bath remodel 2012 555 Selva Lakes Cir r pr r✓�x
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000132 Date 2/01/12
Property Address . . . . . . 555 SELVA LAKES CIR
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
bath remodel
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Owner Contractor
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CLAYTON THEODORE ET AL FISETTE CONSTRUCTION & REMODEL
555 SEVLA LAKES CIR. 2336 PINE ISLAND COURT
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224
(904) 992-4782
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Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . .
Permit Fee . . . . . 00 Plan Check Fee . 00
Issue Date . . . . 2/01/12 Valuation . . . . 0
Expiration Date . . 7/30/12
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total . 00 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total . 00 . 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: ��j ryjV0,La&_L-)r• fel(Iy`i, p"c4� _Permit Number: /.2 —0®9Z
Legal Description s� i r751f alreel#
Floor Area o q. t. q.
Valuation of Work q,00, V1 Proposed Work heated/cooled_ non-heated/cooledi
D
Class of Work(circle one): New Addition AlterationRepair Move Demolition pool/spa window/door
Useofexisting/pro osed structures) circle one): Commercial Residentia
If an existing structure,is afire sprin er system installed?(Circle one): es o N/A
Florida Product Approval# F►row} Dbsr (oly2,4 12Qny FL.(otg2,q
For multiple products use prodapprove ori f I b
uct
Describe in detail the type of work to be performed: wa-('. ���j'AbiH�,tS17N 1�?.Ytib�a�,
t)k'y-rte. y.
Property Owner Information:
Name: Address: Y'•
Cityd„ State Zip —
Phone Cqgq) 9--3:5Z7
E-Mail or Fax#(Optional) �
Contractor Information: /
Company Name: - Qualifying Agent: /
Address: City v�� StateZip 3ZZ _
Office Phone a� ZyL 03t�4I Job Site/Contact
State Certification/Registration# 1�51113 11
D FOR CODE C-MVILAP!11 ie.
t 'a.
Architect Name&Phone#
Engineer's Name&Phone# 0 Crry OF AltAN 111C BEMHt
Fee Simple Title Holder Name Ad Address SEE FERMI I'S FOR ADDMONAL
Bonding Company Name and Address
Mortgage Lender Name and Address {
Application is hereby made to obtain a permit to do the work and insta S1R71tidrr' , >rtt t no'wor ar std e
issuance of a permit and that all work will be per ormed to meet the standards of all laws regulating construction in this jurisdiction. This per comes
and void tf work is not commenced within six(6f months, or if construction or work is suspended or abandoned jot aperiod ojsix 16)months
work is commenced. /understand that separate permits must be secured for ElecMcal Wo►k,P/umbing,Slgns, Wells,Pools, l�_urnaces,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF ''Y
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVE "
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/have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type p work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal.state, or local law regulating construction or the performance of construction.
Signature of Owner ignature of Contr or
Print Name Print Name `
ra. ......G- � r... ............................................................... �.. ............1. ........
Sworn tgand subscri ed before me Sworn to and subsuibed before me
this�Day of 120 12, this a k4 Day of J 20 1 w�
Notary u lic ota Pu c a• " �,•,, WENDY FUCHS
NopuyRiAtec. oiFlotlds ry P Notary Public-State of Florida
CommissionO EMM -ii m
M Com.Expires Dec 8,2014
�, r 1"ir0�d0Q1r 1146 At"
My comm.expires May 2s,xols ��,•
.. • ,•,,'� Bonded Through National Notary Assn.