Permit 1860 N Sherry Dr remodel bath 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001510 Date 1/03/11
Property Address . . . . . . 1860 N SHERRY DR
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 14617
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Application desc
REMODEL MASTER BATH
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Owner Contractor
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BANKS, RICHARD CHAPPELL CONSTRUCTION INC
1860 NORTH SHERRY DR. P 0 BOX 51112
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 254-9722
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Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 125 . 00 Plan Check Fee 62 . 50
Issue Date . . . . Valuation . . . . 14617
Expiration Date . . 7/02/11
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Special Notes and Comments
NEED NOC
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 125 . 00 125 . 00 . 00 . 00
Plan Check Total 62 . 50 62 . 50 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 191 . 50 191 . 50 . 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
Job Address: V�o Lo L,, She f r r('V(L-A4V(01(,C _Beacv� PermitNumber:
LegalD ription L-6-f- k (9 �'e(uA_ #^,6,viucL Parcel
L),v I - -;:r k 0 — C, Valuation of Work$ 114) 617, �2Z'
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s) (circle one): Commercia Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval 4
For multiple products use product approval form
Describe in detail the type of work to be performed: 4"e_( I
Property 0 ner Information:
V\C-LA 1; Address: �-O S hC-f f'y
Name: Nek R6-\ar3 'Ban�, t>
city ('h State RZp Phone Q- C)4--
E-Mail or Fax#(Optional) 6 ct,K---s 10 D e_--�
Contractor Information:
.ck"MAOdc
CompaiiyAl-,,�_
QuaLfyin g A ni.
Address: .3.
city State FL_ zil)
Office Phone_�104-Z41 2- Job Site/Contact Number Fax#
State Cei tification[Registration# C_
Architect Name&Phone# RMEWFn FO
Engineer's Name&Phone# R CODE eOMTLIXN U
IMPY OF ATtAN-nC BEACH
Fee Simple Title Holder Name and Add ss OR ADDrrioNAL r 'i ru n
Bonding Company Name and Address R F.QLT1R9A1EN-ffi AND C011D]I IONS. 11 1 IL b U 17
Mortgage Lender Name and Address
REVIEWEDBY:
a hereb ade an a ermit t a zo i wAA stallation has co 3 tWe
11 . T&- in mmencea prior t
to o't 'rk P be performe 0 me tan ar o isjurisdiction. This permit becomes null
at all wo wi
d 'th six(6)months, or if c
pp ic c'io'is Y md h
is3uan e o a permit an
and id f work is not co, ece in nstruction or ork is sus en e or a 7 eriod of six months at any time after
is".,"" . I u "t" t t s
k d nd, d a eparate permits must be securedfo lectrica Work,Plunibing, e ,Pools,Arnaces,Boilers,Heaters,
Tanks andAir Conditioners,eta
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.
Ihere certify that I have read and examined th lication and know the same to be true and correct. Allprovisions of laws and ordinances governing this
1�work will be complied with whether sf ecsi 75 herein or not. The granting of a permit does not presume to give authority to violate or cancel the
c -mance o
provisions of any otherfederal,state, or local aw regulating construction or the perjbi fconstruction.
Signature of Owner Signature of Contractor
T'j a i i --D
Print Naine �(A.IA C Print Name CQU49)
........................
..... .... ..........
................................... .......... ............ ...............................
Swor d subscribe4 re me SworiLto' and subscri!7$,,,,e e me
this 1)a of 20 /a this ��ay of 20/0
d sul
t Zori)ayof
Notary Publi
DEBORAH A.WHITE Sif 1RAHAM
MY
My COMMISSION#DD 634126 .1 N-1 9577 1 6.1
EXPIRES:May 21,2011 E4 0
9(irlded Thru Notary Public Underwriters 13011ded Thru Notary Public Undewhers
06/- 33 0 � 52
City of Atlantic Beach APPLICATION NUMBER
"S" Building Department (To be assigned by the Building Department.)
- 800 Seminole Road
$4
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
11 It E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /V J121'f rl �-f V Department review required Yes,,, No
/) A Building --) V
Applicant: C_// qe�7'fn _PTa—nning &-2oning
I_j�T I ree Administrator
Project: zdaeldfl, A46P-14 6q7w Public Works
Public Utilities
Public Safety
Fire Services
Review or Receipt
Other Agency Review or Permit Required of Permit Verified By Date
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: EApproved. ElDenied.
(Circle one.) Comments:
0 C_
�,BUILD(NG__)
PLANNING &ZONING Reviewed by: Date: /d--?0-/0
TREE ADMIN. Second Review: []Approved as revised. r-]Dkn/ied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. [–]Denied.
Comments:
Reviewed by: Date:
Revised 05/14109
NOTICE OF COMMENCEMBNT
(PREPARE IN DUPLICATE)
.Y� < Permit No. Tax Follo No
State of County of
To whom It may toncem:
0 The undersigned hereby Informs you that Improvements will be made to certain real propeft and In
0 accordance with Section 713 of the Florida Statutes,the following Information Is stated In this NOTICE OF
.2 COMMENCEMENT.
D Legal description of being Improved:
W- I PIG
D
Y)
Addres of props It ing1j roved,
W ID 8 P T (k
UJ 100 T 6-
-j
Z)Z General description of Improvements., r
E LL
0 Ld
D Z X=3 Owner—
Address M V-r t la I +j C— F
Owner's Interest In site of the Improvement
Fee Simple Titleholder Qf other than owner)
Name
Address
Contractor
Add
Phone No. j 04 rf I?-Z— Fax No. 'Le
Surety Of any)
Address __Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the Improvements.
Name
Address A— '
Phone No. Fax No.
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No._
In addition to himself,owner designates the following person to recelve a copy of the Lienor's Notice as provided In
Section 713.08(2)(b),Florida Statutes.(Fill In at Owner's option).
Name
Address
Phone No. Fax No
Expiration data of Notice of Commencement(the expiration date Is one(1)year from the date of recording unless a
different date Is spectfled):
THIS SPACE FOR RECORDEWS USE ONLY
s
Igned, LL�L
Sailors me this—_L_Yday of
C of State of N!�Z& arson
'�'�sppeqrsd
!7 4� t--�- tterein by
4-
himeNITherselfand elfimns that all statements and doclarstrans hereln
DEBOW X WHITE are true and accurate
MY COMMISSION#DD 634126
EXPIRE&May 21�2011
Thu No"Pubk Underwriters
Notary Pubflca Countyf
myoommisef
PersonegyKnoym-
P d Identilloafto
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