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Permit Siding & Repairs 33 Lewis 2011 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 11-00002936 Date 11/30/11 Property Address . . . . . . 33 LEWIS ST Application type description RESIDENTIAL OTHER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 929 ------------------------------------------------------------------------ Application desc siding, window and door repair --------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HILL, LINDA FAYE BEACHES HABITAT 1671 FRANCIS AVENUE ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241-1222 ------------------------------------------------------------------------ Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50 Issue Date . . . . Valuation . . . . 929 Expiration Date . . 5/28/12 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONAL ELECTRIC 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 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. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 3 3 �` eli'is �7'�e�?" /�T,�aH1`r� 1e/lcA. Permit Number: Legal Description Parcel# Floor Area o q. t. q. t Valuation of Work S 9"�S. �O 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 structures)(circle one):. Commercial esidential If an existing structure,is a fire sprinkler system installed? (Circle one): es o N/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: Reltac-e RoTTe-o T-lt/ ��t�r�, p`�l'��Q•t-•�A}i1►7- hrGNT' 1�06G� ^ ��/�A�R I��RI.I/nJc Wi►+ OGt,�s /+t5 pec>/9eO- Property Owner Information: Name: L 1) • /-/t 1/ Address: City 047-J_,4H),('c Q3oAch State�LZip_323 Phone 8 7,2 9- 94�� E-Mail or Fax# (Optional) Contractor Information: Company Name: 13PAc)ei 1=-2 119,*, H, t Qualifying Agent: , p),,4e 906-01 Address: 14YI -i,ANti p e Citv gP,4-eti State l� Zip32233 Office Phone q f•,2y/ / - Job Site/Co mer r A'A M•. .. State Certification/Registration# 5F� M Architect Name &Phone# t +' Engineer's Name &Phone# Fee Simple Title Holder Name and Address REQUIREMENTS Bonding Company Name and Address Mortgage Lender Name and Address BY: . -I3- Application is hereby made to obtain a permit to do the work and installations as indicated. certify that no w(r or ins s co n r the issuance of a permit and that all work wall be performed to meet the standards of al[laws regulating construction in this jurisdiction. This]7 mme 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)mock alma•a,}i'er work is commenced. I understand that separate permits must be secured for Electrica Work,Plumbing,Signs, Wells, Pools, urnaclstoBoilet4Ys, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE 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 hereb certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions o,f laws and ordinances governing this type of work will be complied with whether sped aid herein or not. The granting of a permit does not presume to gave authority to violate or cancel the provisions of any other federal,state, or local law regulating construction or the performance of construction. r Signature of Owner dam- Signature of Contractor Print Name `-i.f11Sa........ .!....I.... .................................................................... Print Name 41..R...M!.c. I1.......... ....................................... Sworn to and subscribed beforg me Sworn to and subscribed before me this; �Day of No e-m ►J' e p_ 201 1 this;? N Day of N D UG+»bieP_ 20 1 of ry Public �'_ Notary Public-State of Florida to ublic � JOYCE M FREEMAN ,ti'Ry Pu4 y "My Comm.Expires Jun 10,2013 e�;. J Y MAN % �o���.•°�+ Commission#a DD 897794 I�' "° elYdF�fi � of Florida ®y0-° My Comm.Expires Jun 10,2013 ''o,' oFf�d;` Commission#t DD 897794 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) SS 800 Seminole Road Atlantic Beach, Florida 32233-5445 ` •l Phone(904)247-5826 • Fax(904) 247-5845 E-mail: building-dept@coab.us Date routed: Z City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: � Lo/_5 'X� ent review required Yes No Building Applicant: a/ _f 7_517 ng &Zoning Tree Administrator Project: Public— !t_/�/V Leo(,c� Public Works Public Utilities y Public Safety Fire Services Review fee $ Dept Signature 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: BUILDIN PLANNING &ZONING Reviewed by: Date:_'&:,2 Of 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