1802 Hickory Ln 2012 interior remodel CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000725 Date 6/18/12
Property Address . . . . . . 1802 HICKORY LN
Application type description RESIDENTIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 86642
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Application desc
interior remodel
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Owner Contractor
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JOHNSON SUSAN & BENGT OLFOSSON ABEL RENOVATIONS INC
1802 HICKORY LANE 12187 HAZELMOOR CT
ATLANTIC BEACH FL 322334515 JACKSONVILLE FL 32258
(9 04) 3 16-2 0 05
--- Structure Information 000 000 INTERIOR REMODEL
Occupancy Type . . . . . . RESIDENTIAL
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Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . .
Permit Fee . . . . 428 . 00 Plan Check Fee 214 . 00
Issue Date . . . . Valuation . . . . 86642
Expiration Date . . 12/15/12
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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 6 .42
STATE DBPR SURCHARGE 6 .42
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 428 . 00 428 . 00 . 00 . 00
Plan Check Total 214 . 00 214 . 00 . 00 . 00
Other Fee Total 12 . 84 12 . 84 . 00 . 00
Grand Total 654 . 84 654 . 84 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITYOF 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
JobAddress: Ln Ak6y\tc. �!)s� Fk, �9233 PermitNumber: 12 —7o2S7
. . kot 2-1 �,'Ckv 47 U"'t *\-L(:-
Legal Descnption vs -7 Ct Parcel#
q,6 (�4 1, -. Floor Area of Sq.Ft-.__ sq.Ft
Valuation of Work S Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition G� Repair Move Demolition pooYspa window/door
nti
Use of ep4ting/pr osed structure(�)(�ircle one): Commercial 6 -�_ _
If an existing s"Xre,is a fire sprinider system installed?(Circle one): Yes N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Rtv�vr_q. �J- tc,(iVAK CgNj%V%1t ( ctkj,;�� M
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Property Owner Information:
I V I
Name: e-i-11\ Address: V�\C\<CrN4 L_V�_
city_.AiNQ;V\1kt lhv State fLzip ail�- Phone
E-Mail or Fax#(Optional
Contractor Information:
Company Name: AoA 9,�Y\cj 'IN c- -Qualifying Agent:
Address: 1*2kE? City fC_ State 92).Sp Zip
OfficePhone `?Q11 31,q gCCIS Job Sited/C q=U%11
State CertificationtRegistration# UT OR
Architect Name&Phone# VU-01DE eo E 1 1
Engineer's Name&Phone# Tl--aTMC BEACH
Fee Simple Title Holder Name and Address R SEE PERMfTs roE ADDMONAL
Bondi.ng Company Name and Address QU'"MEN91 AM C[)NDrT75N_S.
Mortgage Lender Name and Address 11 REVIEWED BY--
E)OT]I Lft; 4 C.4 n
ommencedprior to the
is permit becomes mill
onths at any time after
aces, Boilei-s,Heaters.
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 YOM NOTICE OF
COMMENCEMENT.
I here certify that I have read and d h7i ?pfication and know the same to be true and correct. Allprovisions oflaws and ordinances governing.this
=e S
r
1�work ivill be complied with! I ecAd herein or not. The granting of a permit does not presume to give authority to violate or cancel the
=19ions of any otherfederal.state,or local regulating construction or the peFfo�mahce ofconstructi6n.
Signature of Own5y'_ Signature of Contractor
Print Name QjL-A-A
Print Name
..... . .........................................................................
Swornp and subscribjed bef9re me Swo b��bed b 7e
this to Day of J 0 r-i 20 this Day 20
a ec0ea herein or n,
wN wnreioncear,5 regulating constr,
s
e&r state,o
..........
...................
CgjgP) Notary pUW State of Rotida 940CAtieL 3ajidx3
P P
ete LON$ Revised 0 1.26.10
Myc aled
my commwsw DD05018
W
,pires,OSM50=013 ep!jou io awe 31"nd�JAWN
E,
DO NOT WRITE BELOW- OFFICE USE ONLY
Applicable Codes: 2010 FLOMDA ME=C=
Review Result (circle one):
Approved Disapproved Approved w/ Conditions
Review Initials/Date:
Development Size
Habitable Space Non-Habitable
Impervious area
Miscellaneous Information
Occupancy Group
Type of Construction
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
Flood Zone
Conditions/Comments:
LA&hl
City of Atlantic Beach APPLICATION NUMBER
AMBuilding Deparbnent (To be assigned by the Building Department.)
—06 800 Seminole Road Z2
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab-us Date routed:
City web-site: http:/A~.coab.us I Pz
APPLICATION REVIEW AND TRACKING FORM
Aeloo -RN!T!Tqnt review required Yes..oNo
Property Address: Building
Applicant: db /V0 V&h rn 6 ba e, " PlantrMg &Zoning
Tree Administrator
Project: d Public Works
Public Utilities
Public Safety
Fire Services
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:
APPLIPATION STATUS
Reviewing Department Fimt Review: 2�pproved. E]Denied.
(Circle one.) Comments:
(E�p
PLANNING&ZONING Reviewed by: 221 CL, Date:
TREE ADMIN. bf
Second Review: ElApproved as revised. nDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. [—]Denied.
Comments:
Reviewed by: Date:
ROWSW 07127110
MAP SHOWING SURVEY OF
LOT 21, SELVA MARINA UNIT 140. 12-C REPLN11 AS R�XORDED IN PLNT BOOK 37, PAGE 29 OFUWwaWN0ff"r rjc-wRjj=a=0:7
FLORIDA.
FILE
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301,
FOUND 1/2"IRON PIPE
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FOUND CONCRETE MONUMENT
21.6,
NOTES-
THIS IS A BOU14DARY SURVEY.
NO BUILDING RESTRICTION LINE AS PER PLAT.
BEARINGS BASED ON THE SOUTH LINE OF LOT 21,
AS PER PLAT. I'a.
/40
, L FOUND 3/4"IRON PIPE
V-4
NOCAP
SOCK 36, IJAftl.
P406, $9 Afo, to
THE PROPERrY SHOWN HEREON APPEARS TO LIE IN FLOOD
ZONE. IX' (AREA WMIDE 500 YEAR FLOOD) AS WELL
AS CAN BE DETLRMINED FROM THE "FLOOD INSURANCE
RATE MAP' CU44JNITY-PADEL NUMBER 120075 0001 D
REVISED APRIL 17, 1989 FOR ATLANTIC BEACH, FLORIDA.
I I-MRM- Y CERTIFY TO CHARLES EDWARD ALLICOOD, AMRW-Y'S TITLC FUND,
U.S. FINANCIAL ACCEPTANCE CORPORATION �11V��,,�_HAVE SURVLYED THE:
LANDS AS SHCWN IN THE ABOVE CAPTION PM'TljM 1:�MAP IS A TRUE
AND CORRECT REPRESENTATION 017 THAT SURVFY I&PRE-
SENTED HEREON �EETS lliE M-Umlum
�PF THE FLORIDA
ADNIINISTRATIVE CODE CHA?TER TrTLE
V 1:e,jj f'j.�
ASSOCIATION
THIS SURVEY NOT VALID UNLESS
SEALED*ATM AN EMBOSSED SEAL DDNir I-W'A-7my G HTI,
OF SURVEYOR SIGNED HEREON FLORIDA'�,R' � L L) '&WEYOR No.3295
E: 1";2 0'
DRAWN BY:D.FREEMAN BOATWRIGHT LAND SURVEYORS, INC. DATE SIGNED:
JANUARY 18,ISS4
FILE, 94-56 1711 51h S REET SOUTH JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET I OF
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11�"'S�- Tilis is an original design and must 15Q�ed-�5/10/2012
All dimensions�size designations
given are subject to verification on L.G�I i'S' not be released or copied unless Printed:6Y5/2012
job site and adjustment to fitjob applicable fee has been paid or job
conditions. order placed.
OLOFSSON CLUTE Print #
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