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Permit 190 Magnolia St (vault) CITY OF 1*e4a is Vead - ` 4vv ea 716 OCEAN BOULEVARD P.O.BOX 26 ATLANTIC BEACH,FLORIDA 32233 TELEPHONE(904)249-2396 June 26, 1989 Marius Johansen 197 Seminole Rd. Atlantic Bch. , Fl. 32233 RE: 170604- Lots 625 + 626, Salt Air Sec. 1, Atlantic Beach, Florida Dear Mr. Johansen, We have determined that the above property is in violation of Ordinance No. 55-82-19 in that weeds, grasses, or other deleterious, unhealthful growth is exceeding a height of twelve inches. The ordinance stipulates that upon the failure, neglect, or refusal of an owner to out and remove weeds, grasses, growth, etc. , the city is authorized to cut the growth and pass on all costs, plus a charge equal to 100% of such costs to cover city administrative expenses. Your property will be inspected for compliance in seven days from the date hereof. You are respectfully advised that we are not obligated to provide written notice each time the property is in violation of Ordinance No. 55-82-19. We are however, writing this letter as a courtesy and ask that you take immediate corrective action and continue to maintain your property on a regular basis. Do not leave the debris for the City to pick up. You or your contractor must haul it away. Thank you for your ation. Sincer y, CITY OF ATLANTIC BEACH CODE ENFORCEMENT OFFICER CC,. City Manager MAP SHO WWG BOUNDARY SURVEY OF LOT 6,;0 BLOCK AS SHOWN ON MAP OF A/o • / fZWAAC inti' Pl .: T £30OK—f _PAGES __6L------—OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA �i u"Rtr� _ ,fir , .[� 700 /-.. - 11d.5��.z•�• 7�'_Ly��T T/TGA B Off•�AGk'.1��CF< <� c� i p N o • /90 �.11._._� Di✓E STORY 9' N t V < ` i In :�J•_9 T ✓AL1D rL S.5 EMfjGSSED wJT1I SEAL OF THE UNDERSIGNED. L�_ in�TE2/Of'.�w'!C <S`lJF'E 90 OC O'CO TH£ PROPER 7Y 5h O,vN HEF?EON APc'FARS TO I IF WITN/Al ci 0n0 HAZARD ZONE_? AS SCALED FROM FLOOD INSURANCE RATE MAY �=�_1 " i FOR a rc dnirlc �EAc �.vj FLORIDA, DATED _`;:—LL_89 TRI-STATE LAND SURVEYORS, INC. 84" :�A )IvEADGWS WAY SUITE #2, JACKSONVILLE, FLORIDA 32256 (904) 737-7235 e;Etic ,' H:"REBY CERTIFY THAT THE ABOVE LANDS WERE SURVEYED UNDER MY Dawc "a` RF�:PONSIBILE SUPERVISION AND DIRECTION, THAT THERE ARE NO i°°" `4R ENCROACHMENTS EXCEPT AS SHOWN AND THAT Ti 7E SUR✓EY SHOWN `2' w'" �AP '' ''N' HEREON MEETS THE MINIMUM TECHNICAL STANDAR05 LET F-0 77-I BY purr '?�£ FLORIDA BOARD OF LAND SURVEYORS FURSUANr Ti.) .SECTION or#4 ase " 47'.027, FLORIDA STATUTES. t xass z- ar- fASY]/O LA;?RY v. FOV"" F.L.S. No. 4144 ov aw�tr Af-(A SCALE: 'C AR REGISTERED S_JE YO,:, ST,< T�E OF FLORIDA RADIA, J,G'A'Y 3A TE: / - ,] < w %� ( MY OF JULANFI C PEACH ODL E VI01ATION FOR4 /dv& Da t' Ad ess and/or'•.Location of Violation' OONIE'umn 1,ozeeetz Owner and/or Tenant of Proper J OF 0��]?7�AINAN 2C��' �� Mmej ADDRESS l/ ------------------------------------`------------------------------------------- Date of Investigation Investigator Conditions Found Action Taken Cmpliance OP r , CITY OF 716 OCEAN BOULEVARD P.0.BOX 25 ATLANTIC BEACH,FLORIDA 32233 TELEPHONE(904)249-2395 June 26, 1989 Marius Johansen 197 Seminole Rd. Atlantic Bch. , F1. 32233 RE: 170604- Lots 625 + 626, Salt Air Sec. 1, Atlavitic Beach, Florida Dear Mr. Johansen, We have determined that the above property is in violation of Ordinance No. 55-82-19 in that weeds, grasses, or other deleterious, unhealthful growth is exceeding a height of twelve inches. The ordinance stipulates that upon the failure, neglect, or refusal of an owner to cut and remove weeds, grasses, growth, etc. , the city is authorized to cut the growth and pass on all costs, plus a charge equal to 100% of such costs to cover city administrative expenses. Your property will be inspected for compliance in seven days from the date hereof. You are respectfully advised that we are not obligated to provide written notice each time the property is in violation of Ordinance No. 55-82-19. We are however, writing this letter as a courtesy and ask that you take immediate corrective action and continue to maintain your property on a regular basis. Do not leave the debris for the City to pick up. You or your contractor must haul it away. Thank you for your ation. Sincer y, Ww CITY OF ATLANTIC BEACH CODE ENFORCEMENT OFFICER CC,. City Manager .� ._ . .�---- . . .� ........MAP SHOWING BOUNDARY SURVEY OF LOT 61;0 BLOCK . AS SHOWN ON MAF' OF ✓A/o A3, T HOOK / PAGES _____ of INE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA �E�R r r ` ,. �: . , < ;.;. + �5 ��L��!-s77��r��r� :`N�00h' --5 Y�.r 71��+C��Yi �I TEjS p4?I T/TGA G�f C t SDh f c �- x:07_ ��/C�• - � --- __.._ w v `sI /0O . 00 �l ' • /90 b� V, O ONE STORY 0 t^ STo.•/E J.z' • � i • � �— - - � fir, h ^ T VALID iJ.z'iL EMf30SSED iNTH SEAL OF THE UNDERSIGNED. Cc_ �TE2/p2�J,v��C_ES�IlPE 90�00'pC� " THE PROPER'Y SHOWN HEI?EON AP"FARS Tn 11F WI7i4IN n00 HAZARD ZONE- AS SCALED FROM FLOOD INSURANCE RATE MAP_'c___>!FOR arc4Nrlf �EAcNj FLORIDA, DATED L7 =0�9 TRI-STATE LAND SURVEYORS, INC. 6Y' ' 3,4 YMEAD6 WS WA Y SUI TE #2, JACKSONVILLE, FL ORIDA 32256 (904) 731-72,35 LE:EtrC rl REBY CERTIFY THAT THE ABOVE LANDS WERE SURVEYED UNDER MY ' ""'r_ """ RE`.PONSIBILE SUPERVISION AND DIRECTION, THAT THERE ARE NO 1Rq" ENCROACHMENTS EXCEPT AS SHOWN AND THAT Ti 7c SUR�Ey SHOWN N SAP f '' HEREON MEETS THE MINIMUM TECHNICAL STANDAR05 'ET F OH T?-I BY w.cc 11lE FLORIDA BOARD OF LAND SURVEYORS PUi1SU,4Nr TO ScCnCN "POh COR. "A'"- 47'.027, FLORIDA STATUTES. t atoss a'- 2J7 EA5J300.7 LARRY u. f,001', F.L.S. No. 4144 ,b wan-Gtr-PA` V awo•er ,wc. 'C AR CON,>'[>41,G PA.: REGISTERED J.I,j YO ST,vTE OF FLORIDA RApAa s ti `x OA TT: �✓' q �. ;, xr+cRr;t } i APPLICATION FOR FENCE PERMIT \ rn Ovnera Job Address_1�.�_ _�2��t�A.L�s�,. 'S \`_ J A-r1�-l==--------- Lot_(.CLj v _Block and/or Unit •............Subdivision \�o� j�-'�i�l� 1 -,.------- - -y 1L- -- _ Contractor if different from owner ,_________ l ------------------------------------------------------------------ valuation of fence •____________ Corner or interior lot -�r .uC. Type construction_—, Q,�--------t= %erg ----- Shov location and height of fence as well as location of streetls). t Owner signature -- ___ j-.- -- DatelS_V,% Contractor signature_/�,----------------------------Date Wl- 7777-7 --__-_-- DEPARTMENT OF BUILDING n n 36 CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO.- '7 'T PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date 8/6 19 80 Valuation$.tel umb ing— Fee$ 11 -00 This permit not valid until above fee has been paid to City Treasurer, and is subject to revocation for violation of applicable provisions of Lw. This is to certify that R & G Pl inching Co. has permission to install 1cink,2 lavatnrieA,2 bath tubs,2 closets. I water heater,l, dishwasher,l disposal,l washing machine Classificatio++ Residential Owned by Lewis Taylor Lot 640 Block S/D__ Salt Air House No 190 Magnolia Street According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS ,1 AFTER DATE OF ISSUE x A11. ► 0 Building material, rubbish and debris from this work const not be placed in public space, and must be cleared up and hadled away by either contractor or owner. d1 .J� Tl. Till M. Davis I i e tWC(T O .. Ilnl FOR OFFICE PERMIT USE ONLY NUMBER DATE CON�1Q> NIOR V ' '� ` . I PLUMBING — ELECTRICAL SEWER WATER .. ,dwIIM,.. r t CITY OF ATLANTIC BEACH 716 OCEAN BOULEVARD ATLANTIC BEACH, FLORIDA ADDENDUM TO BUILDING PLAN 1. Building location.- 2. ocations2. The attached plan building is approved subject to meeting the following applicable const Its; a. Footings �j, '41ic concrete under exterior walls, reinforced with two 1` $rIl 's for one-story buildings and three 5/8" defornr $$�►Z `'�►� `)uildings. Reinforcing rods shall be place �►l,� -is, properly placed and fastened on. • inches wider on each side than the vra $4ir and shall rest on firm soil at b to tr + o f .it cell shall be reinforced with at r'ft��App",r ��?r ,� p Bald And tamed with concrete; such rein- lp�r� ooting and spandral beam. ® �rh►,� �r con) , shall be securely fastened to the '�Mtyn►� �j'c1j te anchors or clips. ,d0 d 'yy►�r°� dwellings, which are duplicates or intensely similarity considers the external configuration sof, -er wall materials, window size and design, and ics) structures. in accord with the foregoing, similar or , 11 nC . be constructed within close proximity of each other, and si. . 500 _eet apart if any one similar dwelling is visible from any othei ellir 3. e. The final conn, _on between the house plumbing and the ewer service connection (at tLie property line) must be ted by ty >efo 'being covered. ty g The undersigned hereby certifies that he has read the above and understands that this addendum takes precedence over any contrary details to the plans and specifications and agrees to carply with the intent of this addendum. for/Owner Date CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT SATE PLUMBING MRSTER PLUMBER C.IT/COUbF,'" OCCUPATIONAL LICENSE NO� ��� /7P j:0P"o 3TA'l'E CERTIFICATE NO. BUILDER OR 0012 TRACTOR d a1:P2 OF BUILnXNG Rto(,j SHOWERS VA` ORY r- GRATER ]EATERS , MTH TUBS ! DISMRSHERS - �- URINAIAS s -DISPOSALS .CLOSETS WASTd L CHINE FLOOR DRA INS L OTA f NSrALjATj0K OF PLUMBING AND F URF,* MOST BE 124 ACCORDANCE WITH THE MOST RECENT it YON OF Tree SOUTHERN 6TANDARD PLUNB114G CODE.� FOR OFFICE USE ONLY Date..../l'"s /f�..............19D CITY OF ATLANTIC BEACH Permit Valuation ................. FLORIDA House #....1 ,� - =........� -�&4A............... APPLICATION FOR BUILDING PERMIT �1 '. 9.1�0�_____ : Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach,Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can be verified. Date........... 7= j�.....--•........................................ 19. �... Owner.(��-1-•(-•-S• ....... ----..-•----•-----.-Address............................................................Telephone No............................. Architect-- .. ........--•.......................Address Telephone No............................. 1 ..........................Address./-`J -,&1 .13J.Y-.�. ......................Telephone Contractor Builder_/el�d/d,� l -•--, Lot No.-__ln-��...................................Block No--------------------------------Sub Division:f.ZT17!_�......................................................Zone................. ........................Street......W------.........SideBetween .................................and......................................................Sta. Valuation $ -7._Q!1 .........For what purpose will building be used....,'��..S........................Type of constructionZcc2' '!.(` ............... Dimensions of Building._.3.�)(A----------Dimensions of Lot......��„Xf!.&........................:Size of Footings._.Y.. rZ.4..................... Size of Piers--------.:.-------------------------Size of Sill's------------------------_.....GTeatest Sill Span in ft...........................Type Roof_....T�.51_/l5..�............... How will Building be Heated?-_.clG-of---------.................................._-Will Building be on Solid or Filled Ground?..4;L/i..A............... Size of Ceiling Joists------..._\.............................. Distance on Centers............................................. Greatest Span............................................ " Size of Floor Joists...............................................Distance on Centers........... ................................. Greatest Span............................................ " Size of Rafters-----------------------------------------------------Distance on Centers........ .................................. Greatest Span............................................ " _ This rectangle is to represent the lot. x � Locate the building or buildings in the '� right position. Give distance in feet from ` all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall J U L 2 19�� be submitted with application. Inspections required. ��++'' N 1. When steel is in place and ready to pour foQXNvL QF ATLANTIC BEACH w 2. When steel is in place and ready to pour columns and/or lintel. r� 3. When steel is in place and ready to pour beam. ' ^ N 4. When framing is completed. n P r-' R 0 \! 1< D C!1Y 5. When rough plumbing is completed,and ready to cover up s 6. When septic tank drain field or sewer is laid but before it is cov d 7. Electrical inspection by City of Jacksonville. W 8. Final inspection. f Note: In case of any rejection,re-inspection MUST be called fo corrections are made. FRoNt OF LOT In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building regulations of the City of tic Be Signature of Builr/ r . . .............._....... Address... /1. / J//...-Z------------------------------ ------ Signatureof 0 er............ ....................................I................. Address.................................................................................................... CIS OF K 11 411101 w c C 6EE ACH gD. PLUMBING FIRM_ MASTER PLUMBER,� BU XDER OR CONTRAC K Cis TYPE OF _^ffi._..,. k�Xti�"HRO00, GRW CONSISTING OF SHOWER STA k,.3, iJ6sMES d I C jG €n u tea MTER CLOSE1 LAVATORY & BATNTUS/o.00 whom (WITH oR WIT"CU's. OVER HEAS SPOWER) (2e,ir lts) .. ,...=UR w.Of�S BTMK (3 units) _.._., BIDET (3 units) _. FLUSHING Rtfd SIlIK (Sullitst _..._ COMBINATION SINK AND TRAY (3 units) . SERVICE SYNK TRAP STAN? (3 t of ts) COMBINATION SINN AND TRAM' WJFGOD 01S. POT, SUl ERV SINK (4 wits) 0, units) DENTAL UNIT OR CUSPIDOR ;I wilt") _ .. ,BLOtM T (8 units-) -_-_—DENTAL LAVATORY (I. unit) . 1JRIE.AL. WAL). LIP (4 writs) EOt;hTP IN (4 emit) JRINAL STALL, WASHOUt' (4 wilts) DISHWASHER (2 snits i ao-°° URINAL TROUGH EACH ?-FT. SE.rTXON vnits —FLOOR DRJdNy (I aria) ) ._..`,.�i,�SRiNO P�iC14IP�aE: RES. 1arrri'�s�.�0 .Dd WASH SINK 0CH SET € F FAUCIE7 KITCHEN SINK "WIFOC'D WASTE GRINDER -2 UAIts .._w.�(3 Barriis LAVATORY (I unit) CATER CLOSETS, TANK OP (4 units) WATER CLOSETS, VALVE OP (8 units) LAVATORY, BARBER, BEAUTY PARLOR .�.' _...... ,._(2 UnI is) LAUNDRY TRAY t2 unit.,) .jX�ATORV, SURCEONOS (2 units) j DEP.AkRTN ENT OF BUILDING 4424 CITY OF'ATLAINTIC BEACH,FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date _July 28 19JOL Valuation$ 41.594.96 Fee$ 115.48 This permit not valid until above fee has been paid to City Treasurer, and Is •abject to revocation for violation of applicable provisions of law. This is to certify that Lewis Taylor has permission to build a single fami4 dwelling accordira to Rills submitted. Clasaifieatio*t res i d nt i a l 7++ne Owned by Lawis Taylor Lot 640 Block SSD Salt Air House No 190 Maziolia Street According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIR MONTHS AFTER DATE OF ISSUE ^� ► 0 Building material, rubbish and debris Z from this work mast not be placed in � public space, and must be cleared up and hauled away by either tr or owner. __T1"* $ � DaiS iY�O►f6�a i �, t3 a J Bafl ?3 !/fi,' /5 ' 1011 FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER " ntIwIA!, l CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD :u ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00029413 Date 12/17/04 Property Address . . . . . . 190 MAGNOLIA ST Tenant nbr, name . . . . . . 10 FIXTURES Application description . . . PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ----------------------- MOORE, WILLIAM WILLIAM B & G PLUMBING 190 MAGNOLIA STREET 13997 BEACH BOULEVARD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224 (904) 484-4209 (904) 223-3585 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 105 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 105 . 00 105 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 105 . 00 105 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. '�) . e r BUILDING OFFICIAL CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION Date: z 17 0 41 Property Address: no t^i raCti o it, s Owner: Ngoa W-g Telephone#: yep- X1,20�j Contractor: &F4 r4Lv s,H dro-2 C ca. Telephone#: 2-A.7 .7f-Ff Contractor Address: /3997 6640-14 0CVV 'Fax#: 22-?- I 730 In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: If other construction is being done on this building or site, p list the building permit number: Re-Pipe Number of Fixtures: I Bath Tubs _ Showers. Closets Shower Pans Dishwashers Sinks Disposals Urinals Floor Drains �_ Washing Machine _ Lavatory Water Sewer l Water Heaters a Other k6 St Q` ✓�►3S Fees Permit Issuing Fee: $35.00 Total Fixtures: � _ X$7.00 + $35.00= (®t ,00 800 Seminole Road.Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5800. Fax: (904) 247-5845. http://Www.cl.atlantic-beach.fl.us CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-dept(d),coab.us Application Number . . . . . 07-00001356 Date 9/28/07 Property Address . . . . . . 190 MAGNOLIA ST Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4600 --------- ----- -------- -- ------------------------- --- -- --- - ---- - -- --- -- ------ Application desc re roof fl 250 . 6 ------------------------------------------------------ ---- --------- --------- Owner Contractor ------------------------ --------- --------------- MOORE, WILLIAM AA ROFFING JOHN GRAHAM 5310 CRESTAWAY ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211 (904) 591-3219 ------------------ ----------------- ----- ------- --- ------------- ----- -------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 55 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 4600 Expiration Date . . 3/26/08 ------------------------- --------------------------------- ------------------ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- -- -------- ---------- Permit Fee Total 55 . 00 55 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 55 . 00 55 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. err CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 O7_ l • r r) OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILDING-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY ,.. i. FTe NtlEftt� =,.,, l Cl C) M ��{ tA 3 z UPJ 4 LES t[3ESf`Ft .' ❑NEW BUILDING ❑DEMOLITION 1KRESIDENTIAL r: 1-4� BD LOCK_SUB DIVISION �I� �• ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL Y)ESGRII 1 1V `..� ❑ALTERATION 11 ACCESSORY BLDG."u A' .IlEREPAIR OL/SPA �YES ^SE 1 ❑1N/„A ON © ❑MOVE OOTHER + , e,-12 C/j- ❑NO F^ "',P - «" xtib IEu.Y, 4 tr „ « a r;.«µ ;Its', ANTRA TAR.n(al°6 i ,«7i��F� ', HITEC TEROINEER. 7777777 �..�2 ,,.� I� ° 77 777 9.NAME: 15 COMPANY NAME: 23.COMPANY NAME: /rtf R0 111G Q;, Al c7k i H rL. xc' e 16.NAME: 24.LICENSEE NAME: t P Jr,lid tJ-&AA11AM 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: mrr��t4c1'4. �-� CCc- 1'3 z L�q7 lA-0 pN AzL,- I-( -.3Z-Z-3-3 18.ADDRESS: 26.ADDRESS: 510 C RC-5 T-A wAV 3 zZij 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 13.CELL PHONE:K/-A-AC 21.CELL PHONE, 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: (T12'4ri'f/r/'TLe17C CZI Cam e4,i7i N97, � BPP' 3 (� „ Ifli tiT, d@�� �n�� r a ,�. w ,.ai �•: a ii @,"_. ds k" ��i�is.a^:i[ 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I 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. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. * WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. iayG xg; .° F 6 l,. e tr �-= 9'n �. p, �N ,.,. n ,..a� Signed. M.' ti � -rt Date: � Signed: Date: Before me this day ofVrtFA ,2007 in the county of Before me this day of 2007 in the county of Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared herin b< imself herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are true and accurate. 1, true and accurate. Note Public at Large,State ofRA `��L' ,County of DL0A� Notary Public at Large,State of County of LYPersonally Known ❑Personally Known ❑Produced Identification- df, OW ❑Produced Identification- Notary Signature: Notary Signature: I of HA AMG MMrfrP�Me->II�Md�NAilu c1�Er�IMtMr17, COAB FORM BLDG01:REVISED:8/2/2007 � ' t Ci � /\ O ?3dd17 t � � ;x r 'inn N3. QNv SG33A 'T'7I M 'NO I 90T0000 TO G3AIOS3V i ----------- wow "I ON 3 .I. < y. M iF . 41 OXPARTMENT aF 6UILDINQ CITY OF ATLAIVTIC,`$ AI:. SIT INFO LOC7ATION -IN PORMA *IO 9' A dr 4 MAGNOLIA $TRLl ' PENCE ait l�; ISI W ATLANTIC pxBBACH '� W � CT 22c RAMt ILSCRIPTION + � A ILf44 0O ' cckr Section: I': s led VajuoxSubdiv -,t «.' SAL"TAIR SECTION N ,`Ya• 71 4 Cost , + rii c x / /X14 No LANs 1 »•. rXES ullOOR Ad P �I`I' _ . . $10 .04 ACII, F i�C I DA u, ''RATL IMPACT FEE $0,,00 fl IMP INOTA OSI >Ri NER _ tI41?Oi ABC Ad�> t CA +ITAT, IMP tC B S .60 00 .„ _ 1iCt5NNTIO Std.t 4p A 1 BSC IMPACT , c � _ �4� 0 COQ' . t`RCNflE .44 BCH. '� 44 r e IOtt i 1 IMQfiiCE�-ALL Ct'3NeRETE FPRMS AND FOOTINGS MUST8E INSPECTED BEFOR IE I POURING' # Pf;RMIT 1lOID=SIX MONTHS AFTER DATE Ot=ISSUE BUlttlNf ;MATERIAL,RUBBISH AND DEBRIS FROM THIS WORB PLA LLEAI UP AND•HAUL fD AWAY 8Y El THER K MUST NOT CONRACTQR OR OWNER IN I.N PUBLIC SPACE,AND MUST BE z URIE T COMPLY WIT14MECHANICS aC)PERTY © /NERr4Yl� TWLGE Qin ' EN LAIN GAN RESULT I�1 � ` l tLOIN � R#LOVEMENT3.°= 4SSUED""ACCORDING TO APP 3laLATI©N t>F ROVEDVISI PLANS WHICH ARE PART Uf TFIIS PERMIT AND;SUBJECT T4 REVOCATION FOR _ Lf RRijV{MOMS# F C.AYI 'AILANT , IC'REAGH PART paw 6111 �1 R R. 1§ R;iso.^ 1764 V �I,. r .'>A,. ,.^r „ `'_'' v r ff i e. " t £,•.' 4_ 111