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Permit Glass block window 107 Fleet Landing 2012 iea t r „K \1 CITY OF ATLANTIC BEACH ;. j 800 SEMINOLE ROAD j AI, - , , , s ATLANTIC BEACH, FL 32233 '3 F, INSPECTION PHONE LINE 247 -5814 Application Number 12- 00000097 Date 1/26/12 Property Address 107 FLEET LANDING BLVD Application type description WINDOW AND /OR DOOR Property Zoning TO BE UPDATED Application valuation . . . 1500 Application desc add glass block window at shower Owner Contractor NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 1 FLEET LANDING BLVD 6771 SHINDLER DR ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222 (904) 838 -9179 Permit WINDOW AND /OR DOOR PERMIT Additional desc . Permit Fee . . . 60.00 Plan Check Fee . . 30.00 Issue Date . . . Valuation . . . . 1500 Expiration Date . 7/24/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 60.00 60.00 .00 .00 Plan Check Total 30.00 30.00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 94.00 94.00 .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 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 4 ,.y LA,,� ' ■■ Permit Number: /2 - 97 • Legal Description Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ j ,S40 Proposed Work heated /cooled non- heated /cooled Class of Work (circle one): New Addition Alteratio Repair M Demolition pool /spa window /door Use of existing /proposed structure(s) (circle one): Commercial Residenti If an existing structure, is a fire s nkler system installed? (Circle one Y i N /A Florida Product Approval # �I' 1— a 9 5 R 2 For multiple products use product approval form Describe in detail the type of work to be performed: ac ( AS5 13/0C si,Ado i"1/4 Q shd„)fir' wl &/( ,._, Property Owner Information: Name: NCCRF Address: One Fleet Landing Blvd. City Atlantic Beach State FL Zip 32233 Phone 904 - 246 -9900 xt.150 E -Mail or Fax # (Optional) Contractor Information: Company Name: North River Builders Qualifying Agent: Joshua M. Hogan Address: 6771 Shindler Drive City Jacksonville State FL222 Office Phone 904-838-9179 Job Site/ Contact r -" ' ' ' ' ' • ' I ' ! : -' State Certification/Registration # CGC 1518918 ! �� ��� .- ��� • ��.1v � R. p * „ t � _ 1 v Architect Name & Phone # �� Engineer's Name & Phone # SEE PERMITS FOR ADDITIONAL 1, IONAL ,, Fee Simple Title Holder Name and Address _ __ _ _ _ _ Bonding Company Name and Address p ,= 1 Mortgage Lender Name and Address . Alin a _ , : Al , ; , „ _ iamb ! Application is hereby made to obtain a permit to do the work and installations as Indic.' •.. " certify rruu naw _ crit G. • " as c ;l 2 e K i.riot' ts the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction T , germ - .r. omesull and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of sax (6) '.i'``t hs at ar time ter work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnn;l , Heti rs, Tanks and Air Conditioners, etc. � =.„ . A „ '' .... ' 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. 1 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 this type of work ieill be complied with whether 'peci led herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, stat or local law regulating construction or the performance of construction. Signature of Owner 60 i .. --it Signature of Contractor "- �~ ,.t♦L/ '.:r! _ Print Name Joshua Hatfield Print Name Joshua M. Ho l Sworn to and subscribed before me Sworn to and subscribed before me this Day of , 20 this Day of , 20 — — — — a — — ./' ! ! ' LIZABETH TESKE — • 4 _ 1/ �'e'�4� �� r ", u e� ti ELIZARFTH TFSKF , ,) : - ° Not .'Publi ; +» Notar Public • State of Florida Notar j u.lic 1 : +� ;, ��•. Notary Public -State of Flori ` 1 z • « « • _ My Comm. Expires Apr 5, 2013 N« u « a My Comm. Expires Apr 5, 2013 l • "' +' �' it 3rtisi Q$72f91 0 %�+ �.�� a Commission # DO 867829 t '�''� °' Comm ' `7 ' Bonded Though National Notary Assn. l °l. .. Bonded Through National Notary Assn. 1 } � a a ', e i i Pri P. 0 R h t i .x 'r - x > ti r O ,i','.. t !a . � �s 8 l a aV 4 z !> ,, t o 5 E £ fi / f k , 1',;&4', o t i a r ' ' > — I D D D > l-) D n D m 0. (I) C 0. s - 0 1 0 0 r a ' ns o n �-, a 0 n 3 a v # z 1 -p U 3 N r i ni 7 j O O d )0 :o <� I J rn n, m c _ r� , `~ 3 c 3 c v '" rt a J c 15 O a r ,7 r. D < a » t -t _ r .e of y � ( € fl ` ? j � 3 PPPP P �� rr � s v t �.3 � N f1 kk 1 111i 1 . 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O_4 i n m .A 4 O ro (DD 01 (D N (D U 1 VI D U1 U1 , J ��NO� a�-ra%*, N c n. , 'G NJ (j) �• a o4 it, • • � 7• �NN rt ND r N O O • J 0 W H 1--1 0- = N in ('t 7 01 'A 1 Cu a �i = P 0 0 O V c O 0 et ` i O = Z D- W O � = C Ot in 3 -NN f7 ; W g N I a a (0 X X a , nr - Ai a I-.• °' °' ." o "0ral Q 1 3 * g �'0 a o, = �, a . n a 0 0 14 0 c - h 1 V a4 N m N W J • N a. o City of Atlantic Beach APPLICATION NUMBER *, Building Department (To be assigned by the Building Department.) 800 Seminole Road 2 — o D T 7 Atlantic Beach, Florida 32233 -5445 •t Phone (904) 247 -5826 • Fax (904) 247 -5845 V E -mail: building- dept @coab.us Date routed: / O� City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: / / 12ff/ /m-7n/� ent review required Yes No Building Applicant: Werth 7/17he #(5- Planning & Zoning � // 1� Tree Administrator Project: (l " D f ,4 3 �/c:' e G( !7) Public Works SM� GOa // Public Utilities Public Safety Fire Services ,;4 ® 61:1 r } x I S sad. ��p �e'^9 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: BUILDING 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 07/27/10 01 -Alt 4 f J � . CITY OF ATLANTIC BEACH .r. r) 800 SEMINOLE ROAD j - - zt' ATLANTIC BEACH, FL 32233 � . INSPECTION PHONE LINE 247 -5814 ' �J13 �3 Application Number 12- 00000097 Date 1/26/12 Property Address 107 FLEET LANDING BLVD Application type description WINDOW AND /OR DOOR Property Zoning TO BE UPDATED Application valuation . . . 1500 Application desc add glass block window at shower Owner Contractor NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 1 FLEET LANDING BLVD 6771 SHINDLER DR ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222 (904) 838 -9179 Permit W /W /O PLUMBING PERMIT Additional desc . Sub Contractor . ASHLEY PLUMBING CO INC Permit Fee . . . 152.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 7/24/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Other Fees STATE PLBG DCA SURCHARGE 2.28 STATE PLBG DBPR SURCHARGE 2.28 Fee summary Charged Paid Credited Due Permit Fee Total 152.00 152.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.56 4.56 .00 .00 Grand Total 156.56 156.56 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: 10 f L e+ i "- 6 I v , PERMIT # Z q 1 NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Z. Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory 1 Water Heater Other Fixtures Water Treating System RE -PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ❑ Lawn Sprinkler System - Number of Heads ❑ Well * * ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. ** ❑ Other f.P . •ift- Ind bar Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violatte the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name ��QQ J . 1 .6(10 I AG' Phone Number Plumbing Company 194U A./, PIRA Office Phone 9O 7Q5 I Fax g 0 4 -3999-055 Z, Co. Address: 1182,i W L7 fed City 1 State f Z - Zip 3 ZZI q , r License Holder (Print): l � L i !4 to Certification/Registration # OS — 7 lc{ Notarized Signature ;�s =�a�� --- EXPIR h' cUn ribe b- — '• I .� rd' d. of 20 :q „ � Bonded ThruNot / Notary Publ Underwriters W`� .� . ary Pub ' - / 0 7 FVd 4 rd/A 1 1.10 1 ' . - 127 ) : '"::",-;'-',,' . ' -1 ' '' .:4:,: , . -) ‘''',',.• : . - Vi4 . ;:,-, ' ,,,..., „,,,,,„ 0„, ,,,,,,,,., ,,,,., , .,,, ,,--. ,:„,,, ,,,,,,,...„„:, , „,,,,.. ,.,,, ., ,,, ,, , 4, , ,,p ',.,:, - - 2" Att. A, A' _:' _ V \,- :k /V Y f! CITY OF ATLANTIC BEACH BUILDING AND ZONING DEPARTMENT I ' I iv fm i ' • ;*, r ' / , 1 C i A .1t u _, This building has been inspected and: General Construction fl Mechanical fl Concrete and Masonry , Electrical IR' Plumbing Li Gas Piping IS NOT ACCEPTED CORRECT AS NOTED BELOW, BEFORE ANY FURTHER WORK Li / i e f ni i C i 0 NOT NEroiOVIE, nitof; rk,10'!fif(CtE Inspector: fit 9 ate:/ — f3 5 / Z.- Failure to respond to this Notice withio it) d'AyS Viflii I`C'Y'1G iJ1 ii his vioh11.3 nPipg fon to the The potifiLi of this Placard Oy its conienis shall ,. ,_;ry do,' hotic:,.