Permit Siding 152 3rd St 2012 t�•"V r
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000665 Date 5/31/12
Property Address . . . . . . 152 3RD ST
Application type description SIDING PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2499
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Application desc
sding replacement
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Owner Contractor
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ANDO STEPHANIE ELIZABETH FIRST COAST HOMES LLC
152 3RD ST 1323 6TH AV N
ATLANTIC BEACH FL 322335209 JAX BEACH FL 32250
(904) 509-2814
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Permit . . . . . . SIDING PERMIT
Additional desc . .
Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50
Issue Date . . . . Valuation . . . . 2499
Expiration Date . . 11/27/12
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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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 12
Office (904)247-5826 Fax (904) 247-5845
Job Address: /5:�, Vit` , 4, 1441a,1k, ck ft3 3 Permit Number:
Legal Description jc>:ts S-god iloB1ak ;A8 Parcel#
'r, - 'Floor red of q. t. q. 't
Valuation of Work$ 14TY, Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition AlterationRepair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(eircle one): Commercial dentia
Resi
If an existing structure,is a fire sprinkler system installed? (Circle one): es o N /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed:(ec—mcwe tg'jf j cXj-1e c 5 ofye,d`+t cel
S 8,4 n e a y1d Leolesce LtjlVX n leev oLx�c�s.
Property Owner Information:
Name:, AYLoto Address:
City ;ifi,'C 03Ca cG,, State FL Zip 3 3 Phone !2 - 30 - 2-9
E-Mail or Fax#(Optional)
Contractor Information: .{
Company Name: , 1 CLIS H0Me31. (_ -Qualifying Agent:
Address: 17jq 1 *A No t- City Jae n wit Q State 'L, Zip :3 Z
Office Phone -Pq- 09- / JQb �e1. -5 - i Fax# 9G 5!/ Zip
State Certification/Registration# (�
Architect Name& Phone# 64 tDATE:
Engineer's Name & Phone# ZA CM OF ATTANnC BEACH .4 .
Fee Simple Title Holder Name and Address SEE PERMIT'S n -am
Bonding Company Name and Address REQUIREMENTS!AND Mortgage Lender Name and Address
ppicationsereby made to obtain a permit to do the work a artcontmen d prfor to t
issuance of a permit and that all work will be performed to mZt the standards of all laws rEde
atThis perm be rn
and void if work is not commenced within six(6)months, or construction or workisspd or abandoned for a period of six(6)months a innwork iscomencd. I understand that separate permits mbe secured for Electrical rk, Plumbing,Signs, Wells, Pools, Furnaces, ars eii�ater
Tanks and Air Conditioners,et,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVE TTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
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 governin�y this
type of work will be complied with whether sped ted 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 s"W" Signature of Contractor C.
Print Name ��r Print Name 1
... .. . .v..i1�. s...... ' .... .v...�..J'd'.............
Swora to and subscri ed before me Sworn to and subscribed before me
this cZ Day f 201 this �at Day o 20
Notary Pu Notary Pu c
ate of Florida
L;4_
otary P c State F i
v Harfl VState�d� 6.1
R19
EE 175645 rY16 y Commission EE 175645
pires 03/04/2016
City of Atlantic Beach EDate
ICATION NUMBER
Building Department ed by the Building Deparbnerd)
800 Seminole Road
Atlantic Beach,Florida 32233-5445 2 - (!
r•.
Phone(904)247-5826 . Fax(904)247-5845
E-mail: building-dept@coab.us 0 /Z
City wob-site: htfpJhNun aoab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 13-�z 2e'-w � Department review required Yes o
Building
Applicant: T s- C O f}S7 - m S anning&Zoning
Tree Administrator
Project: n j Public Works
Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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:.' 70-12-
TREE
p iZTREE ADMIN. Second Review: []Approved as revised. ❑De ied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Dom:
FIRE SERVICES Third Review: []Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07WI10