Permit Bldg Picnic Shelter Jordan Park 2010 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001062 Date 9/01/10
Property Address . . . . . . 1671 JORDANPARK FRANCIS AVE
Application type description COMMERCIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 10000
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Application desc
picnic shelter
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Owner Contractor
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CITY OF ATLANTIC BEACH GRUHN MAY, INC.
800 SEMINOLE ROAD 6897 PHILLIPS PARKWAY DR.N.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32256
(904) 262-9544
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Permit . . . . . . BUILDING PERMIT
Additional desc . . PICNIC SHELTER
Permit Fee . . . . 100 . 00 Plan Check Fee 50 . 00
Issue Date . . . . Valuation . . . . 10000
Expiration Date . . 2/28/11
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
FLORIDA FIRE PREVENTION CODE
NATIONAL ELECTRIC CODE
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 100 . 00 100 . 00 . 00 . 00
Plan Check Total 50 . 00 50 . 00 . 00 . 00
Grand Total 150 . 00 150 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: f,4 /,D
City web-site: hftp://Www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 71 J)ep#dMent review required Yes)' No
BuLilding—)
Applicant tv Planning &Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire Services
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: g3A'pproved. E]Denied.
(Circle one.) Comments:
(:BU:IL:D:l�
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN.
Second Review: OAPProved as revised. F]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 06/14/09
BUIELDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address:
-A ve- Permit Number:
Legal Description Floor Area of Sq.Ft. Parcel 9 Sq.1A
Valuation of Work S 10
Proposed Work heated/cooled non-heated/cooled 00
Class of Work(circle one): Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is afire spHnkler system installed?(Circle one): Yes N6 X/M�
Florida Product Approval 4
For multiple products use product approval form
Describe in detail the type of work to be performed: CevL-�i4,VOC,7' OPJ64)16 5&174eff-
2, ezk/—V 5, ki e-14a le
f
Property Owner Information:
Sam
City
E_Mail
Contractor Information:
CompanyName: AZJ�/J MAY Qualifying Agent:,6tgl>'o 660�^)
Address: Lg--1q P,6j'/j,�f Pr,,-w city OA- State zip—32Z3�
Office Phone 24.2:-?,T4-0 4ob Site/Contact Number Fax A 2-&g,04, 7-r
State Certfflcatio;/Registratio'n# C13Cp!j1 1AS
Architect Name&Phone# yj A - C11 z",
Engineer's Name&Phone 'R.4ffe X&�,-%) I -q- 0 F
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
or installation has commencedprior to the
thisjurisdiction. Thispermit becomes null
a
,?eri,od of sbc(6)months at any time ajlter
ells Poolk, Fkirnaees,Boileis,Heaters,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR 11"PROVEMIENTS
TO YOUR PROPERTY. ]IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMAIENCEMENT.
1here ceryfy that I have read and examined th' lica 'on and know the same to be true and correct. All provisions oflaws and ordinances governing this
111�work will be co�nplied with whether&p1e111XP§herein or not. The granting of a permit does notpresume to give authority to violate or cancel the
provisions ofany otherfederal,state, or lo a law 11 lating construction or the performance of construction.
JA -
Signature of 0 "4 Signature of ContractorPY9�
Print Name Print N e "L) eq
............ ............ ..................... ........
Swo
DD S orn t sub ci?,�*"re
this D o 20
IVA
NotWublic UH I"#"Zoe,
SEE PERMITS FOR DITIONAL
REQUIREMENTSAN
CONDITTONS. Revised 01.26.10
REVIEWED By. F1 E COPY
DATE: �1' 26 6-10