Permit sidewalk/walkway repair 2009 CITY OF ATLANTIC BEACH
} 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 09-00000669 Date 5/15/09
Property Address . . . . . . 303 ATLANTIC BLVD
Application type description COMMERCIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
repair of sidewalk and walkway (private property)
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Owner Contractor
------------------------ ------------------------
AL PIZZA BP BUILDERS INC
303 ATLANTIC BLVD. 221 JASMINE RD
ATLANTIC BEACH FL 32233 ST AUGUSTINE
ST AUGUSTINE FL 32086
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Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 11/11/09
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2004 FLORIDA FIRE PREVENTION CODE
2005 NATIONAL ELECTRICAL CODE
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 35 . 00 35 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
gi!�j4j City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
IS
j 800 Seminole Road q
j � Atlantic Beach, Florida 32233-5445 a a
Phone(904)247-5826 • Fax(904)247-5845
Fo}�� E-mail: building-dept@coab.us q
Date routed;
City web-site: http://www.coab.us J
APPLICATION REVIEW AND TRACKING FORM
t review required Yes o
Property Address: a'7rf�7 (� SVG Buildin
Planning &Zoning
pp B ��,�� /N C Tree Administrator
1�Ps
Applicant: / Public Works
c- Public Utilities
Project: �/��E(�(�/4 V �7.d (d,�/¢/(� i"- a0�'(� Public Safety
�LS Jai zlvO,
2 a.. ��1 t C� J 5 Fire Services
I s o
Other Agency Review or Permit Required Review or Re eipt Date
of Permit Verified B
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:
CULDI
PLANNING &ZONING
TREE ADMIN. Reviewed by: 122 Date:
PUBLIC WORKS Second Review: []Approved as revised. ❑Denied.
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
FIRE SERVICES Reviewed by: Date:
Third Revie%v: []Approved as revised. ❑Denied.
Comments:
j
3 r, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 09-
OFFICE,
9 OFFICE(904)247-5826•FAX NO.:(904)247-5845
} BUILDING-DEPT@COAB.US
BUILDING PE MIT APPLICATION DUVAL COUNTY
1.JOBADDRESSi 2.VALUATION OF WORK, ER,ROOF
�3 IC , C
3.Sq,FT.UND ..,,
A>LEGAL`DESCRIPTION r " 5.CLAS"OFyyORK',, L, 6.;U.SE OF STRUCTURE
❑NEW BUILDING ❑DEMOLITION ❑RESIDENTIAL
LOT_BLOCK_SUB DIVISION ZI ADDITION ❑CONVERTING USE ❑COMMERCIAL
7.DESCR.IP_TJON OF_1NPRK,
„i; ALTERATION ❑ACCESSORY BLDG. 8:FIRE SPRINKLER;
REPAIR ❑POOL/SPA ❑YES ❑N/A
GT Sf 0 W4 1 MOVE ❑OTHER ❑NO
OPERTYOWNER,, ^=!a, ,. ""' ARCHITECT/'ENGINEER:; ,.9
r. t CONTR CTOR
9.NAME: a 15.CO ANY NAME: 23.COMPANY NAME:
(( Ju..ni Bus't,o r. _ �s
", GV iJ 16.NAME: y 24.LICENSEE NAME:
1�AK&" 'rre-vvz-
10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
303 A&r)7i6 JGUD C-13c r >.SSa Swo
18.ADDRESS: �VS iTr�4 FL^3 i�Q�6 26.ADDRESS:
3rvii s i. W-0
11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.:
qOq 3 q*.-3 0Q h - --7Sq 1
13.CELL PHONE: 21.CELL PHONE: ;.,o - 29.CELL PHONE
14 EMAIL ADDRESS: 22 EMAIL ADDRESS 30 gMAIL ADDRESS:
SP Sus >xw-ec-m
,. FEE SIMPLE TITLE:HOLDER BONDtWG:COMPANY r t r p`"' �' A MORTGAG L !�
(IF 71HER THAN O MJER) - >;' t ,�.,�i?�. e: ,,. - - �re
31.NAME: 33.NAME 35.NAME:
32.ADDRESS: 34.ADDRESS: 36.ADDRESS:
AO 111111k
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that now inla' ha
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulat g c ctidN�r this V/'
jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or vorlospId
abandoned for a period of six(6) months at any time after work is commenced. I understand that separate permih me
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 complia app(cable
laws regulating construction and zoning.I will not occupy or use the referenced building or any part therof,until all insp eti n
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 I YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE TH
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINACING, CONSULT WITH YOUR W
LENDER OR AN ATTORAEY BEFORE RECORDING Y UR NQME OF COMMENCEMEN
WNE or AGENT CONTRACTOR
r y or Agency� Letter Requires (Qualifier Only) 51
z `
Signed: Date: Signed: Date: 0 Z
Before me this of 2009 in the county of Before me �Iorfda,
day of 2009 in the cou9 O 0-+
Duval State of Florida,has personally appea Duval,Sta has personally appeare Q O
�9 C'I ,L � vrbL � U A
herin by himself!herself and affirms that all statements and declarations are herin by himself!herself and affirms that all statements and declaration
true and accurate. true and accurate. C¢z
Notary Public at Large,State ofCounty of Notary Public at Large,State of _,County of
❑Personally Known `/fj (``�` ❑Personal)
�'�duced Identification ,Qs1.\C1� \ \��l aJn_ IjadncedyKnown
Identification
Notary Signatur • Notary Signature:
M NEW ale Ll zNotary Public-State of Florida ,,�,,,, M NENdMAN♦` KV PUMyCommission Expires May 12,2010 ;zoA at; Notary Public-State of FloridBLDG01 Permit Appli Fr. ':12/SfkAaroeission#DD 514747 '•;�;• My Commission Expires May 12,2 0
Bonded By National Notary Assn. =N." `osCommission#DD 514747° .. Bonded By National Notary As