Permit Siding 190 Magnolia 2012 ( -- 4 ...,,,t
e At -'' CITY OF ATLANTIC BEACH
h s) 800 SEMINOLE ROAD
--4 ATLANTIC BEACH, FL 32233
� N ` INSPECTION PHONE LINE 247 -5814
. ` . ----0111 1)
Application Number 12- 00000147 Date 2/10/12
Property Address 190 MAGNOLIA ST
Application type description SIDING PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 2100
Application desc
replace siding
Owner Contractor
MOORE, WILLIAM OWNER
ATLANTIC BEACH FL 32233
Permit SIDING PERMIT
Additional desc .
Permit Fee . . 65.00 Plan Check Fee . . 32.50
Issue Date . . . Valuation . . . . 2100
Expiration Date . 8/08/12
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
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: i C ID i4C Q0b/ S +• Permit Number: /c ^ d /Y7
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ Z I t a° Proposed Work heated/cooled N' es- non- heated/cooled N (4--
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing/proposed installed? (circle one): Commercial 4' esidential ~
i
If an existing structure, is a fire sprinkler system nstalled? (Circle one): ' s 141 N /A
Florida Product Approval #
For multiple products use product approval form _
Describe in detail the type of work to be performed: , ove — P� L4 t ,,,/ � - .0h' f tb
`rill .SiD ,
Property Owner Information: s>, :t1 .
Name: 5#4q1)6 +184 ad Address: / i+► I/ . � `
City 1+ia lg I C e � C State P /Zip ,3 ZZ 33 Phone = �r1 I1 dill dr V 1
E -Mail or Fax # (Optional) -,, .,
C ontractor Information: /� triffe.r.... 4 _ 3 = L>
Company Name: C ' n�TCZE LL ( ONIS`TKUalai ' TAW-Qualifying A ent: "r te
P : a 14 0 1 City f� 04 i c_ Be- State F/ Zip 3 2. Z 33
Address: 0 • o f_ c Bii. h'
Office Phone ..S"W5 — / (/ 2- : Job Site/ Contact l • ....L. 3, , - , C I'... - & ' ` _ ;' 45
State Certification/Registration # C. _ 0 • ZS i i! nt I 1 ni t. 1, 1 ii " _ - ! _ e .. t
Architect Name & Phone # Al •�,�: ;�.
A. L'�
Engineer's Name & Phone # n1 fl` 1 - • PERMITS FOR ADDITIONAL
Fee Simple Title Holder Name and Address til ._ _ . . S o
: �►
Bonding Company Name and Address A/ ( , , 1 .
Mortgage Lender Name and Address l i t w. t i :�
Application is hereby made to obtain a permit to do the work and installations as i ' icate • . certi t at no wor or tnsta a ton • _ 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 work void if ommenced. I understand within
hat separate permits or must is
st be secured for Electrical Work, , or Signns, a W Po Fu B time alers,
Tanks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
T • a ' PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
1 • y r. � -' ATTORNEY BEFORE RECORDING YOUR NOTICE OF
Mary Public, stateotAodtl COMMENCEMENT.
Commission# 08
I here erti j th • M how • , • , , M R 'cited is application and know the same to be true and correct. All provisions of laws and ordinances governing this
type o ��. 'rwt '• e liU :'. herein or not. The granting of a permit does The presume to give authority to violate or cancel the
provisions of any other federa ss7 e;"Tirtot al • regulating construction or the performance of construction.
Owner Signature of Contractor Roo l re /
Signature of O 0
Print Name 5■„,p L \s,c� Print Name 144A-fl.14...r. C' &r£a
Sworn to and subscribed before me Swora N and subsc ibe4 before • me
this b Day o F�bv v ar 20 la this `l Day o GYM ' • ■ '
i � / DONNA L BARTLE
�_��_ / W : ,; �, COMMISSION 1 DD 853524 I
TORRES� No t ary Public ��� '
Notary Public No Public, '
StateotFiOno. I e . 1
� �; Commission# gp827P '
MY Comm. eYnirm ,+,.,
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
A' 800 Seminole Road 2 - d 7
Atlantic Beach, Florida 32233 -5445
Phone (904) 247 5826 Fax (904) 247 -5845 /
v).> E-mail: building- dept @coab.us Date routed: /
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Addr ss: /9e 2 a D/ A Xr ic .4ent review required Yes/ No
� Builds 1/ Applicant: /,�1 // & 1( e' -7,,Y) l anning &Zoning
Tree Administrator
Project: � 7�c� J7p_, P ublic Works
� Public Utilities
Public Safety
Fire Services
R ,� �k� ��' � � i,x� per¢ ���;,'� �� rJu' ��; + ��
e ie . ` �.� ..� ��la 0,60 to 1 1
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: QApproved. ['Denied.
(Circle one.) Comments:
(BUILDING
PLANNING & ZONING Reviewed by: /V7 Date: 7
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