1076 Hibiscus St 2013 siding CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . 13-00002244 Date 3/01/13
Property Address . . . . . . 1076 HIBISCUS ST
Application type description SIDING PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1500
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Application desc
Hardie siding
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Owner Contractor
-
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MILLAIRE JEFFREY S & ANNE R PLUMBING BY JOSH
1076 HIBISCUS ST 5677 FLORAL AVENUE
ATLANTIC BEACH FL 322332652 JACKSONVILLE FL 32211
(904) 237-5706
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Permit SIDING PERMIT
Additional desc . .
Permit Fee 60 . 00 Plan Check Fee 30 . 00
Issue Date . . . . Valuation . . . . 1500
Expiration Date . . 8/28/13
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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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 30 . 00 30 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH l�l�
800 Seminole Road, Atlantic Beach, FL 32233 s2
Office (904) 247-5826 Fax (904) 247-5845
Job Address:
(� S V S s l Permit Number:
f ,Z�-�
Legal DescriptionParcel#
oor ea of
q. t. q. t
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): Commercia Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product app_rovalfform
Describe in detail the type of work to be performed: -as,AIS � +v2 oJe/� FX S7�IT
-r PIy I,�vO .9.,►a il+cQ ,it d AW
Property Owner Information:
/I n ,,
Name: J�'� M) l/i4;t�C_ Address: 41D ga` CO9Ac),4 CT'
City �,�-S� StateeZip j Phone 3 8 6-7 Q 4 — Z6 C6
E-Mail or Fax#(Optional)
Contractor Information: I D
Company Name: V � Qualifying Agent: �oS ��T� 1
Address: S6 /9 Ci State L Zip 3.�t I
Office Phone 24.5-3330 um e — #
State Certification/Registration#
+ + FOR
Architect Name&Phone# CITY OF Ail-A bM. C,BEACH
Engineer's Name&Phone# SEE P
Fee Simple Title Holder Name and Addr s REQUIREMENTS AND
Bonding Company Name and Address _
EEWW 13 199
Mortgage Lender Name and Address DATE
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 rction or work is segulating construction in thisjurisdiction. This permit becomes null
six and work er
void
commenced.work
is not Icommenced within understand that separate permits must or be secured for Electrical Workended Plumb ngor , Signs,or aWells,Pools,period xFurnaces,Boilers,months at tHeaters,
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 BEOR ERECORDING YOUR NOTICE OF
COMMENI here b certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type ojywork will be complied with whether speci eed herein or not. The granting of a permit does not presumZR;.
rityto viola or c cel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner ^��� KL
Signature of Contractor
Print Name (I Print Name / "IO ........ ................� ....................
BeforBefo ,7e 201
this Day of�Gt 20 this vv�� Da3 �
Notary is ,.n1't'� !k. MEUSSAA HART
Notary IC My86t9 *. ;: MY CAMMISSIOpNu�IfrEE}�86�19t3p5n
"- ., C; EXPIRES;
lTr�env�iT 2 .12
EXPIRES:January 1,2017 yt .• Bonded Thru N eis
.t,.. Bw4ed TMu Notary Pte*Urderwr8aa
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
r 800 Seminole Road
r� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: D 7�Q 14t 1015CLt o S-�' Department review required Yes No
N Building
Applicant: Planning &Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
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: MApproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING3-- / '/3
Reviewed by: � 1 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:
Revised 07/27/10