Permit Renewal 76 17th St 2011 •L
'A � " - I'
O' 4-rire, CITY OF ATLANTIC BEACH
\ ,,,,, -- t 0
`e 800 SEMINOLE ROAD
``4 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
4 ' 1 - 01119
Application Number 08- 00001217 Date 4/27/11
Property Address . . . 76 17TH ST
Application type description SINGLE FAMILY RESIDENCE
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
renew permit # 06 32077
Owner Contractor
DAI XIAO -QIONG JLS BUILDERS LLC
P 0 BOX 2899 144 AZALEA POINT DR S
DURHAM NC 27715 PONTE VEDRA BCH FL 32082
(904) 881 -8952
Structure Information 000 000
Construction Type TYPE 5 -A
Occupancy Type RESIDENTIAL
Flood Zone ZONE X
Permit RENEWAL PERMIT FEE BUILDING
Additional desc .
Permit Fee . . . 147.30 Plan Check Fee .00
Issue Date Valuation 0
Expiration Date . . 10/24/11
Special Notes and Comments
contractor DS Killian no longer in
business. construction taken over by
another GC
Other Fees ST CONSTRUCTION SURCHARGE .00
AB CONSTRUCTION SURCHARGE .00
STATE DCA SURCHARGE 9.86
STATE DBPR SURCHARGE 9.86
Fee summary Charged Paid Credited Due
Permit Fee Total 147.30 147.30 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 19.72 19.72 .00 .00
Grand Total 167.02 167.02 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Reed Brothers Custom Homes Inc.
6437 Greenland Industrial Blvd Jacksonville, FL 32258
(904) 545 -5565
License Number: CBC 1252544
Date: April 26, 2011
To Whom It May Concern: With the City of Atlantic Beach n
From: Reed Brothers Custom Homes U 7 Justin Reed /Owner
(904) 545 -5565 A 2 ? 2011
6734 Greenland Industrial Blvd By 4241
Jacksonville, FL 32258
Re: Lot 72 & 76 17 Street
Reed Bro ers Custom Homes is turning over the building permit to Jeremy Schroeder
' with Builders to finish construction on the two dwellings. Please contact our office
l V with any questions you may have.
(This form of notary block to be attached wherever notarization is needed:)
�h
State of:
F� O n t day of - Apr l \ .„2,01, personally
appeared before me\„y— > %-}tr' who
County of: )A-{„ s ted tJiat ( he is the OL of
QC � �Y�� 11 le6 a corporation, and that the
instrument was signed in behalf of the said
corporation by authority of its board of directors
and acknowledged said instrument to be its
voluntary ac - d=. -d. Before me:
Notary Public for Florida
My Commission Expires: I `1LJ
.r2'`M-• ";e4. JODYHART
* ; * MY COMMISSION t OD965977
T " 4 EXPIRES:June26,2014
\0, vo e Bonded Thai Budget Notary Services