Permit Chimney Repair 869 Bonita Rd 2011 CITY OF ATLANTIC BEACH
IJ 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00002921 Date 11/21/11
Property Address . . . . . . 869 BONITA RD
Application type description RESIDENTIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 400
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Application desc
chimney repair for wood rot
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Owner Contractor
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DAVIS, MARTHA BILTRITE HOMES INCORPORATED
869 BONITA ROAD 10550 BAYMEADOWS RD UNIT 119
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32256
(904) 509-3042
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Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . .
Permit Fee . . 55 . 00 Plan Check Fee 27 . 50
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/19/12
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 55 . 00 55 . 00 . 00 . 00
Plan Check Total 27 . 50 27 . 50 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 86 . 50 86 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
01 BUILDING FERMT APPLICATION
CITY OF ATLANTIC 13EA.CH
g0U Seminoic Road, A.li�rrtic Beach, FL 37233
office (904'1247-5826 Fax (904)247-5845 NOV 1 7 2011
Address- o `' �n_e�� __(� �:--LZ3_3.__Permit Num _
Parcel#
ti Description Floor AreaOT St
cation of Work$ 6d Proposed Work heated/cooled.. _ non-heatedieooled�
of NVork(circle one): New Addition Aiteratinn fiepai ,►dove Demolition poc lspa window/door
)f existing/propiosedstructure(s) (circle one): Comr'er6al P.esidenti
existing structure, s a fire sprinkler system installed? (Circle one)' fires
da Product Approval#
multiple products use product approva„orm
!ribe in detail the tyrpe of work to he pctfarmed:_4 k!�Aa—_����-�—�---__ �
filo ` _ as C�..-►� _:..4�h
ierty Owner information;
Atlili�as.,�
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tate ?p w�� •a-Phone _---•---.- Y - _
e:_
ail o Fax#
tractor Infor atiow.
p C- G. 1 Quali , n Agent: / � i LJ�
pany Name:,^ r : state Zi
f City- � _ le�
Certification/Registration _�- � Z
)itect Name,&Phone#
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.neer's Narne&Phone 4
Simple Title Holder Name and AddressIff �E$EA£'it r.
ding Company Name acid Address
tgage Lender Name and Address
eQAri the
cation is hereby tnadE to ObtRtn Q eTletn tt tG
dc
i1tE tvtlrk C✓td 5 � � �� LTIT !7W7;"if"til�ricrlii`%ent:• rFi: �rmit GBco d tSilll
ntnv�r it and that all w w r!be pet'r4rtned to YleSI 117 a ..A...,d�.•,n inr r_ a 'r .::b 'tS ti d�Qet'
�+ b'f�rli�!!I�I�Jf 1A1J1l118, LR 1111%rui ..nisi i
:bl(�?'work is nut vutmence 'l!trrj�n :s, r�tr �{ �++! PI”,
is commenced. (undersllnd that saprarate.perrras nttct be s--,-w•' or eet c
:s and Air Conaudoners,eir. i
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"OMM NCriY M Y* iSi J iJ i`1 iT�'�I)iJ 3' J1� F�"�4 A! �..`+.� 3:� 1 f^
r0 YOVR PROPERTY. IF YOU .
YOUR LENDER OR ,AN A TTOR�1E�' B�P� �"O�Ii�C� W , NOTICE _
CO_rv'kJ�i
d 4notu the same f0be trite andcorrect,t. .alil prcvision.:Of laws and ordini:nc-es lover fling-this
eb cerrl,�.-that 1 have read and examined this
piic.uti;rt an to
give ai:?zor.'n':o ;o%,-te or arc�l the
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o�l4prk_witl be camplted with K�hethsr st+ecl ted lterei'7 ur +•tot. 73�e 'r�r!irt�et a permit dims not Tiresu;rt
�islons of any other federal,state, or cocal faw regvia Lrig Corseruc.tcrt art•a
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gq�rJed l hru NolarYPublicUnderwriters IOM1I i DD 98775(}ebruary 14,2014
$4; ary Public Underwriters_ ^-0 _ �. _
City of Atlantic Beach APPLICATION NUMBE
(To be assigned by the Building D;P1
ment.)
Js r s� Building Department /�_ 9 a
800 Seminole Road
=r Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 Date routed: f
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: fC' / ���'�-' �0u D ment review required Ye No
p Building
C6 ]� annmg &Zoning
Applicant: 17'r n
Tree Administrator
-7nh l 60 Public Works
Project: Public Utilities
�—
Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required 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: QApproved. ❑Denied.
(Circle one. Comments:
BUILDI
PLANNING &ZONING Reviewed by: Date:
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 05/14/09