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583 Seaspray Ave (vault) 6750 PSR-3844 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT INFORMATION LOCATION INFORMATION 'address : 583 SEASPRAY ermit Number : 6750 ATLANTIC BEACH . FLORIDA 322 Permit Type: RE-ROOF ---------- LEGAL DESCRIPTION ---------- tlass of Work : REPLACMT PERMIT 11 Lot : Block : Section: .-onstv . Type: WOOD FRAME ­ 0 Proposed Use: SINGLE FAMILY Township: RNG i.ibdivision: SEASPRAY uwellings : 0 Code: 0 Est imated Value : $0 , 00 Imp r ov . Gist SO .00 Total Fees; 522 . 50 4 A OWNER INFORMATION APPLICATION FEES FERMIT S22 S(0 Na e rE TI M, --R jAY MATER IKPA,;�T FEE 9 , :- , ATLANT I "' H FL(�-f �:EWEF IMPIV, FEE FEAC WATER METER RADON GAS-H .R.-S . SO .00 CONTRACTOR INFORMATION RADON GAS -- 5% 50 . 00 Narde: LARRY WESTFALL CORP WATER TAP S0100 Address , 400) BIFC11 STREET SEWER TAP SO .00 MACCLENNY , FLORIDA 32063 HYDRAULIC SHARE 501,00 0,4 f:.1 Tvre , 0 RE-INSPECT FEE So ,("' SEC_-- H IMPACT FEE $r) r. NOTES: NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.95 ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATI01;NFOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. RECEIPT NUMBER- 08733? ATLANTIC BEACH BUILDING DEPARTMENT By: r H i i CITY OF ATLANTIC BEACH PERMIT APPLICATION ROC Owner(s) : m Address: Phone:. xA Lot # Block or Unit #_ 6uod.Lvision_ Contractor: LQ&v- t- Vti w 2 S A Q a 14 Co t p. Address: 3 2 cs�- Thor �{�O --- -- �� A� State License Describe work to be done: Materials to be meed: /�.�-��J�n�.�e ► i Signature OWNER: Date:_ Signature CONTRACTOR: DEPARTMENT OF BUILDING 7730 CITY OF ATLANTIC BEACH.FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB 0!00 T r3.I:IOCKT Date May 27 1985 4966 1 5/27/13 10.00 7730 .Oom Valuation$ Fee$ 4966 2A 5/27/8 This permit not valid until above fee has been paid to City Treasurer,and is subject to revocation for violation of applicable provisions of law. This is to certify that Jim Beam has permission to build fence Classification residential Zone Owned by Jim Beam Lot_ Block S/D House No. 583 Seaspray Ave. According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS = AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS ,I AFTER DATE OF ISSUE 4 1 4----01 O Building material, rubbish and debris z from this work must not be placed in public space, and must be cleared = up and hauled away by either con- trac�or or owner.. Building Official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER h -�-� 3 0 FEE $10.00 APPLICATION FOR FENCE PERMIT CITY OF ATLANTIC BEACH PROPERTY OWNER Name: -MAJ N Day Phone o2 DAI,3 d4A Address: APPLICANT, IF OTHER THAN OWNER Name: Day Phone Address: Zip Code JOB INFORMATION Address or Location: Lot Block Subdivision APPLICATION MUST INCLUDE SITE PLAN SHOWING PLACEMENT OFFENCE ■ FENCE REGULATIONS CITY OF ATLANTIC BEACH, FLORIDA No owner , occupant or other person shall erect, keep or maintain in existance any fence, wall or structure between the front property line and the front building setback line exceeding four feet in height. In the area between the front building setback line and the rear property line, no fence or wall shall exceed six feet in height. (Front yards of corner lots are not determined by address . The exterior lot line of the narrowest side of the lot abutting the street is considered the front yard. The exterior lot line of the longest side of the lot abutting the street is considered a side yard. ) No owner, occupant or other person shall erect , keep or maintain in existance any fence , wall or structure exceeding four feet in height , nor plant keep or maintain any hedge bush or shrubbery exceeding three feet in height upon real property within a distance of 25 feet from the point where the right of way of any road or street intersects the right of way of another road or street. CITE' OF ATLANTIC 13EACH a FLORIDA APPLICKI"10 " FOR WATZR CUT-IN iK water cut-iii Application is hereby made for ---7— at or092 at the following address for _ � �ti� �nit(s) . Cut--Ir charg�2 of Street Number tg Lot - Block ordered b Owner,% Mailing, Address/K27 Date / 7� Account No. Meter No. Date Installed CITY OF ATLANTIC BEACH APPLICATION FOR SEWER CONNECTIONS PERMIT NO. DATE LOCATION LOT NO. BLOCK NO.� OWNER TYPE OF BUILDING / MASTER PL BER INSPECTED _ BY BILLED ACCOUNT NO. CITY OF ATLANTIC BEACH APPLICATION FOR SEWER CONNECTIONS PERMIT NO. LOCATION, r F3 STREEET .,._,( eyc_Q LOT RQ. -- BLOCK NO., OWNER TYPE OF BUILDING MASTER PLUMBER INSPECTED _ BY BILLED ACCOUNT NO.�� CI` y OF P.TUMIC B&ACH, FLORIDA APPLICA11'100 FOR WATZR CUT-IN Application _Js heren-y made .111:02: _4� water clut-i,,i at the following address for --unit (s) . cut.-Xr. Charge Of Street blumber ordered Owner Mailing Address Date sxcount No. Meter No. - Date installed cAc- (-Zz- nEPARTMENT OF BUILDING 3159 CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date 8J 18Z 19 'r r Valuation$ Plumbing Fee $ •00 This permit not valid until above fee has been paid to City Treasurer, and is subject to revocation for violation of applicable provisions of Lw. i This is to certify that Stanley S. Schwartz has permission to buil install 1 sink 2 &avatories 2 bath tubs closets 1 water heater 1 washing machine Classification residence gone Owned by Mills and Lewis Bldg Service Lot 15 Block 2 SSD Seaspray House No. 583 Seaspray Avenue According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS ,I AFTER DATE OF ISSUE ♦___� ► O Building material, rubbish and debris from this work must not be placed in public space, and must be cleared up and hauled away by either contractor or owner. R. C. Vogel Building official. � FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING 1 ELECTRICAL SEWER WATER k L `= CITY OF ATLANTIC BEACH AFPLICATION FOR FLUMBING PERMIT PERMIT R0. Date : LOCATIO —Street LOT NO. /5� BLOCK N0. �S/D, ), OWNER V MASTER PLUMBER � Bldg. BUILDER OR CONTRACTOR yg-yllad�=it_,NIO,- TYPE OF BUILDING _ SIEK.S 7,-LAVATORY 7- BATH TUBS URINALS2_-,6LOSETS FLOOR DRAINS SHOWERS_....,/ WATER HEATERS DISHWASHERS DISPOSALS OTHER/- Gd TOTAL FIXTURES X1 ,00 NO WORK. MUST BE DONE UNTII A PERMIT HAS BEEN PROCURED PLANS AND SPECIFICATIONS must show a plan and description of the size-"d location of all the sell and vent pipes, and the number and location of all fixtures, (in acoordanse with Ordinanoe no. 188 of the City of Atlantic Beach, Flurida) must be shown on bank of appli- cation and be approved by the Plumbing Inspector. DRAW PLAN AND SIECIFICATION •F ABOVE PLUMBING OP BACK. Approved by Plumb ng Inspector Date , (FOR OFFICE USE ONLY) ROUGH-IN INSPECTED R MARYS _ FINAL INSPECTION: CERTIFICATE ISSUED: FOR OFFICE USE ONLY Date----------• ! /'Q.- 197!� Permit #-------•----•-----••---•Fee$--- CITY OF ATLANTIC BEACH Valuation Opp.......................... FLORIDA House .A .... 4... ....... ............. APPLICATION FOR BUILDING PERMIT ---------------------------------------------------------------------------- ­­---------------------------------------------------------------------- Application is hereby made for the -approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can be verified. Date----Z — -17- ---- ---- ---------------------------------------------9192.01. ....Addressli/?Yll .1;'fAr.A.G -----------Tele hone ....................Address.----_----------.........................................Telephone No............................. Architect--------------------------------------------------------------------------- L I ia ----------Address----------------- -------------------------------------Telephone No---------------------------- ContractorBuilder------------------------------------------------------------------- ------------Block No------------ - ---------- Sub Division-SA!..�--�f f...RA --------------------------------------------ZOne1.2­X2_? L No----------------5_..-----............ RE L vc e ---------------Skeen' and-- hg. .. ..........sto. h,' ---Side Between ---------- Valuation For what purpose will building be used-.R construction_. _------------------ -------Type of constru Footings.M.vVo.k)' Dimensions of Building-1 .............Dimensions of Lot---75 /...?Q4..............................Size of .4JA_91.46 -4----------.-Greatest Sill Span in ---Type Roof Z#6y,..S1JJy..,4A9 Size of Piers.....S_4-14--------------Size of Sills..._-.-_-_...__k How will Building be Heated?_-__...._-. _ _e 7-R.ic-------- ---------Will Building be on Solid or Filled Ground?__....._. ------------- ...... Distance on Centers ---------------- Greatest Span........Iii............................. Size of Ceiling Joists-___- _X Size of Floor Joists_...... --------------------Distance on Centers-. ...-... ...—­---------------- Greatest Span------------------------------------------- --r-6 s -------------------- Greatest Span--------3-------•---•-•---•--•----...... Size of Rafters_______________ --------.......Distance on Center This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall 73--- be submitted with application. i a r-).r-3,Lk A Inspections required. 3's 1. When steel is in place and ready to pour footing. Z 3 tj Z 2. When steel is in place and ready to pour columns and/or lintel. 3. When steel is in place and ready to pour beam. *F, 4. When framing is completed. 5. When rough plumbing is completed,and ready to cover up. 6. When septic tank drain field or sewer is laid but before it is covered. 7. Electrical inspection by City of Jacksonville. 8. Final inspection. Note: In case of any rejection,re-inspection MUST be called for after corrections are made. FRONT OF LOT S,EASIP)!y In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform sai work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building regulations of the City Of Ais Beach. ------- Address.. -I-d...A10 I Signature of Builder_.� _ak---t-------------_---_--- -----•--- --------_------------...... Signature of Owner_/;�7_�,&Vd ... .144V72'4- J!Z�-4ddress............................................................... DEPARTMENT OF BUILDING 1 CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date 6/28/ 1976 Valuation$ 3 0, 0 0 0_ 0 0 Fee $ 75. 00 I This permit not valid until above fee has been paid to City Treasurer, and is subject to revocation for violation of applicable provisions of law. This is to certify that Mill --- & T.P w i s Bldg- S e ry i c e has permission to build single family dwelling Classification )^s i d e» o Zone Owned by NTTK 'dills & Lewis Bldg Service Lot 15 Block 2 S/D Seaspray House No. 533 Seaspray Avenue According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIR MONTHS AFTER DATE OF ISSUE ♦. � �— ► 0 Building material, rubbish and debris 1 from this work must not be placed in Ipublic space, and must be cleared up and hauled away by either contractor or owner. F R. C. Vogel Building Official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER `'S yL�JrJ�i CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD _r ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 ME1>r Application Number . . . . . 09-00001422 Date 10/15/09 Property Address . . . . . . 583 SEASPRAY AVE Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 5200 ---------------------------------------------------------------------------- Application desc REROOF 2806-1 ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- BEAM, DENNIE EMPIRE ROOFING P. 0. BOX 647 2806 GIBSON RD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207 (904) 391-1007 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 56 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 5200 Expiration Date . . 4/13/10 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- ,� Permit Fee Total 56 . 00 56 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 56 . 00 56 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH r Date: ROOFING PERMIT APPLICATION [d Job Address: 5' .Sea /4✓e- µt an f%L Bc RCA r 1 Owner of Property:��✓f~IAU 9n k Address: nn � Telephone: Roof Contractor: r�it KC1 afA D State License Number: t� 307 d as Contractor's Address: 2g©6-' ,h,Sc�i✓ 7 p� Q Telephone: 3,71- J [/©0 7 Fax: t - �Il 7 Email: Scope of Work: R e riyo Roofing Material FL Product Approval# Valuation of Work: Z�Q Required Inspections: Sheathing/In Progress-Dry In /Final If re-roof: Assessed Value of Structure:_<$300,000/_>$300,000;Roof-to-wall improvements required? (Applies to single family structures only) "WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT" SIGNATURE OF OWNER: Date: /l// / 0!f AS TO OWNER: Sworn to and subscribed before me this day of 20 State of Florida,County of Duval tlk:a � J�Ir"oo f boventpr Notary's Signature: Commission#k DOSO8116 0 Pe onally known ,. Expires October 27 2010 E] Produced identification H Bonded imy Rem-Inwnna.lnc eooaaslole Type of identification produced SIGNATURE OF CONTRACTOR: ZDate: AS TO CONTRACTOR: Sworn to and subscribed before me this day of 20 State of Florida,County of Duval Notary's Signature: Q Orsonally,known ;►aroduced identification _.; �..Commiasipn#DD598118 Expires October 27 2010 Type of identification produced t z , �r..,. 1019 r"I 1••BondedTpypam-Inw�a Inc lOOab'3 800 Seminole Road-Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800•Fax:(904)247-5845 FAroof permit applicaton.docx 7/28/09 NOTICE OF COMMENCEMENT rP��PP.F.c..•1 LjF:.iCP.�cj . Permit No. _ Tax Folic N.. Slate of County cf To whom it may concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: Address of property being improved: '!k bin h-r- el, General description of improvements: �QJd C Owner .L_ G Address • „� t1AhFf� c�► Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) Name --- Address Contractor �f;Q Address Ste/ SC'/Kl KGf �/re> Phone No. q 1y�` - Fax No. �ql 1 77 Surety(if any) Amount of bond$ Address Phone No. Fax No. Name and address of any person making a loan for the construction of the improvements. Name Address Phone No. Fax No. Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax No. In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option). Name Address Phone Wo. Fax No- Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specTed): OWNER THIS SPACE FOR RECORDER'S USE ONLY DATE Signed day of in I n e Before ne is County Dural, le ct Florida,has personally appeared Doc#2009249585,OR BK 15038 Page 369, Jaw�last �d�Ch1�L' Number Pages:1 nimseli!herself ar✓1 affirms tial all slatemerts and declarationsh are;roe and accara: Recorded 10/15/2009 at 12:40 PM, i c ►:Commission#DDS98116 JIM FULLER CLERK CIRCUIT COURT DUVAL Ekfres October 27 2010 'bonded Tmy Faro-Insurssa Int al00.3&7019 COUNT RECORDING Lam_ p RECORDING$10.00 h larf Public at Laree.S j^et t CITY OF ATLANTIC BEACH SIJ 800 SEMINOLE ROAD r} ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 09-00001890 Date 11/17/09 Property Address . . . . . . 583 SEASPRAY AVE Application type description RESIDENTIAL OTHER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1150 -------------------------------------------- Application desc GARAGE DOOR REPLACEMENT -------------------------------------------- Owner Contractor - ------------------------ ----------------------- BEAM, DENNIE OVERHEAD DOOR CO. OF JAX P. 0. BOX 647 6884 PHILIPS PARKWAY DR. N. ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32256 (904) 268-1627 --------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . Permit Fee 60 . 00 Plan Check Fee 30 . 00 Issue Date . . . Valuation 1150 Expiration Date . . 5/16/10 ------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ---------- ---------- Permit Fee Total 60 . 00 60 . 00 . 00 . 00 Plan Check Total 30 . 00 30 . 00 . 00 . 00 Grand Total 90 . 00 90 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. "- CITY OF ATLANTIC BEACH _ 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 O� I I I OFFICE:(904)247-5826•FAX NO.:(904)247-5845 -;' BUILDING-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY 1.JOB ADDRESS: 2.VALUATION OF WORK: 13,SQ.FT.UNDER ROOF 583 x � 0 4.LEGAL DESCRIPTION: e 5.CLASS OF WORK: 6.USE OF STRUCTURE: ❑NEW BUILDING ❑DEMOLITION 19 RESIDENTIAL LOT_BLOCK-SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7.DESCRIPTION OF WORK: ❑ALTERATION 11 ACCESSORY BLDG. 8.FIRE SPRINKLER: 3: ! EPAIR ❑POOL/SPA 11 YES 1:1 N/A r /yl 11-/7 ❑MOVE 1:1 OTHER 11 NO t PROPERTY OWNER CONTRACTOR: ARCHITECT I ENGINEER: 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME: 16.NAME: 24.LICENSEE NAME: 10.ADDRESS: ` n 17.S'jgTEOF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: �' Gh 1%ADDR� 26.ADDRESS: O 1 r 11.OFFICE PHONE: 12.FAX NO.: 1 O.O7 FIC PH EZ7120. O.- 7 v 27.OFFICE PHONE: 28.FAX NO.: 99- 13.CELL PHONE: 21 CELL PHONE, L G 29.CELL PHONE: �6u-S� r-- 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER: (IF OTHER THAN OWNER) 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed 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 abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. *** WARNING TO OWNER: *** YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER or AGENT CONTRACTOR I1 Agent,Power of Attomey or Agency Letter Required) (Qualifier Only) Signed: �� [ ��` Date: !-// � Signed: /C r �i/tr�� Date: - Before me this day of 2009 in the county of Before me this day of 2009 in the county of Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are herin by himself/ erse d affirms that all statements and decl rations e true and accu `\`\\\\\\11tI[III///// true and accurat ` Notary Publi at Large, ate of Notary Public at L rge,State f ❑Personallyn M v 0•'. 'moi qpatti5nally Known ❑Produced Identiticatio �+ 8� Produced Identrficationx Notary Signature: // Notary Signature: •���� Q 1 , •• 2 � •. °5 D FOR CODEC L� .9s as Y OF ATLANTIC C n IT �CST �F �� vv ,� .•. �st gate�O. ����\`�� t ITS FOR ADDITIONAL BLDG01 Permit Application Bldg:REVISED:121/1`y/�f0 1N \ REQUIRESEE MENTS AND CONDITIONS. �lU / 1/1 IIIItt1\ I REVIEWED BY: DATE:1 f f l' Ag At NFo ngN jr m � m C N o �x \ � gA gypp" � � u ' IA �Na aeV'°'" g^'•• `/�V R1.00 .N�. D t' y g !m '.z q m � U ~ E. tLiEEf tlk:f�D� roe m. �g g g 8 x of REG u3-11- 40> 99 v Hit ' _ 2 IN 1 > Ft �1 HN .8" _o Na > R s c> so vzltz z k $m P 33 7� �U) cn cn N City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Buildin Department.) 800 Seminole Road s3. Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: Q JJ33� City web-site: http://~vww.coab.us APPLICATION REVIEW AND TRACKING FORM roe Address: �3 sm Jepart�n int review required lies No i? �l iPplicant: D� te- k�� D 2 Planning &Zoning V Tree Administrator 1� 6 0 r Public Workspr®jeEt' Public Utilities Public Safety Fire Services Ra�wee $ � _ f hep-Stgrtur �. Revie�r or Receipt Date Other Agency Review or Permit Required of Permit`�eriY�ed 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 tOth sion of Alcoholic Beverages and Tobacco er: APPLICATION STATUS deviewing Department First Review: proved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: IV Date. TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: evised 05IUM