Permit Siding 1743 Ocean Grove 2012 A . CITY OF ATLANTIC BEACH
4
�
e� 800 SEMINOLE ROAD
,.? :,. ATLANTIC BEACH, FL 32233
� �' INSPECTION PHONE LINE 247 -5814
Application Number . . . . . 12- 00000063 Date 1/23/12
Property Address 1743 OCEAN GROVE DR
Application type description SIDING PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 2499
Application desc
siding
Owner Contractor
POWERS, DEBRA SIDING INDUSTRIES OF N FL
1743 OCEAN GROVE DRIVE P 0 BOX 840292
ATLANTIC BEACH FL 32233 201 BASQUE ROAD
ST.AUGUSTINE FL 32080
(904) 460 -9367
Permit SIDING PERMIT
Additional desc .
Permit Fee . . . 65.00 Plan Check Fee . . 32.50
Issue Date . . . Valuation . . . . 2499
Expiration Date . 7/21/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 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 65.00 65.00 .00 .00
Plan Check Total 32.50 32.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 101.50 101.50 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION ,— L. CITY OF ATLANTIC BEACH L7 (III 800 Seminole Road, Atlantic Beach, FL 32233 I L fr n
Office (904) 247 -5826 Fax (904) 247 -5845 JAN 7 2012
K C�
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Y
Job Address: ( '7 Li 3 G� f ck' Cam. CC,V C' C. /
C Permit Number - G� orb c.3 c: CC / vw r /Vc�
Legal Description l C �% S Z L Parcel # P Co % (e C .] - CO -5
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work s - 9 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 : - 'den •
installed? an existing structure, is a fire sprinkler system nstalled? (Circle one): • es No N /A
Florida Product Approval #
For multiple products use product approval form I ,,
Describe in detail the type of work to be performed: (- 4 0, c a , ( L -c f 3 S i 6 r 'Lig - z� 4 5
Property Owner Information:
Name: S °1c°c e 4.) b t t : "—Pc: i'� Address: I'1 &/3 cc--e-A �-
_. r C ;lei * �!' ..._... ... . .. _ . .
City / Tic ire ,-i'C' State %_c. Zip 3 z z 3:3 Phone _ /C) - 9,5
E -Mail or Fax # (Optional) G. 16 -r y tvt 0 y r fi c c' . C c'-' ( COPY
Contractor Information:
Company Name: ,7 1(1 i w j ,Lit, c (4_..T f n Qualifying Agent: c� G' � �� 1 6 G E
Address: P C i3Cc y L1 - 1s Z City S", c. .cr U - , ,.�C._ State i - L Zip 3 2.6 ec
Office Phone A / 9 (e 7 - 7 Job Site/ • - • - 2C 7
State Certification/Registration # C te. C ( . ti • . . . D FOR CODE COMPLIANCE
Architect Name & Phone #
Engineer's Name & Phone # CITY OF ATLANTIC BEACH
Fee Simple Title Holder Name and Address SEE PERMITS FOR ADDITIONAL
Bonding Company Name and Address ulithMEN IS ANI) CONDITft)NS.
Mortgage Lender Name and Address _ , ,, . di 1
Illilliftliallird
Application is hereby made to obtain a permit to do the wor an. ins a i . '' . ,":7 . r-r .n 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, urnaces, 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
d
type of work will be complied with whether specified herein or not. The granting of a perm does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local l regulating construction or the performance of construction.
S of Owner I (:)121/k, , 1 } . � 1 ,,, ,, 1 _ — — — — _ _ , , '
a" s., JOHN KELLEHER
Print Name Dtw,, L • Po i,C, ef, : i 4 .: Sworn t and subscrj.bed- before m l My Comm ones Mar 142ot5
.s r =; . c Commission # EE 69452
this / Day Da of /flit/(' 201 4 ' ( „gip'
Bonded Through National Notary Assn.
Notary Pub i
Signature of Contractor Amp. f
Print Name r ' . 1� t e e
Sworn/to • s e sere • ed before me
this 0 .; , of deal ; , 20/2-
b I' , 00
Notary ' 9 9 c v
Revised 01. :
:r ..p.Y. • , `` ;.., SHIRLEY L. GRAHAM
` = *• .41 •'* MY COMMISSION "0 D0 957760
`'� i0' EXPIRES: February 14, 2014
�P bonded Thru Notary Public Underwriters
„.. L r; A , City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road t' f _ ae 6 3
-a , �� ” s Atlantic Beach, Florida 32233 -5445
op Phone (904) 247 -5826 • Fax (904) 247 -5845
s } E -mail: building- dept @coab.us Date routed: / `1-
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1713- O e- , ,47? 9rt t //' 2i-- Department review required Yes o
Building
Applicant: r - )q / 4� 'iF S Plarnfing & Zoning
Tree Administrator
Project: S�nej Public Works
Public Utilities
Public Safety
Fire Services
�,:yjV A i
iI '1.
�aYfs. G;�' .. �� s t .. ''�' , ,,m, r,� > A�'r .Y ..
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: Kr? ? r Date: /— [7 2-
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