Permit Remodel 647 Amberjack 2011 'vv.
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_ CITY OF ATLANTIC
-, ?. NTIC BEACH
s) 800 SEMINOLE ROAD
` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
, ; '"
Application Number 11- 00002470 Date 8/09/11
Property Address 647 AMBERJACK LN
Application type description RESIDENTIAL OTHER
Property Zoning TO BE UPDATED
Application valuation . . . 13000
Application desc
general interior repairs drywall, kitchen cabinets
Owner Contractor
GEORGE, KENNETH B. RONALD P ARDARY CONSTRUCTION
647 AMBERJACK LANE INC
ATLANTIC BEACH FL 32233 1360 SORRELLS CT
JACKSONVILLE FL 32221
(904) 509 -4565
Permit RESIDENTIAL ALT /OTHER
Additional desc .
Permit Fee . . . 115.00 Plan Check Fee .00
Issue Date Valuation . . 13000
Expiration Date . . 2/05/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 115.00 115.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 119.00 119.00 .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 ti
800 Seminole Road, Atlantic Beach, FL 32233 \ \
Office (904) 247 -5826 Fax (904) 247 -5845 /
Job Address: 1 '' 7
e , cCt NC— 322, Permit Number:
Legal Description - ( /a .5 0.z 4447 S uN, aA-�
Valuation of Work $ �av oor ' rea o q. t Parcel #
Proposed Work heated/cooled ao t
d /
J �._ non - heated /cooled
Class of Work (circle one): New Addition Alteratio Repair Move Demolition pools a win
Use of existing /pro osed structure(s) (circle one one): :. - ides ' . P dow /door
If an existing structure, is a fire spr system installed? (Circle one): • es o'
Florida Product Approval # N /A
For multiple products use pro uct approva orm
Describe in detail the type of work to be performed: / e,,,
(( i- , 'it( JP ' // .;// ,/fry-, `1z�x -,� ccb,%Kis
Property Own I nformation
Name: T6 ,Ne � Y7
J �, ee Address:
State /-�!Zi l r►�2To,e l� -
City
E -Mail or Fax # (Optional) p Phone
Contractor Information:
Company Name: af,at/'( if IIed tc
Address: � S a.�� e �s C �,. �^'x/ Qualifying Agent: y '�j1 ,
Office Phone Soy 7�� po City 7� x- State
State Certification/Re istration # C Job Site/ Contact Number 7a -es
Sc� f, 6 s Fax # qo Zip ,� 2/
Architect Name & Phone # C - �5 .F ..o.
1 'g'� ?`0--
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 cert that no work or installation has commenced prior to
issuanc if e of wor a perk ims it not and that all work well six (6) be perf to or if meet th standarn ds or owf ork all laws is su regu or a a constru
bando ned for ction in t j re u od o risd f ict six (ion6) . T his ont perhs mit
at a b nu
and
co m , co nstructio a time a
work is commenced 1 under that separate permits must be secured for Electrical s Work, Plumbing, Signs, Wells, Pools, Furnaces, Boile s Hea e 1
Tanks and Air Conditioners, etc.
ers,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROV
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CO EMENTS
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE O WITH
COMMENCEMENT. OF
I hereby certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing 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
9 rovisions of any other federal, state, or local law regulating construction g on or the performance of construction. g g this
signature of Owner & • 11IL# % r • i . .LA of Contractor
Tint Name K"' 14 .-"` . " GM-0 ��f
1 ..e--- Print Name rg 1� , eco4/4
worn tgg��and subsc�� bed before me
hi Day of ilk, .. 20 / Sworn • and subscr ►ed befor- me
,� th' Day of � V• 20il
, f 41 i P E ANP.HARNAGE �
otary Public : *, 41, s.. ,. , ' , - I, r SANp
- r�'� My Comm. Expires July 6, 2014
otary Public ;• 4 ' ,
" ' .• . ' My Com too lor ida
,;A� Commission No. EE 3948 � •' � � m . Exp Ju ly 6,
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