1220 Seminole Rd 2012 - Repairs Permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5814
INSPECTION PHONE LINE 247
Application Number . . . . . 12-00000711 Date 6/13/12
Property Address . . . . . . 1220 SEMINOLE RD
Application type description RESIDENTIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2300..............................
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Application desc
repair trim frame at patio --------------- -------
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Owner Contractor
------------------------
------------------------ BLASINGAME BUILDING SVC. , INC.
ELF, ROBERT D. TRUST 14286-19 BEACH BLVD. , #365
1220 SEMINOLE ROAD FL 322SO
ATLANTIC BEACH FL 32233 JAX BEACH
(904:) 249-1772
--- Structure Information 000 000 PATIO REPAIR
occupancy Type . . . . . . RESIDENTIAL
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Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc - - 65 . 00 Plan Check Fee 32 . 50
Permit Fee . . . . Valuation . . . . 2300
Issue Date . . . .
Expiration Date . . 12/10/12 ---------------
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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
Office(904)247-5826 Fax (904) 247-5845
Job Address: Permit Number:
Legal Description:777. A� /'�l 131k;arcel#
Floor Area ot Sq-.Ft. Sq.11t
Valuation of Work S;2,'�Oc) L Proposed i/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration epair Move Demolition pool/spa window/door
(i��
Use of existing/proposed structure(s) circle one): Commercial dz��
If an existing structure,is a fire spriWer system installed?(Circle one): Yes No
Florida Product Approval 4
For multiple products use product approval fdrm
Describe in detail the type of work to be performed:
Property Owner Informatiom,
N am e. fZ
1.�2 Address: j Q,,�K5
City�_ "A-4,n:Z�7 42h State ip Phone
E-Mai I or Fax#(Optional
Contractor Information:
e /J.
6.
Company Name,
.,Gen4a#.' Qualifying Agent: Deoglas A. geh"Rz
Address: 216 N 20 Str City Jacksonville B"wh Fl. 32250 -7 V 2
OfficePhone 904-246-2+f-_1�_?LY2-/77_1__ Job Site/Contact Number :�59 0963 Fax#904-24?-3869-
State Certification/Registration# t7 t-Mv
Architect Name&Phone# Mu
Engineer's Name&Phone tVrnnv� A_XTr"r.,
Fee Simple Title Holder Name an ddresl IV It VA It I r
d A r
s
s,s _fM17S FO ADr)=A %-ju
Bonding Company Name and Addre 1_1 Frorl;h F.- 1.—4- WN IL r- I
Mortgage Lender Name and Address IN AND 0 yl I
S-'-f Z_
R�.
�pplication is hereby made to obtain a permit to ta te --,fat no work or i tallation has commencedpilmto
VEEWED BY-
issuance ora permit and that all work will be pedbrme tome in risdiction. This ermit comes null
and void ifwork is not commenced within six(6)months, o, 0 MIN iodqfsix(6)mont at. time after
work is commenced. I understand that separate permits must be secured Work Plu ng, Pdols, Flirn Reders,
Tanks andAir Condideners,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.
[here cer16 that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governin this
111work will be co�npl'ed Will? 'h th The granting of a permit does not presume to give authori�y to violate or ca2ncegi the
provisions ofatty otherfederal,state, 0 tion or the pe�formance ofconstruction.
Signature of Owner eSature of Contractor�
-iriPtimiName Dqt!g @
.............. ............ ................................................................ ............ ...................................... ....................................................
Sworn to and subscr ) before me Sworn to and subsc(riibd before me
this 6- Dav of QZZ 2 01<:9, —thig 1-5, nou Af .20
OSAUN K 10)
5 A S 2
' uF
t
"'Notary Public R AUND CLARK 'M%TNo.UyP.b'I i C ers
MY Co ISSION#EE 001736
S:August 25,2014 Revised 0 1.26.10
EXPI
Bonded Th Notary PUblic UnderWrjte,
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be as- sowd by the Building Department.)
8W Seminole Road
Atlantic Beach, Florida 32233-5445 12 - ,7 ,11
Phone(904)247-W26 - Fax(904)247-SM5
te r
E-mail: building-dept@coab.us EDa routed: /J-?- -----
City VM15-0& hftp-/kAkW.e0ab.UP.
APPLICATION REVIEW AN D TRACKING FORM
Property Address: 17- 7-6 ;?J
review required Yes, No
(' Building
Applicant: g &Zoning
Tree Administrator
Project: Public Works
Public Utilities
-7—rifn Public Safety
r Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Peffnit Verffigd 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 Fimt Review: 034-proved. ElDerlied.
(Circle one.) Comments:
PLANNING&ZONING Reviewed by: Date:- k-1 j-
og
TREE ADMIN. Second Review: DApproved as revised. []Denvied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. [:]Denied.
Comments:
Rev'iewed by: Date:
Revind 07127110