Permit Bath Remodel 1112 Fleet Landing 2012 s'1 +- .'-L�4
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s CITY OF ATLANTIC BEACH
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j 800 SEMINOLE ROAD
:J =" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
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Application Number 12- 00000307 Date 3/19/12
Property Address 1112 FLEET LANDING BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 1900
Application desc
shower conversion
Owner Contractor
NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS
RETIREMENT FOUNDATION, INC 6771 SHINDLER DR
1 FLEET LANDING BLVD JACKSONVILLE FL 32222
ATLANTIC BEACH FL 322334599 (904) 838 -9179
- -- Structure Information 000 000 SHOWER CONVERSION
Occupancy Type RESIDENTIAL
Permit RESIDENTIAL ALT /OTHER
Additional desc .
Permit Fee . . . 60.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 1900
Expiration Date . 9/15/12
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 .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 64.00 64.00 .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: Ina a rfee La icliv ka Permit Number:
U
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ f'`j 01) Proposed Work heated /cooled non- heated /cooled
Class of Work (circle one): New Addition lterati• Repair Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial s' e 'al
If an existing structure, is a fire sprinkler system installed? (Circle one): o N /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: Q' . sL h (»— /�-Q� pal
kplue / girl ., -- 1( i 42, �..c.4 .
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 FL Zip 32222
Office Phone 904 - 838 -9179 Job Site/ Contact Number 904 - 838 -9179 Fax # 904 - 838 -9179
State Certification /Registration # CGC1518918
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation 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. 1 understand that separate permits must be secured for Electrical !fork, Plumbing, Signs, Wells, Pools, Furnaces, 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
type of work will be complied with whether spe i ied 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, r local la regulating construction or the performance of construction.
Signature of Owner j , dr Signature of Contracto
Print Name Joshua Hatfield Print Name Joshua M. gan
Swore to and subscribed - before me Sworn to and subscribed, before me
this f Day of MN ff�� , 20 12-- this l Day of h'l:rz , 20 it-
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otary P;blic I ,.,,X∎ pG ' • 1 tale a' A ..LtZAB H •
?a �� •,, Notary Public State of Florida ' Notary Public - State of Florid
4 -. • My Comm. Expires Apr 5, 2013 , • , My Comm. Expires Apr $U8ia 01.26.10
l =;". ' �" Commission 0 OD 867829 I s. • ,' o� Commission # DO 867829
I a ° Bonded Through National Notary Assn. . , ,` „�' `, : , B onde d Through National Notary Assn.
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