Yt H
C"k.0 kl�Nkml 03 11��l
........ NCT VLlL,'WlP;UL)l ANAUDIENTICAIEDELECIRONIG SIGNATURE
T-4 1lk�I- Rt9ED3ffNn&_L 'Y' I L 0 m;.L I.'
AND AVTHENTIGATED ELECTRONIC EEAL
AI nATr r4l Vl:;II)fj MATr "t�ijrl(m
rt,?�,,Awnel A.Actiinr)linrl hy, I'Irlt�
CO
LL-
220 vnlf pnwer under deCk
0
q
x
w
CT)
a) B
LLJ 0 LL U- V)
ISGi:wo`-� Gt,-:90 CIT02-,LO-.(.UW
06:49 Ft-orn:TDSI
ARCHITECTURAL REVIEW COMMITTEE APPLICATION
Hoineomqt:r Name: G. Jack Cumillilig jr
._.. .- 1. ... --------------------
Vruperty Street Address: 1917 Scvilla Blvd Wc�a
904-759-2743
Ditiyume 'I cjcpjjojjk:: 9 04-6.1.0)-.5 8 11
Lmail .Addrcss:
extenor change or 11"POW111clit: (Plezue, include: mati�rim:;, �vijl
I'lerlb"T" Wol'k, and all other relevant informatioll nl'ml[1104� 11ml";' flylylItik-ttilvd, im:111dc a Copy ot'survey. for
color" .111il mmgriak, please mclioe snmpI4�s)
1%P-.,md d\isflng wmd deck by appi-cix i n-Intely 500 $qjjjj,e f
SUpponedwith concrete '"itructurevvill bc kjC%,ClCIp M. Plans ary uttachcd. Footers wi I I he
011 hemldcd arn futurc dzitc. (.tml In s�jkij �j w;i.v (hat approved/permitted screening
Work vill bi� Performed by Incore, a locai Jacksonville buildery'contrutor. All work will tic, pruperly
PL:II11ItWd 1111-01,161h the City ol'AdiinliL 11CA01.
Lslimmicd Siam DaLu 3/1 0j,10
('01"Pit-6011 OPV�' 5124,110
ofplupcl(�' Owm:i6 Affec(cd (adjacciritiand/or those witil view ot 111.0posed Wol'k.)
Note to Priyarty Owners Affri-tvd-yksiir SIEWOLUC OL)C5 not Ccm5fitule appio�,al m jiN4pj)gvvuj,jqjI jjjqrj:jy 1rIdILU(C.S an aA,arcncss m zi)c
appll";1111'� nilvill If V fuit'c'Jll� etmicums-mth the appimmitill pic,140 11(111f�'Fh�AtU.' jold 1%1:�kird inimcd-Imely.
Dm& LLO
1)'Jie 41ifPQ 1.10
Nam,; Dite.
..........
HM AR(.'/B0ARD USE ONLY; Approved Disuipprowd Datc:
NIChTi0in; L11 Approval:
I" T' City of Atlantic Beach APPLICATION NUMBER
-11 it Building Department (To be assigned by the Building Department.)
800 Seminole Road
le -'4-1,1 Z'
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
0� VC_J 14J
Property Address: . �_D�rtm� review required Yeq.,,'�No
Applicant: Z_'o ye5. Plann-iM&Zoning::-->
-Tjj�t�ministrator
Project: Public orks:>
Public fety
Fire Services
Review flee Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
Florida Dept. of Environmental Protection of Permit Verified By
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: 9?rApproved. ElDenied.
(Circle one.) Comments:
BUILDING
PLAN ZONING Reviewed by: /W C11 Date: 5ZI I C)
09
TREE ADMIN. Second Review: []Approved as revised. FIDenied/
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road za
-5445
Atlantic Beach, Florida 32233
Phone(904)247-5826 . Fax(904)247-5845
E-mail: building-dept@coab.us LDate route
=�uted.
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
0
Zoria'a, 7z/vd Ail e artm review requiie—d– Yes No
Property Address:
annin &
Applicant: re ministrator
Project: Public Works:::>
ubli 11
u ic afety
Fire Services
0 e t
' Sionature,
p
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St. Johns River Water Management El-strict
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: D��Pproved. E]Denied.
(Circle one.) Comments: dtv� akxvc,
It be, 5
BUILDING tUo re,*4aA- _10 ;OVC
PLANNING &ZONING I reAV 0 5(0(,C, 10 hms Date:
'Reviewed by:
Second Review: ElApproved as revised. []Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05114/09
APPLICATION NUMBER
City of Atlantic Beach P P LCAT'�N
y partment.)
b as ned by the Building De
"I TV 0 sig
'ou
Building Department (To be assig
EIVED
800 Seminole Road
-5445
. .... . Atlantic Beach, Florida 32233 Y 11 2010
2 F7-58!MAy t
Phone (904)247-5826 - Fax(904)
Date route!did
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: review required Yes No
Applicant: 1_25 Loves annin &Zoning I>
re ministrator
Project: Publi orks
ubli 11
u 1c Safety
Fire Services
............. -77ji
P-1 ".-JO
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. []Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:_(� Date:
TREE ADMIN. Second Review: F�Approved as revised. ElDenied.
P 0 KS Comments:
IC I IT
Ty
PUB*CS ETY Reviewed by: Date:—
FIRE SERVICES Third Review: 7Approved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 05/14109
APPLICATION NUMBER
City of Atlantic Beach (To be assigned by the Building Department.)
Building Department MAY 1 1 2010 -7
800 Seminole Road i
-5445 vp
Atlantic Beach, Florida 32233 V
Phone(904)247-5826 - Fax(904)2-
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
/�/I z", --Z/VJ tj re-p-a-rt-m-i" review required Yes No
Property Address:
Applicant: yel annin &Zonin
re ministrator
Project: 5XY7_E�_—4 ,L) P Ii orks
ubli 11
u ic afety
Fire Services
............
k6�iew'",.,f-e_-'6"$'_'_';'__ t 8-idnatuee
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept.of Transportation —
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: F-]Approved. KDenied.
(Circle one.) Comments: 0
BUILDING ae�Ao ��D4"
PLANNING &ZONING Reviewed by:']/ '41�' Date:
TREE ADMIN. Second Review: r'�7'Approved as revised. F ]Denied.
;-N
QEEE�) Comments:
PUBLIC UTILITIES Reviewed by:A_.�_ Date:5 L8
PUBLIC SAFETY I;= —
FIRE SERVICES Third Review: FlApproved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09