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Permit Siding 679 Selva Lakes 2011 Qt N �w SA CITY OF ATLANTIC BEACH . r 800 SEMINOLE ROAD J 1 =v ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002246 Date 6/23/11 Property Address 679 SELVA LAKES CIR Application type description SIDING PERMIT Property Zoning TO BE UPDATED Application valuation . . . 2495 Application desc REPLACE SIDING Owner Contractor CURTIS ROBERT D CLARK CONTRACTOR INC 18 SEATROUT ST JACKSONVILLE FL 32256 PONTE VEDRA BCH FL 32082 Permit SIDING PERMIT Additional desc . Permit Fee . . . 65.00 Plan Check Fee . . 32.50 Issue Date . . . Valuation . . . . 2495 Expiration Date . 12/20/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. 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: 5ei V � �S � c. ' rL�� Permi� •�- Number: / � � 7 � V c - ,� 9 G - *Legal Description i lk - b 0 1 - 2..S -- -° E 5 C-Lvpr L r 5 Pa rcel # NL Floor Area of Sq.Ft. Sq.r't Valuation of Work $ 2-/ 53 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 si e ntia If an existing structure, is a fire sprinkler system installed? (Circle one): e (Nod N /A Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: A. lair,,c�p t � 1 c ' A..9 r-0-1- -- T i t t 8 ' 1 D .C. . b /741-(nrkt - r i I l `0'r ©, C . II Property Owner Information: 4 Name: 0 ti 6 V 64-- t S Address: SC 70 DS4-1 t- D City PavTf - VFO i Statef 3IckI Phone 1v`1 k b0 -2154, E -Mail or Fax # (Optional) Contractor Information: Company Name: - R 01cci i O .6.164- L C 4- T c.. K .. Qualifying Agent: 64 r-4- . u 0.,r14._ Address:_/. CityP, )tQr t e4 c..L. State ;-' (. Zip Z o 8 L Office Phone 2.4)0 3 N S ca Job Site / - — - __ m State Certification/Registration # G 0 , ' a / Dit t n .. , • i 1 Architect Name & Phone # " Engineer's Name & Phone # 1 Z �;, Fee Simple Title Holder Name and Address — 1 _ N • f• _ • ' •' _ l .� Bonding Company Name and Address - ' ' • ' ' Mortgage Lender Name and Address REVIEWE • 3 • / , . - 2— ' "l . «; , � Application is hereby made to obtain a permit to do the work and installations as indicate.. certz t a no . . . • as 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. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks 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. I hereby certify that I have read and examined this . application and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether specified herein or not. The granting of a permit does not presume to :ive .uthority to violate or concel the provisions of any other federal, state, or local law regulating construction or the performance of construction. Signature of Owner Si i 1b Signature of Contract dr / (� ■ -- Print Name -oi3R T CA./ 2 I f Print Name R . CI, r i SwoeW . , . subscr .e• .efore me Swor c :1 + ubscri e, • before me this.•4 Da, o i, .AJ� 20 this , . y of 20 I r ■ Nota"';1 is ., a MYC•�y a �C 1,. EXPIRES: Febcuafy 14, 2014 if :i" • Awn V 9- Bonded Thru Notary Public Underwriters 1 ,. v P DE • __ _ 1�, __ -- COMMISSION # EE 057349 ,. ‘,.1.1,t...0„..14.1 EXPIRES: May 21, 2015 w Bon ded MY Thru Note ty PubhC Undervrthers )i - - ' Revised 01.26.10 276 s � /�30 s- >>�r ,,,., City of Atlantic Beach APPLICATION NUMBER f � Building Department (To be assigned by the Building Department.) 800 Seminole Road /�, Z �/ ""4` Atlantic Beach, Florida 32233 - 5445 `7 Phone (904) 247 -5826 • Fax (904) 247 -5845 ,'`�olia' E -mail: building- dept @coab.us Date routed: 6 � /fP City web -site: http: //www.coab.us APPLICATION REVIEW AND TRACKING FORM 1A L ' • Property Address lay � c� E /1/41.- / e. Department review required Ye No Building V Applicant: Aker I) £/a 44- ng & Zoning Tree Administrator Project: 7§Q It (/ £ r 1 Public Works Public Utilities Public Safety Fire Services Review fee °$ ° +4 , Qe tnSigOature N 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: proved. ❑Denied. (Circle one.) Comments: (13UILDING PLANNING & ZONING Reviewed by: // Date: 6 -1( TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Deni tl. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/10