Permit Stucco Repairs 2010 , t , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
t) ATLANTIC BEACH, FL 32233 11 ,
INSPECTION PHONE LINE 247 -5826
"" J, 319 ry
Application Number 10- 00000984 Date 8/06/10
Property Address 28 17TH ST
Application type description RESIDENTIAL OTHER
Property Zoning TO BE UPDATED
Application valuation . . . 2000
Application desc
2x6 stucco siding
Owner Contractor
OCCUPANT PHILLIPS BUILDERS LLC
28 17TH STREET 1250 SELVA MARINA
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 349 -2999
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . . 60.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 2000
Expiration Date . 2/02/11
Fee summary Charged Paid Credited Due
Permit Fee Total 60.00 60.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 60.00 60.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
•
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Fob Address: 2 g /711/ c 1U A '2 '3 Permit Number:
legal Description Parcel # Area of S.Ft. S.Ft
Valuation of Work $ • may Pro posed Wok h /cooled non - heated/cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Jse of existing/proposed structure(s) (circle one): Commercial Residentia
[fan existing structure, is a fire sprinkler system installed? (Circle one): No N /A
lorida Product Approval #
For multiple products use product approval form
3escribe in detail the type of work to be performed: -ej4‘ n ( XT . (A/4 AY 17
Property Owner Information:
'lame: c) 1 ov e �— Address: Z� -F .
:ity A stater . Zip s LZ ? Phone
•Mail or Fax # (Optional)
Contractor Information:
- ompany Name: 1 1(x(4 I9.S 1 1 k rS Qualifying Agent:
Address: S ZJ 0 . 'i 1/ ' 44o QI1V City „. State Zip 8 2.234
3ffice Phone /d5t` 2494 Job Site/ Contact Number Fax #
State Certification/Registration # G i3 C 1 L,; 7 3 l f
Architect Name & Phone #
3ngineer's Name & Phone #
lee Simple Title Holder Name and Address
3onding Company Name and Address
Mortgage Lender Name and Address
4pplication 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
ssuance ofa 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 f 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
vork is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, Boilers, Heaters,
Tanks and Air Conditioners, etc
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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
•
r hereby certify that I have read and examined this a plication•and know the same to be true and correct. All provisions of laws and ordinances governing this
ype of work will be complied with whether speci ted herein or not. The granting of a permit does not presume to give authority to violate or can el the
,rovisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contract ` ■_ . ■ 416 ,
Print Name H.-5 t ,/ Print Name µ
Sworn A f an • " - T = Swo 010
:Ills 400 r t MLf /A144411'r c ; . i 20 6 thl � � � er��� „'lM M A SJ/l I 2f
.
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�� = 1ti.: ,,�a' i� ,,,.� Feb,rUa •i i �Ild9fvnitN
Notary l I - I
t�� 2014
-_ L �w . �a rn ;
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Revised 01.26.10