Permit Resurface Pool 47 11th St 2011 e �� ,
= ` I CITY OF ATLANTIC BEACH
' "' 800 SEMINOLE ROAD
J "'" " ze ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
4 t c.).
Application Number . . . . . 11- 00001766 Date 3/07/11
Property Address 47 11TH ST
Application type description RESIDENTIAL OTHER
Property Zoning TO BE UPDATED
Application valuation . . . 5000
Application desc
REFINISH INGROUND POOL
Owner Contractor
HIONIDES, CHRIS HENDERSON POOL SERVICE
47 11TH STREET 159 11TH STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
Permit BUILDING PERMIT
Additional desc . REFINISH INGROUND POOL
Permit Fee . . . 75.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 5000
Expiration Date . 9/03/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 79.00 79.00 .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
Job Address: 41 (l S* C -C -C4 - Permit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 5 000 Proposed Work heated /cooled non- heated/cooled
Class of Work (circle one): New Addition Alteration Rep,' Move Demolition pool/spa window /door
Use of existing /proposed structure(s) (circle one): Commercial ' - . . ,
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes 1��
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed: `RP ctrNiSkt S» j or vY 9 r od
Property Owner Information:
Name: • n • • ' • • ' Address: �1 41 N ,S'
` �Y -c e t
City i�� _ Gh Stat: Zi j2�_Phone � �
E -Mail or Fax # (Optional)
Contractor Information: C" 1 6
Company Name: #k-end—e6son coy 5 eNl C12. Qualifying Agent:
Address: l5 at 10 5}-. City Pr vt-fit, Q J-, State 1rL zip 3223 S
Dffice Phone 24k-1 b fo < Job Site/ Contact Number '11 O -"I l S Fax # 2 lin =1 &78
State Certification/Registration #
Architect Name & Phone # /
Engineer's Name & Phone # � v‘(Ot
Fee Simple Title Holder Name and Address t_ 4
3onding Company Name and Address /
Vlortgage Lender Name and Address l ki (al
fpplication 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 of a 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 if 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 or Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
ranks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMVIlVIENCEMENT 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.
hereby certify that I have read and examined this ..placation and know the same to be true and correct. All provisions of laws and ordinances governing this
vpe of work will be complied wit, whether speci ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
rrovisions of any other federal, . , -, or local l • egula : construction or the performance of construction.
il
signature of Owner A.A_/ r Ali Signature of Contractor
'riot Name '
... /iec7 ht' i Pisa ,/ 1 Print Name
Iwo subscribeo�.-f•re me / // Sworn to and subscribed before me
his 1. Y of 20 this Day of , 20 , / , it, / =-= = =
_...1.6.4.4.,...e....., / . Zotar Public DEBORAH A. " Notary Public
'� „? ,, MY COMMISSION 12
DD 6816
EXPIRES May Revised 01.26.10
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