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Permit 161 16th StreetCITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number 10-00000738 Date 6/08/10 Property Address 161 16TH ST Application type description PLUMBING ONLY Property Zoning TO BE UPDATED Application valuation 0 ---------------------------------------------------------------------------- Application desc 1 fixture ---------------------------------------------------------------------------- Owner Contractor AYERS MIKE SANVILLE PLUMBING INC 161 16TH STREET PO BOX 802E ATLANTIC BEACH FL 32233 GLEN ST. MARY FL 32040 (904) 384-2811 ----------------------- Permit --------------------------------------- PLUMBING PERMIT -------------- Additional desc . Permit Fee 62.00 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 12/05/10 ----------------------- Fee summary ----------------- -------------- Charged ---------- - ------------------------- Paid Credited --------- ---------- -- -------------- Due -------- Permit Fee Total 62.00 62.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 62.00 62.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 l ~ ~ Ph (904) 247-5826 Fax (904) 247-5845 JOB ADDRESS: /~ ~~g ~~' ~,~` PERMIT # NEW OR REPLACEMENT INSTALLATION: TYPE of FIXTURE Bathtub Clothes Washer Dishwasher Drinking Fountain Floor Drau1 Floor Sink Hose Bibs Kitchen Sink Laundry Tray Lavatory Other Fixtures RE-PIPE: TYPE ofFixTURE Bathtub Clothes Washer Dishwasher Drinking Fountain Floor Drain Floor Sink Hose Bibs Kitchen Sink Laundry Tray Lavatory Other Fixtures MISCELLANEOUS: Project Value ~ QTY TYPE OF FIXTURE QTY Septic Tank & Pit Shower Shower Pan Slop Sink Three Comparhnent Sink Toilet Urinal Vacuum Breakers Water Connected Appliances Water Heater Water Treating System QTY TYPE OF FIXTURE QTY Septic Tank & Pit Shower Shower Pan Slop Sink Three Compartmeirt Sink Toilet Urinal Vacuum Breakers Water Connected Appliances Water Heater Water Treating System ^ Sewer Replacement ^ Back Flow Preventer ^ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ^ Lawn Sprinkler System-Number of Heads ^ Well ** SJRWD W, ell Completion Form. Completed form to be submitted to the Building Department for final inspection.** Other ___I ~~ ~r'~~~~ b~-P~, ,~r~ f~h~ (~ ~ ~ r'w~ ~-PN~~G~ Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violat e provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name~,~ S Phone Number Plumbing Comp`any /i/~'~e~ ~Urrf ~~- {~'`~~,~j„~~ Office Phone 3g~/"a~r/ Fax ~~'f~` ~5~~ Co. Address: 5(~a~ ~~{~dhJG ~~, ~,~ '~~ City ~Gt X State Zip ~~a~ License Holder (Print): ~//~'G/(G ~~ ;; ~ ~.. '~ :~= Mu (;~~IM'Sfi'~N ~~,~' nt~t ~ S oi-~1 and subscribed before ~: ~x~~a~e; ~~y a 2~ J <`~ handed ~hru hloteq' f ubiic unadrwdtar~ t ~`~` ignature of Notary Public _ ~~ Certification/Registration # Gc~C~ ~ ~ ~Y~ of 20 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number 10-00000712 Date 6/08/10 Property Address 161 16TH ST Application type description FENCE PERMIT Property Zoning TO BE UPDATED Application valuation 0 ---------------------------------------------------------------------------- Application desc NEW CONCRETE WALL ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ AYERS CORNELIUS CONSTRUCTION CO. 161 16TH STREET 71 19TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 249-9706 ---------------------------------------------------------------------------- Permit FENCE PERMIT Additional desc . Permit Fee 35.00 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 12/05/10 ---------------------------------------------------------------------------- Special Notes and Comments Parking must be off paved streets. 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 Plan Check Total Grand Total 35.00 35.00 .00 .00 .00 .00 .00 .00 35.00 35.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. f~TJILDING I'ERMI'I' APPLICATION CITY OF ATLANTIC $EACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 ob Address: ~(„ ~ I ~~ ~' ~? L/~IJT)< ~C.3-~ Permit Number: 1 d `~' a 7~d- ,egal Description Parcel # ~~ oor ea o q. t. q. t Taluation of Work ~ Q' orr_~,: Proposed Work heated/cooled ~~ non-heatedlcooled ti1Q :lass of Work (circle Dime): New Addition Alteration Repair Move Demolition pooUspa window/doorl~~~„ ~se of existing/proposed structure(s) (circle one): _ Commercial Residential as existing structure, is a fire sprinkler system lil•Ctalled? (Circle one): es o ~~ larida Product Appproval # or multiple praducts use product approves orm tescribe in detail the type of work to be performed: ~, 1r ~~`~ ~~eK roperty Owner Information: Ity /~'T i-A NT t C -Mail or Fax # State Zip 377 3'~ Phone Qu ~ - ontractor Information: ompany Name: nab E>_iU S ~ rJ 5 ~ U ~ ~ ib 9J Qualifying Agent: 1~EC~h~; ~c~u E ~.I ~ ~ ddress: p 0 $ e x 33oh1 ~ City /-4 . t3 _ State ~~ Zip ~, Z Z 33 ffice Phone 'Z ~ ~ • q "J o fa Job Site/ Contact Number 2 y c- . Q ~`/p ~ Fax # :ate Certification/Registration # ~ r3 C o A-1 ~ Z? ~f rchitect Name & Phone # igineer's Name & Phone # ,e Simple Title Holder Name and Address <~ D ~ ~ i cNA`z~Z~.y ER 5 ending Company Name and Address _artgage Lender Name and Address plication is hereby made to obtain a permit to do the work and installations as indicated I certi, fy that no work or installation has commenced prior to the ~uance of a permit and that all workwall be per formed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null d void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned fora ertod of six f6) months at any time after rrk is comnenced I understand that separate permits must be secured for Electrical Work, Flnmbing, Signs, ells, Pools, maces, Boilers, Seaters, :nks and Air Conditioners, eta WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMIV~NCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IlYI~ROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMIV~NCEMENT. ereby certify that I have read and examined this~plication and know tl2e same to be true oral correct. All provisions of laws arxd ordinances governing this ~e o work will be complied with whether speci ed herein or not. The granting of a permit does rzot presume to give authority to violate or cancel the visions of any otlaer fed al, state, or local law regulating corz<rtruction or the performance of construction. gnature of Owner `~ Signature of Contractor °( ~ ~ int Name ~ r .....~~-~-....._`.-:-._.......~~.._E.....~,,~ .......................................... PrmtName l~~~l~~~?1,~T....... ct~,tJ_E.1-!_r:?~....---................-.....-.....------......... aom t d sl~bscn ed be ore Ine Svaorn t and subscrib d before me -, _ - this ~ Div of. _ , ~- /`•' 20 lG` ~~ ~ ~'"~~ - :. eo r4-- _°+: :*_ IFrvtiOMMI ION~`DD957$6 ' -~"r`~,se ' ~ ~ ~a,` sXPlRES: ebruary 14, 2014 ~VI . L O ~~~~ S. I~~ofr;~e~'~ BondedThruNotaryPublicUnderwriters' `{~. ~~~~ REVIEWED BY: DATE: ~~ 3 ~l ' ~ Arm <saxir+n~-~» ~ ~.aaa~;~«. NOTICE OF COMMENCEMENT Permit No. ~ ('~ '~ ~ .7 ~~ Tax Folio No. TIC UNDERSIGNED hereby gives notice that improvements will be made to certain real properly, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1.Description of property (legal description): a} Street (job) Address: ~f~ I f tom''' ~ Ss.. /~S i_AA} s I~ ~Ef~ ci-r 1 FL , 2.Generai description of improvements: ~ Av p~~ ~l a~ i~ 3.Owner Information a) Name and address: (u p Oz ~ ~ c rf A ~ D ~ ~ E ~ S b) Name and address of fee simple titleholder (if other than owner) c) Interest in property 4.Contractor Information a) Name and address: ~~ ~ E -.1C)'S ~o-J,~ ~ . b) Telephone No.:C~Dy `Z y ~~G_7d fo Fax No. (Opt.) S.Surety Information a) Name and address: b) Amount of Bond: _ c) Telephone No.: 6.Lerfder a) Name and address: Fax No. (Opt.) Phone No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: b) Telephone No.: Fax No. (Opt.) B.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: a) Name and address: b) Telephone No.: Fax No. (Opt.) 9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IlVIPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IlVIPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIItST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA f COUNTY OF PINELLAS 10. c Signature of er or Owner's Autho ' Officer/Director/Partner/Manager r~ ..~ d. l- ~~ C G~ Print dam T'he foregoing instrument was aclrnowledged before me this z-- day of ~h~_, 20~ by as (type of authority, e.g. officer, trustee, attorney in fact) for Personally Known OR Produce~dentifi L ~ Type of Identification Produced (name of Notary Signal Name (print) OR Verification pursuant to Section 92.525, Florida Statutes. Under the facts staled in it are true to the best of my FORMS/NOC,rvsd2010 ~L.gpAHAM MY GOMM18510N # 00 95i7B0 EXpIF~ES: Februar i4, 2tl14 Bondad 7hrltQlahu_ Signing (in line # 10.) Above ~, I declare that I have read the foregoing and that 16 ! t6t"' Sr. .a (.,D~IJ~UV.S 11~1.STRUcTIa~! - 2~i9•+~ ~4, - P~ ~ o u ~U ~ . ~ ~C ~ ~ .; . _ MAC" ~SN~'V~i'~I~.~~ ~S.t~RW.~~~':~ OF` ; ~ ~: :: ~ , lot 1, 131ock 1, OCEAN GROVE UNIT NO. 1, according to the plat thereof recorded in PlayE3ook 15, Page 82 of the Current Public Records of f~uval County, Florida.. • ~ CER"t'iFiED TO: Pelkey E3uilders, Inc., ~ " i ~ Peoples First Community Bank'and Old Republic National Title Insurance Company • FINAL .SURVEY: MARCH 2! , 2000 .CERTIFIED TO: RT.CAARD 3 . AYERS , CYD i, • AXERS , ~__ :. ... : ~ ". . ~ FIRST50UTH BANK, . ' . : ' :. _.. . . . . . OLb REPUBLIC NATIONAL TITLE INSURANCE`COMPANY and ; GIB1tALTAR TIZ7,E SERVICES, INC. ~~ ~~ • . '`.~• g 2.. 4' B.e~ --X FO. 3+LZ.00 0 Ito y !~ 2B.a~ ~! Q` Q oa2o L D T . ~~1 + ~ S ~ LL:,lu. u;,, I ro ~ a- t ~` n Gv V40.~.TE Q V Y Q F0.G~..a~C`1.a`b ~.~J ,0 6t_o C.K d G,r+a.a..c.E N ~ ~ , . ~ ~ . ~ .r, :~,'~ ~ 2 . o' '~ ~ ~ sv ~ O .. ) 2h1 dace ¢ , ~ ~ - Po¢tiH N . ~J .~ . '~ ' 9 ~, , d o ~ ~„ a° O ' ' m ~ • tQ ~'' 'J. a FRAM' F .. ~ M N, i to l ~A ~ J ' d• _ ~, • •'~ o ~ Q +' ' t ? '~ ' O • a. •o ~. S \ a. 3 m a ~ P a ¢, c. w S ~ S ~ ~ ~ ;.b 0 ~ : J ` ~d: - ~ 1 n ' - ydo 1 4 N ReuUO~a~~~ `~ 1 c 4 .O ~ T'C Res ! A G. AV ~ Al <L E - • ' " .....s.,..a.. r l~a.e w. h. S Z . o ' S e. • Ca 3't'7-- on ~ ~_ T L1 I ,.T.. ' Q C ~ C ..T.. w Z ~ a ( J tt~=~ 4k~QZ wo a D !_- ~ov~ ~g w ~zd~o w`~ ~•~ ...~~ ~ ~ H 30p~p~ W~i7~d g V z V ~O ~ ,~ C b~ p U c~/~C~~W~ ~ `~ `~ H- >Z ~-~ d ~ ~ UOYp ` ~ N ~ \ co \ \ aD ~ t1iZ fib\~i'~. ~ t) O ~ .~ ... s ' B > ~~~~ co I b ~~...~,..,.,.. ......m.,._..:___._.. ~.._.., ~~ ~ ~~ i °~~ / ~.OL c~ uo-~ HOOK REINFORCEMENT INTO GROUTED CELL AT PLATE HEIGHT CHANGE STANDARD HOOK =10" (TYPICAL} 4,--10 -,! .,~ J C . . .;' d 1 ~ ~ ~ ; . 1 I' 1 I ~ 1~ c :, 17. : ~ 1 ~I' I I L 1 1 ~ I I 1 i 1~ f~ i 1 . r i' I 1 I 1. 1 b I' ~ I I ra r 1 1 i I I 1 •1 I I I .. 1 I' 1• I I 1 ~. 1 1 ~. ' . ~ 1 I 1 1 .' A 1: 1 1: t ~ 1 ~~ : 1 1~ 1 1 -. 1 1, 1 -I 1 1. 1 '1 1 1 1' .1 t. ~ ~. ~ ~ I 1 , ~• . I, 1 ~ 1 1 1 I ' I 1 1. 1 "1 1 1.~ 1 1 I 1.. I ~ ~... . ~ ~... .r i - ~... .,~ 1 ~~1 1. ~ 1 1 1 1 1/• 1 9 1 IY 1 '1 1 IT I ~ r 4 .I 1 r t .i 4 _ I 1 1~ ~ 1 1~ 1 f, 1 I I ~ ~ I 1 1 1 1 1 i~~ + ~ •~i i. i~~ 1 ~i I v ~~ ~I 1 I 1 1 : i .1 i 1 i 4 i I _ •1 __ _________ ___ 1- 1 1 1 f r , i •1 ~ 1 •1 1 •1 ,. d } 1. ,. , 1. . ~~ ~ i. 1 ~~ ~ r 1 i. ~ ~ + 1 r . I 1 1 1 1 1 1 1 i• ~~4 i• 1 1• I dl ~ I .1 ~ .1 ~~ • i 1 I 1 1 I 1 1 i' :~i i~ ~i ~ 1 i 1 '~ 1 1' •1 1 1 1' 1 1 1- 1 I 1 t 1 1 r, ~ r_ ~ , 1 ~ ~ 1 1 i ~ 1 ~ ' • I . . ~ ~' i 1 1 , 1 1 I 1 L ~ ~ ~ 1. 1 1 1 1 1 1. •1 )OWEL FROM FOUNDATION MINIMUM 25" LAP (TYPICAL) TYPICAL) GROUTING OPTIONAL IN THIS AREA (U.O.N.) LINTEL AS REQUIRED PER WALL LAYOUT (LINTEL ~A SHOWN) ~-MINIMUM 4" BEARING LENGTH REQUIRED FOR PRECAST LINTELS - 8" IS RECOMMENDED NOTES: 1) USE TYPE S OR M MORTAR IN JOINTS ~ 2) FULLY BED ALL JOINTS ~~~-REINFORCEMENT REQUIRED AT EACH SIDE OF ALL OPENINGS (TYPICAL) _~~TYPICAL 8x8x16 CMU 'BLOCKING REQUIRED BETWEEN UTS >HEATHING ~ LOOKOUTS ~ 48"O.C. CLIP AT EACH LOOKOUT NOTES: 1) ALL PRECAST LINTELS SHALL BE MANUFACTURED BY CAS APPROVED EQUAL 2) REFER TO "TYPE DESIGNATION" BELOW IN CONJUNCTION WALL LAYOUT TO DETERMINE PROPER CAST-CRETE®LIN' ~w L1 y'~::~ J rJ City of Atiarttic Beach Busi~ing ®epartonent 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 Fax (904) 247-5845 E-mail: building-dept@coab.us City web-site: http://www.coab.us ?r®perty A~~ress. ~~ ~ %l~ ~ ~T Appl6cant: ~~~`~~``' ~-S 1 ~~~~L~--~-' Reviewed by: APPLICATION STATUS APPLICATION NUMBER (To be assigned bey?the Building Department.) U z~ Date routed: ~ d ~~ ent reviewr reeuired I Yes.!' No ~TrPlannina & Zoning l I I I P lic Utilities ' Public Sae y Fire Services Rev e~ ~ fee' De fi Si nature ~.,v_~~.J. ~~ . _....p .~_..9..ti..~,.~,W,.~. ®ther Agency Review or Permit Required Review or Receipt of Permit Verified By ®ate 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; Reviewing Department First Review: (Circle one.) Comments: BUILDIN PLANNING & ZONING TREE ADMIN. PUBLIC WORKS PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES ^Denied. Date: ~ `-3 l~ Second Review: QApproved as revised. ^D~ed. Comments: Reviewed by: Date: Ttoird Review: QApproved as revised. ^Denied. Comments: Reviewed by: Date: Revised 05!14109 ~ rr.ay;.,J,~ City of Atlantic Beach ~~ •. ; ~ Building Department I~ 800 Seminole Road ~* ~'~~ Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 Fax (904) 247-5845 `..=~~st ~r E-mail building-dept@coab.us City web-site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) Y Date routed: ~ ~ ~~/ Property Actress: ~~~ ~~~ ~ ~T Applicant: ~~~`~"7~.`-' ~-~ C ~~~~~.~-~' Project: ~< <- /~ .17 ~ ent review required Yes No Buil ' tanning & Zoning ublic P tic Utilities ublic Sae y Fire Services _ .. ~. T _ ,. _. -_ - _ . ~~. Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified By ®ate 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: APPLICAT-IAN STATUS Reviewing Department First Review: ~pproved. ^Denied. n (Circle one.) Comments: ~ ~ L~,. ~ y~j',~ ~/ ~~ BUILDING-- ~ ts~c~C.~ -~--y(. -~ `fin ~ ~• ~e,L, ANNING & ZONI ~ ~/~ ~~ti""'` ~ Reviewed by: ~ ,t~ocG~S/L- Date: Ali ^ D ~YG TREE ADMIN. Second Review: ^Approved as revised. ^Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES Third Review: Comments: Reviewed by: Date: ^Approved as revised. ^Denied. Reviewed by: Date: Revised 05114!09 -s!.:~i1f,J, City o$Atlar4tic 13eaci~ ~~~~ ,~ ~ ~~~~ 13uiiding ®epartrnent 21 ='° ;~~ ~~ _ :+ 800 Seminole Road ;. ;..... ~~, Atlantic Beach, Florida 32233-5445 ~ ~ ~-~-~,_._ ___ _ ~ _~~~ '~ Phone (904) 247-5826 Fax (904) 247-5845 ___.-~ •^.!J;p ~%~ E-mail: building-dept@coab.us City web-site: http://www.coab,us APPLICATION NUMBER (To be assigned by the Building Department.) 2~ Date routed: ~ d ~r~ ~~r®perty A~9dr~ss: / ~ 1 %l!/ ~ ~T applicant: ~~},~`~'~~l-+ G(-5 ~~~--~~C~-~' went review required Yes No Buil tanning & Zoning .{ ublic P tic Utilities ublic Sae i Fire Services Rev ew feeu~~ ,~DeptS gnature ~~.,.~y_~,_.~.Y. Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept, of Environmental Protection Florida Dept, of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ^Denied. (Circle one.) Comm~n~~ ~g~- ~~ d..Z~ ~p..t~ S?~~- BUILDING ~~~ ~ f/6~~, , PLANNING & ZONING ~ ` Reviewed by: ~ Date: ~/''2 La TREE ADMIN. Second Review; ^Approved as revised. ^Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ^Denied. Cou'a'umen$s: Reviewed by; Date: Revised 05/14/09 rT'`~''f'j~s City of Atlantic Beach ~ "* ~ ~''~ g ~."' ~ ~~'~:' ~_a.~ ~. ,~ -• , S, Building ®epartrnent ~ .iU~. ~ g 210 ~r 800 Seminole Road ~~a Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 Fax (904) 2i~gB?l5 ~-~_--~ ;_ ___ `~^"~J;~ ~~° E-mail: building-dept@coab.us City web-site: http:/lwww.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) o - 22~ z Date routed: ~ c~ ~~ ~~P'~I~~~1®~ ~~~/~~W~1 ~~Y~ ~~~~~~~~7 ~~~~ Pr®perty Address: ~~ ~ ~l~ ~ T ~-ppllca~t: C., D~`~~u G~.S C ~ ~~C~ Pr®Ject: ~L L-- F ~- at~:pent review required Yes hlo Buil '. tanning & Zoning tra ublic P tic Utilities Public Sae y Fire Services Review fee~~ DeptSignature Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date 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: Reviewing Department (Circle one.) BUILDING PLANNING & ZONING TREE ADMIN APPLICATIONI STATUS First Review: Approved. ^Denied. Comments: Second Review Reviewed by: _ ~~~' Date: ~ ~O ^Approved as revised. ^Denied. PJd$,J~QlWOR~4S ~ I Comments: PUBLI,~ S~,FETY FIRE SERVICES Reviewed by: Date: Third Review: Couvoments: ^Approved as revised. ^Denied. Reviewed by: Date: Revised 05/14/09