Permit Bath Remodel 3205 2012 V 4V 1,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001357 Date 9/18/12
Property Address . . . . . . 1 FLEET LANDING BLVD MAIN
Tenant nbr, name . . . . . . UNIT 3205
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2100
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Application desc
remodel bath/shower
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Owner Contractor
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NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS
FLEET LANDING 6771 SHINDLER DR
1 FLEET LANDING BOULEVARD JACKSONVILLE FL 32222
ATLANTIC BEACH FL 32233 (904) 838-9179
--- Structure Information 000 000 BATH REMODEL
Occupancy Type . . . . . . RESIDENTIAL
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Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . .
Permit Fee . . . . 65 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 2100
Expiration Date . . 3/17/13
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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 . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 69 . 00 69 . 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: 3 2p 9 Fla4 jaicktta AiNd. PermitNumber:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq Ft
Valuation of Work$ Proposed Work heated/cooled no'n-heated/cooled
Class of Work(circle one): New Addition )�� Repair Move Demolition pool/spa window/door
Use of existi ng/p ro posed structure(s)(circle one): Commercial
If an existing structure, is a fire sprinkler system installed? (Circle one): N/A
Florida Product Approval #
For multiple products use product approval I–orm
Describe in detail the type of work to be performed: jop stin�'t� vJye– A�cl M
iAall L�=CA (4– t A 6� _�Jej�s
Property Owner Information:
Narne: NCCRF Address: One Fleet Landing Blvd.
City Atlantic Beach State FL Zir) 32233 Phone 904-246-9900 xt.150
E-Mal I or Fax# (Optional)
Contractor Information:
Company Name: North River Builders Qualifying Agent: Joshua M. Hogan
Address: 6771 Shindler Drive Citv Jacksonville State FL Zip 32222
Office Phone 904-838-9179 Job Site/Contact Number 904-838-9179 —Fax#904-838-9179
State Certificatlon/Registratlon # CGC1518918
Architect Narne & Phone #
Engineer's Narne& Phone#
Fee Simple Title Holder Narne and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
I
Application ishereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commencedprior to the
issuance of a permit'and that all work will be pe�formed 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 abandonedfor a Period of sixX months at any time after
work is commenced I understand that separate permits must be securedfor Electrical-Work, Plumbing, Signs, Wells, Pools, urnaces, 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 h' , lication and know the same to be true and correct, All provisions of laws and ordinances-governing this
(ype of work will be complied with whether,,�'e'csia herein or not. The granting of a permit does not presume to give authority to violate or cancel the
ff"Z
provisions of any otherfederal,stat-f or loca,i aw regulating construction or the pe�formance of construction.
a
Si-natUre of Owner'- Signature of Contractor
PrintNarne .,..J,o.s.h..u.a.,,H..a.t.fi.e..I..d.................... ......................... Print Name Jo.s.199a.M...... ogaii
...... .... .... ........ ...... .. ... ... ..
Sworn to and subscribed before me Sworn to and subscribed before me
this �illr Day of szp� 20 this Day of _4A 20
IF
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