Permit Bath Remodel 5409 Capella 2011 ' `'' CITY OF ATLANTIC BEACH
I 800 SEMINOLE ROAD
' 5 4 41, = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number . . . 11- 00002240 Date 6/21/11
Property Address 5409 CAPELLA CT
Application type description RESIDENTIAL OTHER
Property Zoning TO BE UPDATED
Application valuation . . . 2350
Application desc
REMODEL TWO BATHROOMS
Owner Contractor
NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS
RETIREMENT FOUNDATION, INC
1 FLEET LANDING BLVD 6771 SHINDLER DR
ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222
(904) 838 -9179
Permit RESIDENTIAL ALT /OTHER
Additional desc . REMODEL 2 BATHROOMS
Permit Fee . . . 65.00 Plan Check Fee . . 32.50
Issue Date . . . Valuation . . . . 2350
Expiration Date . 12/18/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 65.00 65.00 .00 .00
Plan Check Total 32.50 32.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 101.50 101.50 .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: 540 ae* C� of lc. C-E- . Permit Number: // � 1- 6 5 4
Legal Description Parcel #
Floor Area of Sq.l~`t. Sq.Ft
Valuation of Work $ 2 35o Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration (Repair) Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial • esidential
If an existing structure, is a fire sprinkler system installed? (Circle one): 'es N /A
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed: rev to CZ> show,( eanS wait 67a4(c
Yp`4eS fkmbimp e shower R Atl - 64I)
Property Owner Information:
Name: ! CC /Z F Address: Oile Feed" Ga✓te>>M £lVcJ.
City 4)An - e QGtc_) StategZip 32233 Phone goy -Zy(,- .7.9 co
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: /VO4k Rives Rw�o�,it9 .�o /a�i�rts Qualifying Agent: cT0 L4 /u. 1103ctvt
Address: ( SA,(AcJ/ec ,)r. J City Jt3cks onvine State FL Zip 32222
Office Phone 90t1 -BV-9/79 Job Site/ Contact Number Fax Fax # ',oy- 6$3 -c21VB
State Certification /Registration # Car C. 1518918
Architect Name & Phone # —
Engineer's Name & Phone # —
Fee Simple Title Holder Name and Address —
Bonding Company Name and Address —
Mortgage Lender Name and Address —
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
issuance 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
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Truths and Air Conditioners, etc.
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.
/ hereby certify that / have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or to al law regulating construction or the performance of construction.
Signature of Owner J `0^ Signature of Contractor
Print Name Jt7SIrAPc OA'Ci'l cD Print Name " 71- 05\ ,M. {---\ sc
Sworn to and subscribed before me Sworn to and subscribed before me J
this ZA Day of Z",,,„e , 20 II this 21 Day of .Tlty■ , 20 II
Notary Publi — '.— — — — — — — - Notary PtJlic y ' : ''. ELIZABETH TESKE
""""' ELIZABETH TESKE a`�""
A P eN4>d RtlQNa �e of r
i Public - State of Florida
I. ! • s My Comm. Expires Apr 5, 2013
My Comm• Eip 6Sl Apr S, 20
+ A Commission . 1 00 68712.9..E -' Commi +p �TFloa2fl ida
,''• T�j,,, P Through National Notary Aron. ''•,�,o�i, ``, Bonded Nymph NNW Nobly AWL