Permit Bath/Shower Remodel 1652 Coquina Pl 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001411 Date 10/01/12
Property Address . . . . . . 1652 COQUINA PL
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 200
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Application desc
BATH/SHOWER REMODEL
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Owner Contractor
------------------------ ------------------------
KNIGHT S .E.JONSSON CONSTRUCTION, INC.
8 STARFISH PLACE
ATLANTIC BEACH FL 32233 PONTE VEDRA BCH FL 32082
(904) 54S-2714
--- Structure Information 000 000 BATH REMODEL
Occupancy Type . . . . . . RESIDENTIAL
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Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 200
Expiration Date . . 3/30/13
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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 55 . 00 55 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 59 . 00 59 . 00 . 00 . 00
PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
0
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: f.,I 'A,!q Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial Residential
If an existing structure,is a fire spriWer system installed? (Circle one): Yes No N /A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: lurocA,"_ a4 Ad W P
��_*(�X I I --
Property Owner Information:
Name- Address: 2
110C, —('D9(-.21 K
city -I't(Z4,-�. _State'�-1 Zip 32IIS Phone
E-Mai I or Fax#(Optimil)
Contractor Information:
Company Na e: _S C; -10 14 �s eq w;;g K. a if ing A t :5 14A-N L7 rso it
Qu ly
City gen
Address:, 5_-tA I -N& Llec)ka —State Zi p3 z r)Et,;?
Office Phone_. :!!Z-�Z- ?_!�I V Job Site/Contact Number Fax#
State Certification/Registration 4 6y6__C /5-06-3!10
Architect Name& Phone#
Engineer's Name& Phone 4
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
reby made 0 b 0"' ermit 10 do the work and insa"Zions as indica or installation has commenced prior to the
1,b or led 0_ tthesan ds law thisjurisdiction. This permit becomes null
i 0 t ' a p r a' . s
0 k ss aWeriod of sixp,6)months at any time qfter
s 0 n or O�r us
f
n r 'ad 0,E ctrca ells Pools, urnaces, Boileis, Heaters,
'p ca!7 is d h a k e e f h c _,tuct
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C"�J",es'et,
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 ceriffy that I have read and examined this application and know the same to be true and correct. 411provisionso s d ord' n e
f verning this
ope p�workivill be complied with whether specified herein or not. The granting of a permit does not presume to give uth ri a vi a. r canc�l the
provisions ofany otherfederal,state, or local law regulating construction or the peFformance ofconstruction.
Signature of Ownei A Signature of Contractor
Print Narne
Print Name ......
RI.S.6... ........................................
S'
orn t Sworn su ibe e
'w n t and s scrilo,,M er 'In
Ls" - /Z-
thil, Day 120/Z this Day o o) . 20
N No
otary ic MY COMMISSION#DID 957760 u LEY G HAM
MY COMMISS11 N#DD 9
EXPIRES:February 14,2014
60dod Thru Notary Public Underwritem 57 0
ry 14,201
EXPIR Februa Revised 0 1.26.10
Bonded Thru Notary Public Underviriters