1767 W Park Ter (vault) P CITY OF ATLANTIC BEACH
800 SENIINOLE ROAD
ATLANTIC BEACH,FL 32233
SrJ
INSPECTION PHONE LINE 247-5826
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Application Number . . . . . 06-00033284 Date 7/28/06
Property Address . . . . . . 1767 W PARK TER
Tenant nbr, name . . . . . . INTERIOR REMODEL
Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 18700
Owner Contractor
------------------------ ------------------------
NARUSAS TOM TROUT, INC.
1767 PARK TERRACE W 5569 BOWDEN ROAD #1
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
(904) 737-5412
-------------------------- --------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 125 . 00 Plan Check Fee 62 .50
Issue Date . . . . Valuation . . . . 18700
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 125 . 00 125 . 00 . 00 . 00
Plan Check Total 62 . 50 62 . 50 . 00 . 00
Grand Total 187 . 50 187 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
PLAN REVIEW SHEET Routed to:
�S.Ma�-sk�i
Building Department Public Works&Public Utilities Departments
800 Seminole Road 1200 Sandpiper Lane S. Doerr
Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 R.Carper
(904)247-5800 (904)247-5834 D. Kaluzniak
(904)247-5845 Fax (904)247-5843 Fax Public Safety
PLAN REVIEW COMMENTS
Permit Application# h n 914
CQ
Property Address:
Applicant: �} `
Project: ��` I�t 1r' `�1 . rA b � 1
This permit application has been:
Approved as noted by the -0s\ Department.
Final application approval must come from the Building Department.
F-1 Reviewed and the following items need attention:
.e
Please re-submit your application when these items have been completed.
Reviewed By: U� Date: 1 I4
Date Contractor Notified:
CITY OF ATLANTIC BEACH
BUILDING PERMIT APPLICATION
(FOR INTERIOR REMODEL)
Date: e. /o
Job Address: 17 (.,7 P 0
Owner of Property: L�` . vj a_r --.5,0-
Address: ) ') le) �4--1 �-) - Telephone:
Legal Description: Block Number: Lot Number:� j_ Zoning District:
Contractor: Tom Trout, Inc. State—License Number: 0 a to /,!0
Contractor's Address: 5569 Bowden Road Jacksonville, Florida 32216
Telephone: (904) 737-5412 Fax: (904) 737-1044
Describe pro,P°sed use and work to be done: °4- s�..Li
c --
Present use of land or building(s):
Valuation of proposed construction: 7 9 es
New electrical or increase in service? 8 New plumbing fixtures?
New fireplace? P 0 New heating/air conditioning? 90 ,
,
Is approval of Homeowner's Association or other private entity required?[u a If yes, please submit with this
application.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate.
Incomplete applications may result in delay in issuance of permit.
Please submit Building Permit Application,Energy Code Forms,Notice of Commencement,Owner/Contractor Affidavit if owner is contractor,
and two(2)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hail, 800 Seminole
Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826
In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being
performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner.
I hereby certify that all information provided w' is a kation is correct.
Signature of Property Owner:. Date:
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and
ordinances governing this type of 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 federal,state or local rules,regulations,ordinances,or laws in any manner,including the
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atlantic-beach.fl.us
Pagel Revised 1/15103