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Permit R/W 352 12th St r -cell. .1. 14: FROM: CLERK OF COURTS 904 270 1512 TO: 92475845 P:1/1 NOTICE OF COMMENCEMENT Permit No. Tax Folio No. State of Florida, County of Duval THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with Chapter 713, Florida Statutes, the following information is provided in th.is Notice of Commencement. 1. Description of property (legal description of property and address if available): 41' a I oc. Id. a Sc km 44 t _.4_ :44 I &S (.1 S 4. 4 414! 4,..4 L. s C.xc_g. ri ..7 z- 3 3 2, General Description of improvements: g 44-0- ve e R e o 1 c e ye�,-f, ( -__ d r e 3. Owner Information: a) Name and Address: )r "l (`- _ f '‘ Ct. a-.. A 3 c2- t aZL S . , 1.„.., 2.. e &,C 77 3 La 3 S b) Interest in property: c) Name and address of simple titleholder (if other than owner): . Contractor Information: a) Name and Address: -> A 6'4ti.s4 t.c"r'o n e , I L 0 17 , -*- A (c)) 4 a. 4 - to f 7 ► �n to t. � S r s Surety Information: 3 2 - z5 / a) Name and Address: b) Phone Number: c) Amount of Bond: $ 6. Lander Information: a) Name and Address: b) .Phone Number: 7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as provided by 713.13 (1)(a) 7, Florida Statutes: a) Name and Address: b) Phone Numbers of Designated Person: 8. In addition to himself /herself, Owner designates a copy of the Lienor's Notice as provided in Section 713.13 (1) of to receive a) Name and Address: �)): Florida Hlorida Statutes. b) Pl.on.e Number of person or entity designated by owner: 9 Expiration date of Notice of Commencement (The expiration date is one (1) year from the date of Recording unless a different date is specified: WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER , R THE EXPIRATION NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 71.3.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR. .IMPROVEMENTS TO YOUR PROPERTY, A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU 1NTE.ND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR. AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. The foregoing instrument was acknowledged before me this ` of day ,20// DEBORAH / it ,/ / NOTARY -�" �� �' A r P LIC, STA OF /,l E.: MY COMMISSION 7 °5'349 Print Name: �- FLORIDA, 4 (t! �^ >:XXPIRES a M�r 21 . — -- - - Li Personally Known Identification /Type ; >r / Cr�, Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of .my knowledge an fl _ ,//:. poop d1)1 1-I -f 1:$4 , OR 8K 15613 Page 1910. Signature of Property Ownor Number Pages: 1 Recorded M27:2011 at 03 :09 PAIL, (I) JIMI =ULLER CLERK CIRCUIT COURTQUVAL GVUNTY RECORDING $10.00 Revised 10 /1 /2009 -�' J'J , :it "Or '-`? CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD .. „, ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 �M/ r c ry , Ap• on Number 11- 00001110 Date 6/30/11 Prnpprty AAeirACC 352 12TH ST RE number 171927 -0000- - NCR OLD ACCOUNT NUMBERS . . AB03032 Application type description RIGHT -OF -WAY PERMIT Subdivision Name Property Use Property Zoning TO BE UPDATED Application valuation . . . 0 Owner Contractor ROBICHAUD, WILLIAM OWNER 352 12TH STREET ATLANTIC BEACH FL 32233 Permit ENG REV FEE BLD MOD OR ROW Additional desc . Permit Fee . . . 35.00 Plan Check Fee . . .00 Issue Date . . . 6/28/11 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 35.00 Special Notes and Comments Roll off container company must be on City approved list and container cannot be placed on City right -of -way. No increase in impervoius surface area authorized. Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 UTIL REV MODIF OR ROW 25.00 Fee summary Charged Paid Credited Due Permit Fee Total 35.00 35.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 29.00 29.00 .00 .00 Grand Total 64.00 64.00 .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 // d 800 Seminole Road, Atlantic Beach, FL 32233 _ ---1 Office (904) 247 -5826 Fax (904) 247 -5845 W - u W MAY 2 2011 Job Address: 35 1 a+e\ S +r ex+ Permit Numb! . --../ Legal Description '- 01 s Nock_ 02 5606 m art AcA Un tk it 1 Parcel # a3 - q 1c, . - ZS - 07`1,,,,„„„ Floor Area of Sq.Ft. Sq. Valuation of Work $ (off 5 , ' 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 Reside • . installed? an existing structure, is a fire sprinkler system nstalled? (Circle one): ' es No N IA Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed:_ r\ c(-eta dr w - ape (0) c 6) C 5 F . C IM / ` De lud e ) Property Owner Information: `\ ;1 Name: l>J 1ha+M ko1pi c1na,+cA ■ (,r I 54 City Akla,ni'ic (?leach State FL-Zip = V E -Mail or Fax # (Optional) �, V Contractor Information: v 73 \ Company Name. 1-. oV 65 (7c, a\ S +f J AtPrs• I . T.0 \ / . Address: IT? — NW W4l rye Or FL Zip 3.49s9 Office Phone q d-4 - (i 2.y -1-1(014 Job Site/ Conta State Certification/Registration # 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. I certifi 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 aperiod of six f6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, W ells, 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 a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type ofwork 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 loca re dating construction or the performance of construction. 1 c .F _ I t 6. Signature of Owne de# ._,,, -/ r. c f ' Signature of Contras -." 111. Print Name / / / , a w 1 � a i c° k .A. Print Name oy M��0T S Swor o i subscn • - ' ,, • f• e me Sworn to and subscribed before me ha / j' /Sloe ' /vc th': . /Day of , 20% this 2 D. of a `/ ��r' 20 / Notary Pu + ' r ' ' b i a ' ub1TcOMMISSION # ■ 1• �' _ ' ;; DEBORAH AMANDA WHITE FXPIRES: Au ust . 4 , 2013 ^. '•1 .c MY COMMISSION # EE 051349 I f B _ o, d �' Bo Tnr No tary public Underw hers !' evised 01.26.10 4 p th Bonded T P Underwrders , i Public Utilities Plan Review Comments Date: I 3 1 1 1 k, Initials: Project Name /Address: 3 S 2_,•1-1, Application ermrt #: I ( -/ // t Check Boi .Application Tracking Comments to kfld :Comment Avoid damage to underground water /sewer utilities. Verify vertical and horizontal � location of utilities. Hand dig if necessary. If field coordination is needed, call 247 -5834. Fnsure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 co ncrete box with metal lid. Cleanout to be set to a ade and visible. A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be ❑ tested by a certified tester and a copy of the results sent to Public Utilities. Plans note the building will be unsprinkled. If plans change, any fire line installed must be metered with a Sensus touch -read meter in a properly sized vault and an ❑ appropriate backflow preventer installed. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities. If fire sprinkler system is provided, contact Malcolm Clemons at 247 -5839 for backflow requirements. At a minimum, will require double check backflow ❑ _ preventer. Fire lines must be metered with a Sensus touch -read meter. Meters larger than 2" ❑ must be installed in a vault as noted in JEA specifications. ❑ • 0 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 D 1 2 11 Li Office (904) 247 -5826 Fax (904) 247 -5845 MAY 2 2011 Job Address: 35c) 1,), 5 -4 -r eel- Permit Numb . --./ Legal Description `-0r 5 Nock_ o2 Se_Ioc, Martn Qv 0- tt 1 Parcel # a3 '-i l - 4,-=- E Floor Area of Sq.Ft. Sq. t Valuation of Work $ CI 9 5 , a° 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 Re ide • If an existing structure, is a fire sprinkler system installed? (Circle one): es No' N /A Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: Rein o•J e ca,1 c) rep ki ce G)(tS4 r,c, Ct. I\ C t r' e M ;Ql,,c SP CIci'r� stir ce Ca1eu1 0,15 o4c- chv(i Property Owner Information: Name: l.).) % 11 't avv► KoVi c Via ucl Address: SGw.e - 3.5D 0 5 ee4 City A - Hank ( State FLZip 3:133 Phone c?'-I9 — �r3`l N 3 E -Mail or Fax # (Optional) Contractor Information: .. N ame: �... o ° A ing Agent: T y Lo T+ S Company Name: � �vS � S�t � � �'� �, �-. I �C . Qualify Ci ��n4 .36�� "5 State FL Zip 33_9 s9 Address:- i3? • finny -h � a5e 0:. ty Office Phone C i4 - Gl2.9 - 4614 Job Site/ Contact Number 01-1 - &).y - 4 w Fax # State Certification/Registration # 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 errf ormed to meet the standards of all laws regulating construction in t_hiis jurisdiction. This permit becomes n ull any time aer and void work is co menced.otl commenced within six understand that separate permits must be consction for Electrical 1Vork, Plumbing, Sig a Wells , Bode sr , Healers, 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 a placation 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 e p f y federal, state, or local law e ulating construction or the performance of construction. `w7r c c w y� .►�.rr Signature of Owner �� Signature of Contaac :° �; � Print Name `{ q //, w, i c • I' � � c r Print Name Troy M 1.-c 1 S Swor o subscri• ,p f• e me Sworn to and subscribed before me 'u. � C- th% /Day of � 20 � this 2 L/ Day of ,fl/ a/ . , 20 / / p ¢ r Ub1TCOMMISMN tt • e1 S35 i Notary Putt `ter "a' %, DEBORAH AMANDA WHITE -4.F : ram' �� • EXPiRLS: August �4 2013 ►: �!� .ir MY COMMISSION # EE 057349 ...._ ; Bonded Thru Notary Pubic Under , iers Revised 01.26.10 EXPIRES: May 21, 2015 . " Bonded _ •. y P ub s ■ ■ ■ ers 1,; d`. Bonded Thru Notary Public Underwriters ry NOTICE OF COMMENCEMENT Permit No. Tax Folio No. THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1. Descriptionof property (legal description): Lb\ S NaC.k a Se‘vc, V'V'arinet OVA t1 1 a) Street (job) Address: ,5 1d, Sfrexf 1 A #1 - -c? D,, n I FL- 3.D.�33 2.General description of improvements: tern oue r,1., i rept(' t5{,M3 c,ArYa-J AT vvc 0-y. U 3.Owner Information 1 !1 a) Name and address: Wt \ \ Q..Q31cYlcko - 33a l,- S r M ( J is �'oc41i 3) b) Name and address of fee simple titleholder (if other than owner) c) Interest in property 4.Contractor Information a) Name and address: L...041.) \) S 6. oc Vir , ITAC - Troy L.-0 1 l b rf oe Or. S :vt,,n5 b) Telephone No.: qp�-I - (a ,) I-(- Lk:. 1 `I Fax No. (Opt.) 5-)c 5't 5.Surety Information a) Name and address: b) Amount of Bond: c) Telephone No.: Fax No. (Opt.) 6.Lender a) Name and address: Phone No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: b) Telephone No.: Fax No. (Opt.) 8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: a) Name and address: b) Telephone No.: Fax No. (Opt.) 9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA /ri 1 /(''' 'e- C'' ''----"- OUNTY OF PINELLAS 10. Signature of Owner or Owner's Authorized Officcer/Directo r/Manager `Ul / /I G.w • I / R r' t r < hex-f tl4 Print Name A ,� I The foregoing instrument was acknowledged before me this day of 1" ( , 20 /1 , by 110 i 1 l 141A b l cka. t 4 as Y? 1,0 A Q r (type of authority, e.g. officer, trustee, attorney in fact) for (name of party on behalf of whom ins ment was executed). Personally Known OR Produced Identification ✓ Notary Signature il VLI 1 Type of Identification Produced Ft- Ar l t/p f s � 1 Name (print) M e ' AA/ki t. AReki INCA OR Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. 4. FORMS /NOC,rvsd2010 M ARGARET MANAHAN � a .+ ef,L Notary Public - State of Florida 0 of Natural Pcrson Signing (in line # 10.) Above 0 ; M Commission Expires Sep li 2011 1 s ' i P ` 0 Commission # DD 712223 '',°; �.`'�,,` B anded Through National Notary Assn. 0 OIMPINIIIPTVriliipqripmermi 5 T�.'�► -..„ _ a 7' Z 6 " . . . . el. X3 � 3 7 _ _ . f 74 ' 40 � ,. .- Ti 26' - . . . . • . _. , ._• . . R � • . _-• ; ....: q - i.114.•• ! •...... i ,,-, . . :‘ c(), ..„...\,- ..: ,i • ,-,..-„,--,-„,,-.,,..„-„--- --,-,-..,: . • 7---r .-: i ....'. I . I 1 j _ 4' 274' til 0.13' - . , ,•, _ fG -tom _ . 4). . - -. ... _ ice, tvi . c' ,, � ..A.<- Te `� l — Rem a d : c)p1a ce.. e x�s s'i n `\ n c= cat i v .a, i ° 4 • Q h r ' 4.--...;,-----_, .e. 7 .. ,,,,.. „ _ ,4 • f es° 4i' , JA ,,•-_ ,K, .1., - NOTICE OF COMMENCEMENT Permit No. Tax Folio Na. THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1.Description of property (legal description): Lok S l P iA cCIC a Se c, V'Nud i rl , ) '�� r ff , ? a) Street (job) Address: 5 ? all" l" 5-[ (-e. f • AA- I .„(4- - , «, in , F L `3.) 2.General description of improvements: vem ove c w,) reptO uz r i.5 \ri C © Ar Y e d if vies- ' 3.Owner Information f I a) Name and address: 'A) ■ 1 V( C vvt (Q ■ c�ct v c� - 3S of 1,4 l '' SIB Ai �pp T l a,"4-+ a-c, kik, FL. 3 »33 b) Name and address of fee simple titleholder (if other than owner) c) Interest in property 4.Contractor Information 1_� L . a) Name and address: c - L-0-"\ "\ S 6...11 plc l j v� Or\ , C ` Troy 4 S 137 w 1 A 'i't o�� 'Q; s4 :.hvnS t L b) Telephone No.: 9 WA — (7,,) F l ` (, 4 Fax No. (Opt.) 3) S 5.Surety Information a) Name and address: b) Amount of Bond: c) Telephone No.: Fax No. (Opt.) 6.Lender a) Name and address: Phone No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: b) Telephone No.: Fax No. (Opt.) 8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: a) Name and address: b) Telephone No.: Fax No. (Opt.) 9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA '` /1 ,,- COUNTY OF PINELLAS 1 4..I .. L ^ ._ , Signature of Owner or Owner's Authorized Officer/Director/P. 1 - r/Manager Ai //(G..wl / • r`l to r`r it,..„-..pi ✓ Print Name 1 I The foregoing instrument was acknowledged before me this ! day of ,. ,20 I/ ,by WI 1 t 14. Itik bi C kGt{,ka as f) U-t ('. .2er (type of authority, e.g. officer, trustee, attorney in fact) for (name of party on bhalf of whom inst ument was executed). Personally Y Personall Known OR Produced Identification ✓ / % Notary Signature � "'ti'l -'" J p j L., 1 Type of Identification Produced L' �r i l/� ? I I (-' Name (print) v`G�. i /l. / �� i\ AV v \ OR c. Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. eoamts /NOt,NSa�oio ! „ nin, MARGARET MANAHAN to .`t °��'' i Pcrso i i � c # S B e c , ' s Notary Public - Sta of Florida Signature of �� I l. My Commission Expires Sep 6, 2011 s ,, v l� :,- Commiss # DD 712223 ,, n°P ao Bonded Through National Notary Assn, 1 Impervious Surface Calculations: Total Lot SF - 14,330 SF - (100.0 %) Existing Impervious Area Residence - 2,175 SF Shed - 144 SF Sidewalks - 160 SF Front Porch - 100 SF Front Patio - 100 SF Driveway - 2,265 SF Total - 4,944 SF - (34.5 %) 4-- fia tt7 /s --- -.N. A ... 76 • ., ,./...-74 ----, - a74$ za-,••=- ...._. • • ...._._ . ..t5a....9 37 '3 7 -;,.... t 74 , ie. 26 ' . : t\il , ! .1.' - ' . \ ' • - 1 , co, 1 • ' - ...- / ! . -...-:"-••••••-:• =I --,-- ..............„.._. • 1 . ...‘ • • J i • . • : . . , , .. j . q J7,..--"e:. • . ,. ,p-,, ...e..._ 7.,;.; ' 7 . 4, . •.' 1 I _,--- .-: 47 ..... ....--t-- _...... .. ... . "RI r" " 07 5 ' IN., '0' e . o • _ ii ; ... V•i . .. • • , i 7%, „it...ki Cc/ ' . . • ' 1 ;: 1 1 • ) 1 14 •,,.. r (4 / . 6 ,4 10.retde . ' . . . - : a • ..s*. ' 0 L• . ''. ' ' .' 1 '''' I I ) k\i - .,q'2' •.-, ',. '. I.: trl 1.4 .6e- Ai: • . ' .,... tt4 /3 _ 4 . 27 4 1 /' i . - - • 1 ' k. 1 . \ \ . . . . , . a ._ /a . (,‘'• ' . - , •• . / - 2 ."'• . I . . • -• • - . - ., 1 • i '... / .. - - ' • . . . . • •K l': . ' - • : ' - ' - ,- • -. • •- . . . . e-,z.e.- .4--- 7 -,,- .....,-,.,...- _•.- ,::,- .,.• . -.. , , % '. ' . '. - ;/'--- : k- .. 1 CAA() ' .4 t ( ne3 . \ . f t v (A., i ____ t ,C) f , ; . i : ' 0, •Z . , k ... _ - . .. .. _ ..- . , . 9 ro 6r ---". ger.' 4' , 2' ' .1A • ,-11.A4 ran City of Atlantic Beach ,j-Z ;,�. APPLICATION NUMBER s Building Department �' I (To be assigned by the Building Department.) r ' 800 Seminole Road r , .*1 ., : , ' Atlantic Beac Florida 32233 -5445 MAY 1 2011 // �� Phone (904) 2 47 -5826 Fax (904) , =45 ®�� .: E -mail: building- dept @coab.us - -- Date routed: City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: .52.- /2 Iv ST Department review required Yes No Building Applicant: 0/4)- Planning & Zoning T - ` tor Project: Z.vit a v� PE» tD i8fJ-1"' `-, "' n! 1!� • iiiti A)P C TL oJr, ✓f 137 ` Public Safety 137 Fire Services Review fee s De f'si tote s ,..„ a 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: OApproved. ied. (Circle one.) Comme t• /� II // �,p� A BUILDING � s . /��tt�/ -. ,-, �,r(r� ,�f►.,r✓"� �' " "� CAA 0k44.1 PLANNING & ZONING Reviewed by: _ Date: •£) / lb TREE ADMIN. Second Review: Approved as revised. ❑Denied. 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 r r S �,j» City of Atlantic Beach ` APPLICATION NUMBER 1�, Building Department A ' �" � . (To be assigned by the Building Department.) r 800 Seminole Road Iy y I 4� // `°" Atlantic Beach, Florida 32233 -544' . Phone (904) 247 -5826 Fax (90 1 pff ��� .%A*4' 09,- E -mail: building- dept @coab.us \ Date routed: City web -site: http: / /www.coab.us �--.� APPLICATION REVIEW AND TRACKING FORM Property Address: 3 /2" S r Department review required Yes No Building Applicant: (JitTh Planning & Zoning T - ° for Project: ak 6 vi✓ kklo. le is 1n ' u . 0 On 0r %L Oir / ✓t L)4 / Public Safety Fire Services Review fee $ fit` r 471e pt Sl afore ,' +, 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: Approved. ['Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: 6.)--)--- Date: 4/— // TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PULLeveA ea :.S omments: BL C UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: (Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 07/27/10