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City of Atlantic Beach
Planning and Zoning Department
This approval verifies compliance with applicable Z ii
zoning, subdivision and other local land i
development regulations, but does not constitutern Z�
approval for the issuance of permits. Compliance
with Florida Building Code and all other applicable
local, State and Federal permitting requirements
``-� must be verified by signature of the City of Atlantic
imPSt5i0� 1 ��' �,�^��C} Lti/Z Beach Building Official prior to the issuance of a
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CITY OF ATLANTIC BEACH
SQL! City of Atlantic Beach APPLICATION NUMBER
800 SEMINOLE ROAD
Building Department (To be assigned by the Building Department)
ATLANTIC BEACH, FL 32233 J. -s� 800 Seminole Road
Atlantic Beach, Florida 32233-
INSPECTION PHONE LINE 247-5814 5145 �� A l� 7
. � Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
i APPLICATION REVIEW AND TRACKING FORM
Application Number . . . . . 12-00001897 Date 12/21/12
Property Address . . . . . . 377 4TH ST
Property Address: -3_57 ' l_ A SJ Department review required Yes No
Application type description RESIDENTIAL OTHER Building
Property Zoning TO BE UPDATED Applicant: 61� GC Planning&Zoning
Application valuation . . . . 750 � ��/^i✓f Tree Administrator
------pp---------- OW
---------------------------------------------------------- ����„ Public Works
Application desc -----
Project: /�`
pergola 16 x 12 • • Public Utilities
P V1 I a/ ri
---------------------------------------------------------------------------- Public Safe
Fire Services
Owner Contractor
------------------------ ------------------------ Review fee $ Dept Signature
FOPPIANO THOMAS D AND DANA H OWNER
377 4TH STREET Review or Receipt
ATLANTIC BEACH FL 32233 Other Agency Review or Permit Required of Permit Verified By Date
Florida Dept. of Environmental Protection
--- Structure Information 000 000 OUTDOOR PERGOLA 16 X 12 Florida Dept.of Transportation
Occupancy Type . . . . . . RESIDENTIAL
St.Johns River Water Management District
----------------------------------------------------------------------------
Permit . . . . RESIDENTIAL ALT/OTHER Army Corps of Engineers
Additional desc PERGOLA 16 X 12 Division of Hotels and Restaurants
Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50 Division of Alcoholic Beverages and Tobacco
Issue Date . . . . Valuation . . . . 750 Other:
Expiration Date 6/19/13
----- - - - ----- ----------------------------------------
APPLICATION STATUS
---------- ---- - - -------
Special Notes and Comments E `
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE f Reviewing Department First Review: Approved. ❑Denied.
-----------------------------------------------------
----------------------- (Circle one.) Comments:
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00 BUILDING
=i
--------------------------------------------
-------------------------------- j
LANNING&ZONING
Fee summary Charged Paid Credited Due Reviewed by: Date:
Permit Fee Total 55 . 00 55 . 00 . 00 00 I TREE ADMIN. Second Review:
❑Approved as revised. ❑Denied.
Plan Check Total 27 . 50 27 . 50 . 00 . 00 ` PUBLIC WORKS Comments:
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 86 . 50 86 . 50 . 00 . 00 I PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ❑Denied.
Comments:
SCAN ED
i
Reviewed by: Date:
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES. Revised 07127110
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