Permit ResAlt 522 Aquatic Dr 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002124 Date 2/07/13
Property Address . . . . . . 522 AQUATIC DR
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . PLANNED UNIT DEVELOPMENT
Application valuation . . . . 1800
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Application desc
bath remodel
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Owner Contractor
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BALWIN ARLENE D ET AL S .E.JONSSON CONSTRUCTION, INC.
522 AQUATIC DRIVE 8 STARFISH PLACE
FLEMING SUSTAN T/C PONTE VEDRA BEACH FL 32082
ATLANTIC BEACH FL 322335174 (904) 545-2714
--- Structure Information 000 000 BATH REMODEL
Occupancy Type . . . . . . RESIDENTIAL
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Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 1800
Expiration Date . . 8/06/13
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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 60 . 00 60 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 64 . 00 64 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE wiTH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
,hvAje,wP_ iam.Pom"
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845
Job Address: 0&4f'(� bp)g� Permit Number:
Legal Description jP �71 cls-'Is -;t_9 47 2bucth 60,�P)e
L WS Parcel v�v
Floor Arett of SO.Ft. q.
Valuation of Work$ )1;00 Proposed Work heated/cooled 9!�e non-heated/cooled
Class of Work(circle one): New Addition Alteration (!�F Move Demolition pool/spa window/door
Use of exi�ting/proposed structure(s) circle one): Commercial esiden *
If an existing structure,is a fire Mr system installed? (Circle one):i��es �P N/A
Florida Product Approval #--- =l
For multiple products use proURt approval form
Des,cribe in jetail the type of work to be performed: P_4pta I U 94et,U ()0,6
I\kj6jek-U I-'?V_Q A-9-iA uo_& +o cl-a;&l u�16'
ki
14 U
Property Owner Information:
Name:!L-jL�fewf&!�Tle Adette Bativl� A eT 4CAddress:
city I —State—Zip Phone
E-Mail or Fax#(Optional)
Contractor Information:
CompanyName: 51�afo%( 'k 0A.&0WCi*U Oualifving Ap-ent:
Address: 6 _Sia EAS'� oar -city —State tLo_ Zip_T1ctS,7
Office Phone !Rp� ,C-4j--.2)/V Job Site/Contact Number Fax# A-y 1:
State Certificati6n/kegis'tration# C&n /,5n(6 ,3?6
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Ap a i ereb ade ain a e m ,o d he and insta"ai�ns as i ndic or installation has commencedprior to the
ic h 1 ..r i 0 0 work t, tan ar a low thisjurisdiction. This permit becomes null
0 o't or p b d
'io i y th a k e e e
0 k is s a period ofsi%)months at any time after
I c t uct fr 0�' .
r f rm to m7 W
nd s c 6 nt or ion
s cur or ctric i U,
*s p nce a erm a at w ix P( 0 05e e ed E �ells,Pools, urnaces,Boilers, Heaiers,
su 0-d 0 w p k not co", ed w thin s
ce I" r t t se p r i s must
soern d de ta a paratem e e
v f
work is co in s
Tanks andAj,Con,�fitione"S,eta
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 hereb�certify that I have read and examined this application and know the same to be true and correct. All provisions ofl and ordin es governing this
work will be complied with whether specified herein or not. The granting of a permit does not presume to give ority to te or cancel the
provisi.ons ofany otherfederal,state, or local law regulating construction or the pe�fo�mance of construction.
Signature of Own &�t 0�_�LAI\_ Signature of Contractor
-b PaAALZ I Print Name
Print Name C,I I
....................................................................................................................
......... ....... &.......................... .. .........................................
Sworn to and subscribed-1- — A SW subscri fore me
this_1,4, Day of -1 MEN!% Da of 20
Nowy rVow-I
my con=.Exoss ju!n Q726.�20 5
S LEY
Notary Publ* N
EXPIR��.
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Borided Th
0011— — — — — — — — — -Revised 0 1.26.10