Permit Shed 1769 Beach Ave 2012 "',k I .
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
jilt
Application Number . . . . . 12-00001684 Date 11/21/12
Property Address . . . . . . 1769 BEACH AVE
Application type description SHED PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
storage shed 7 x 8
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
COUGHLIN THOMAS R & JUDITH A GRIDER CONSTRUCTION INC
PO BOX 330306 2057 VELA NORTE
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 463-4606
----------------------------------------------------------------------------
Permit . . . . . . ACCESSORY STRUCTURE NEW RES
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/20/13
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
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 ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
z lit
z
F=
z 00 U)
0 � ..c CL
C4 t--
7 0
13 C4 -Ar< N
a Z C) T 0
0 co CL V) 0.
Z 0
Z z
C,UA R
z
LLJ
09- o
z V)
ca ks-
0
90.09 F=
3-10,1 �OMOd Cloom z
—1ci w
S83SI6 Ai
0
U)
<0�! 0
OL
CL LLJ La
wzx J(2
CL 0 PQ
V) 75
Z-
11) Co
uj
3.;40,6ZONs
z -�t
0
COPY
C,
Ld
0
u-
DIV
ui C�
ui 0
C� Ln
a z ui
ti) U-
0 Ln
_uj 0
LO 0
.3: u)
Ln ao
(S) V)
0)
7-
P
a. H
Cq
Go
1`�rT
RZ
0
w
C-�
z 0.(n
.0- cu
LT
5 . ra
7r--
0 —A-w
0- 7-LJ 0
0
0
F=
3-10d 83MOd Goom Ci
—
S83SI8 Al
0
co
<(L 0 x
0-0
M:s
P X
tN3V43/\'Vd 'in CD
IX
3.9'V,6ZOr'OS
z --t 0 L ":d' V--0
0
14
0 0 ip 'S-0
Z CL
L) 0 Vo
o ot
�o
s. O-A
.10
C�
2 LO
c� W
LO LL- 3:
Lf) LO
to 0)
tn
co
V)
0)
co
z
OCEAN GROVE UNIT No. 2
PLAT BOOK 20 PAGE 20
li;ve
5- WUUU r
3A7 5-7t0t0le,
0 1
C,
::E
I nc) �
::E 0
*0
0 _9
z
m
rr,
10
m
0
.......................................................
jlllj�
. . ..... ASPHALT PAVEMENT 13E
0 GAR
C-)
TV RISERS
m OR WOOD POWER POLE
m 914�
nm N030 0. 61
rl 91 4511W 50.
CMD Rl 00 L4 0
I) A M C
Z> x N) z
z co 0 r- m N r-0
0 ;0 0 M U)
z 0 111) > ;u
M
0— 0 (A G) m 00
;:0-n
0
> O;D
0-F� 0 z c
Z
0
0 z
0 0 31.0'
zm
z
co-
VD.
3 -Z9,LO-toS s 41 ;0
60'09 3:Fg.—Lovo
03
02'Zoc 0
z
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1769 Beach Ave Permit Numbei
Legal Description - Floor Area of sq. t. Parcel Sq.Ft
Valuation of Work$ $600 Proposed Work heated/cooled n/a non-heated/cooled
n/a
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 sprin=system installed? (Circle one): Yes No N/A
Florida Product A proval#
For multiple prosucts use product approval form
Describe in detail the type of work to be performed: storage shed ;k4ZO meUlaw.4'
cow per airsw,dyi& cquz 'e"
Property Owner Information:
Name: Judith Coughlin Address: 1769 Beach Ave
City Atlantic Beach State Fl_Zip 32233 —Phone 904-853-6655
E-Mail or Fax# (Optional)
Contractor Informatiom
Company Name:
Qual IfWy' Age t ;4,eV
Address:aQ city I -StAte oe�_l Zip
Office Phone Job Site/Contact Number Fax#
State Certification/Registration 4
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
is he e made a*na ermit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
to o't 'rk P 11 be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
t all-0 -
Apphco"o 1 a per r 'y d tha d thin six(6)months, or if construction or work i's suspended or abandonedfor a period of sixP6)months at any time after
issuance 0 -it-
and id f work s t com ene
no in N
o k onim"ced. I understand that separate permits must be securedfor Electricar Work, Plumbing, Signs, Wells, Pools, arnaces, 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.
Ihere certify that I have read and exam i.ned thi's application and know the same to be true and correct. All provisions qf laws and ordinances governing this
type 1�work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provi.si.ons of any other federal,state, or local law regulating construction or the pe�formance of construction. OF
Signature of Owner Signature of Contractor-,5&
Print Name J d� Print Name
............................. ............................................ ......................................................................................................................................
Swom.to and subsc 'bed before me Swor u ri e 0 e mp
thi,-,� DayefN-, DU�jMSk[Z_ 20 1Z A i Dav of 20/z,
SHIFiL a M
PATEL
Notary Publi' 4W My COMMISbIUN;f ttJ4110Z PrUbliES:Febru
C 5-r1-el 41
Elondee t rs
EXPIRES November 09,2014 Thru Notary Public Undervirt
3 , RcndaNataryService.com L Re Ais d 0 1.26.10
L
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic e ch, Florida 32233-5445
a
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: tk- 13 - 13
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: DepaTh"P_,nt review required Yes No
(_ByadHTT:::�
�rl <2�ian ' zoning
C.
Applicant: ktuy Tr is ra r
Project: 5�vcb (2��
PU I
C-w 1 koN�) L4 (0 _PTuiblic 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:
APPL)CATION STATUS
Reviewing Department First Review: M/Pproved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: DApproved as revised. F]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F]Approved as revised. F]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road 12- - b
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(PO4)247-5845
E-mail: building-dept@coab.us - 13 - 13
Date routed:
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (Ocl head� DepartnWt review required Yes No
Gr I nrC �Zoning
Applicant: Z/ 77 '��Ia
r s rator
Project: 5
Public Safety
Fire Services
ARVAIVN_
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:
APPIL)CATION STATUS
Reviewing Department First Review: [YA/pproved. ElDenied.
(Circle one.) Comments:
BUILDING
�AN:NING &ZONIN Reviewed by: Date:
TREE ADMIN. Second Review: FlApproved as revised. F]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [—]Approved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05114/09
'IVA, City of Atlantic Beach RPC APPLICATION NUMBER
,J--
Building Department (To be assigned by the Building Department.)
800 Seminole Road V
(IV 12- b'?
Atlantic Beach, Florida 32233-544
.4, F1
-5826 - Fax(PO4-�4Y-5845
Phone(904)247
9, E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: [1 (47q beadi A-y-f Depa1tnWt review required Yes No
Gr 1 -77 �a �Zoning
Applicant:
Tr is or
Project:
P
Gr I ADN-) Public Safety
Fire Services
wv or Receipt Date
iit 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:-
APPLICATION STATUS
Reviewing Department First Review: proved. FIDenied.
(Circle one.) Comments: PIP
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. V
Second Review: []Approved as revised. FlDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FApproved as revised. FlDenied.
Comments:
Reviewed by: Date:
Revised 05114109
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
t antic Beach, Florida 32233-544 12-
Phone(904)247-5826 - Fax(904)247-4�
'0
1,9 , uted: It- 13 - J3
E-mail: building-dept@coab.us Date ro
201
City web-site: http://www.coab.us "' 11
APPLICATION REVIEW ANUTRACKING FORM
Property Address: (eq hea(du AV( t review required Yes No
4 ( Bui!4��
-rr,c"I&OA 1_77 <2:1 aLnmqq_&Z o n i n g
Applicant: kIL111-Y C' Tr is ra or
Project: 5�v&.' (2:��
Publi . . .
Gri I AD(\.) Lfl�3 -q —Fu--blic Safety
Fire Services
M14141"W�K_m iNT10-16-w2_112113,7411 0111-K
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:
APPLICATION STATUS
Reviewing Department First Review: Approved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed b Date:—
TREE ADMIN. Second Review: E]Approved as revised. ElDenied.
AOftKV . Comments:
UIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [:]Approved as revised. FIDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09