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2209 Alicia Ln 2013 deck CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002677 Date 6/04/13 Property Address . . . . . . 2209 ALICIA LN Application type description DECK/PATIO Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 15000 ---------------------------------------------------------------------------- Application desc NEW DECK ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MARSHALL DUANE F & LYNN L. MATHIEU BUILDERS 500 CHERRY POINT RD 15899 SHELLCRACKER RD WOOLFORD MD 216771311 675 ATLANTIC BLVD (SIGN) JACKSONVILLE FL 32226 (904) 813-3661 ---------------------------------------------------------------------------- Permit ' * . . . . BUILDING PERMIT Additional desc . - Permit Fee . . . . 125 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 15000 Expiration Date . . 12/01/13 ---------------------------------------------------------------------------- Special Notes and Comments Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Shappelle ' s and Waste Management . ) Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities . Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. 2010 FLORIDA BUILDING CODE, 2008 NATIONAl ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities . Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Shappelle ' s and Waste management . ) ------------------------------------------------------------- PERMIT (%t4veRDVFEt OBLY IN ACCORDANCE WITM ALLXIT)SWULARIU�B.$VJW-&AWACES AND THE FLORIiA 0 0 BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 C Page 2 Application Number . . . . . 13-00002677 Date 6/04/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENG REV BLDG MOD OR ROW 25 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 125 . 00 125 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 29 . 00 29 . 00 . 00 . 00 Grand Total 154 . 00 154 . 00 . 00 . 00 PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. mAy 31 2013 By May so. 3o13 4: p7rm rwa i v OcM Sary ic-aa tnc vlFlF,^r4v ev lits O%sbc-C- W-L &I mra O"r.—O_ 05 plbcwwt itvmmmp 2dow-amme. Ak F.... 4-&n4p ;A4;x-lbft 79b ...... PAWY 50, 2al 3 ubwa sawaaMban " Fldbmc*bm%mw aAa*AP 4& —SLAOO�4UUA& Lgbavm 'Tc-,2, C:3,n OAMV 7, 201-A, tfUft -rgffm-MV t3,V 9ft4a S-Oak *,tW3b%&Rdb=2&AVJbl R~1*1W 6—d oppec,wma Vc3.ur ffvbcjLbma* 6ga. ed��Im.CM ttbdll CIMMndh*jdMd ddOMr-&41'kj@L -T-Ok- 4savintl4�rb 24�eftm woructLarml rckagpd;nt Al%a gt%db AbppdbftM&nC-�S O"C:00 W"O #A A*j-Cbftr.*ini^A wb�. .-,44wv. P.(%"VwO*dl Ph&a>,& :01comwv�darkp*w7na" ta, aftiA dbfnc�w Aaa V��&Ar "low. 046%bow.Opoew wh,*ir wo*"4vepworwwod Ow WW#Aoqrc-q 04P 4NAP "*Y, 4camumody, Abefto Alfimsw�AkAFw~j, mbpobwwpb�� Air— 'Irttle J�ftMr %,V611 13.0 PgdbC:dWJ Irb -eCl"l ClilO t-Q- .,ka rrL&r%&Mmra cwr Terwk"v Jav To,=SO^&4c3u--wc:>%Pvwm4m'L jrcw C^4p Almmujw cW jolawmorm -vc- Oao,,d of Ar--Aed�cmata City of Atlantic Beach CE Building Department 8W Seminole Road Atlantic Beach,Florida 32233-5445 1 2013 Phone(9"247-SM6 - Fax(904))2 E-mail., buffdrq<W1@c0abus ft:1A~coab.u9 APPLICATION REWEW AN� TRACKING F RM Property Address: Z77 Uepartment review roquired Yes No Applicant: MPIrarqning&ZjoW pt -FreaAammistrator Project: P Pu ic u - safety Fire Services Other Agency Review or Permit Riquired R*vkm or Receipt Date of Oermit Verified By Florida Dept.of Enviror-mental fttection Florida DepL of Transportation SL Johns River Water LUnagement Distrid Army Caps of Engneers, Division of Hotels and Restaurants rosion of Alcoholic Beverages and Tobacco Other APPLICATION STATUS i Reviewing Department First Review: E]Approved. Denied. (Cirde one.) Comments: BUILDING PLANNING&ZONING Reviewed by: Date: TREE ADMIN. Second Review. P��ed ass re0sed. E] ed. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Revjew�ed FIRE SERNACES Third Review. []Approved as raVised. []Denied. Comments: Reviewe.d b�- Dab.- Revlwd 07WI10 mAy 3 2013 4#4�,%p4v few 10 Or 'or-Ak "C*mvrvwv-4t as ^%scjb",%Ir IC3,P.4 IWIL J%j jjhl6%"97VIVA,OP":- -%-kp4"0 & Owimploo-naL nwovft#L AAA4616 a 0. ao 1 31 PW 3 14,bnAtftdbn i 4&V 0 & — j%Ij.Wo A d VVI PC�-A I'l MAV C:CA'-4t-1 MI-6- Cc,Ova f.*.2Spd;#bl -,-A 8"� 10.,r jd 463,A I &kA- F&AV 90 is j~",jr4 r� &j..A fol.- ooa�ow-*&$*,ft .ffp,, C7dNkWS#p', '00*60 P. Aboo-O ff S.P. A. cvwzwp%�dg�rw �ff T WrAmle IXs- tl 4w vc Auol��.d�f BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: CZ0!r 94c. Permit Number: 4e,11- y L Parcel# Legal Description 71 t7loorZeCao q. t. on-he# 1�1 d de. Proposed ork eated/cooled fed Valuation of Work S Addition Alteration Repair Move Demolitio l/s W1 w' oor Class of Work(circle one): cze:w) Use of existing/proposeel structure(s)(circle one): Commercial �[W s Zid e�n t i�al If an existing structure,is a fire sprinkler system installeV (Circle.one): 0 N Florida Product Approval 4 For multiple products use Vro—duct ap rm Describe in detail the type of work to be performed: Property Owner Information: Name: Address: ip.�,�3� Phone f-Ot (3- /067 city 4 State E-Mail or Fax 4(optional) Contractor-Information: uall ent: 5114 ceY A (45 olt Company Name: 9 le Zip Address: _City*VX1, State Office P ne Job Site/Contact Number 916P!V"I le',4__Fax State Ce i ication/Registration Architect Name&Phone# AK IG 4t ex Engineer's Name&Phone 4 Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and 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 iTwork is not commenced within six(6)months, or if construction or work is suspended or abandonedfor a period qfsixP6)months at any time after work is commenced. I understand that separate permits must be securedfor Electricar Work,Plumbing,Siqns, Wells,Pools, urnaees,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 FINANCING9 CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that I have read and axamined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type pJ 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 provisions of any otherfederal,state, or local law regulating construction or the peFformance of construction Signature of Contractor Signature of Own� & w(.1-4 ................................................................ Print Name _Aqn((" a­r-c4i o-e�-111*111,11*11, Print Name ....................................;;;e"*"",*"""""*,1*11,111,111,11*1111*111,111*11,111,11,*11,111,111,11,l**"I Belo*,!97e- Befor thi of 20 this y of 20 1 11, 1P PAOLA GIL lorida Notary b ic Notai y Vublic-State of F 2015 fAyCOMMI ION DD957760 my Comm.Expires Jun 23, 0.24.12 ",,OF f , commission#EE 105915 FLORIDA DEPARTMENT OF ENVIURONMENTAL PROTECTION Bureau of Beaches and Coastal Systems 3900 Commonwealth Blvd-MS 300 - FL Tallahassee,FL 32399-3000 Powif Number.- - - - - - - - 850)488-7708 No.ofPaSmAdacked: F1!ELD PERMIT PURSUANT TO SECTION 161.053 or 161.052,FLORIDA STATUTES FINDINGS OF FACT AND CONCLUSIONS OF LAW: The request for a perinit wa considered by the staff designee of the Department of Environmental Protection mW found to be in compfiRim vAth Ow mqvimrr�mts nf Chspb-62B-31 Florida Administritfive Code(F.A.C.). Approval is specifically linu�todic activity in the stated location and by the prcoa d=jjWn,appmtod a C *i if any),aftschad xWxlud conditions,and any special conditions stated below pursuant to Paragraph 161.053(5),Florida Statutes. This permit may be suspended or revoked in accordance with Section 62- 4.100,F�kC. J PROJEC`r LOCAI�1111-. + PROJECr DESCRIPTION:,:- 7" J- 17� r yl SPECIAL PgRhffi CONDITIONS: This pmnit a vaW only saw aN applicable federal,date,and local permits we obtained and does not authorize contraventmm of local setback requirementi;or zonmg or buildmi;eades. This perind and pubic notice shall be posted on the aft unmediately upon I ssuance and mW remain pooled alorig with local appvW md#A of any ud*n*mned by this permit Other special omfitions of this pp-ruait include: e-ri-I iL It.I--,' A L XrAMARD FEW r COND11TIONS: The parmifte dM comply with the aftwhad standard field parnit condifiomL APPLICANT INFORMATION: I hereby certify that I am either. (I&)the owner of the subject property_q (1b)I have the owner's consent to some Ob permit on the ownces beh4 and dot(2)1"obtain any applicable beams or peiTnits which may be requited by federal,Ask,county,or municipal low prior to commencement of the authorized work (3)1 acknowledge that the authorized work is what I requested;and(4)1 accept responaWk for sompliance with all permit conditions. Applioaft Signatim 7/ 113 T `50.('�W ) J1140i'll-1p< Applicant's Printed N�me Adilsass If applicant is an agent printed nanie ofpropff ty owner pvpa*bww propffly mow's telephone no. DEPARTMENT FINAL ACTION AND FILING AND ACKNOVAUgDGMENT: This fold permit is approved on behalf of the Departinerit of Envkonmental Protection by the undersigned staff designee,and filed on this date,pursuant to section 120-52,F.S,with the uridmiped designated 13eputy Clerk.receipt of which is hereby acknowledgW. StqffDesi�eeTiepvry Cierk P7*ifed Name qfDon", p 09- CJW* Date PUBLIC NOTICE IS ON Tit E MCK OF THIS FERWl'. RX11`11RATUNDAT& (Emargency permits issued PUT=t to Section 6213-33.014,F.A.C.,are valid for no mom than nindy&p wd~am pennits are valid for no more dian 12 months. The staff Gesignee may specify a shorter time limit.) EMERGENCY PERMffT:0 YESO NO Approved plans are aftched: 13M' ONO AND PUBLIC NOTICE CONSPICUOUSLY ON THE SITE DEP form 73-122(Updated 01/06) MileCopy-Tall-haswe Office] ffello-Copy-Applicant] [P;nkCqpv-SAqffD=gneej FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION Bureau of Beaches and Coastal Systems 3900 Commonwealth Blvd—MS 300 - Pew*Num*er. s FL Tallahassee,Fl,32399-3000 488-7708 No.ofPagesAvoched: F1 i ELD PERMIT PURSUANT TO SECTION 161.053 or 161.052,FLORIDA STATUTES FINDINGS OF FACT AND CONCLUSIONS OF LAW: The request for a permit was considered by the staff designee of the Department of Envionmental Protection and found to be in compliancewith the requirements of Chapter 6211-33,Florida Administrative Code(F.A.C.). Approval is specifically limited to Ithe activity in the stated location and by the project description,approved plims(if 011Y),attached abumiard conditions,and any special conditions stated below pursuant to Paragraph 161.053(5),Flofida Stiltutes. This permit may be suspended or revoked in accordance with Section 62- 4.100,F.A.C. CT"PROJZ '2, PRCkJXCT DESCRIPTION :f' f-76 ky fi L"J SPECIAL PERMIT CONDITIONS: This permit is v@W a*sfkw 81 applicoNe federaL state,and local pemutB we obtained and does not authorize contravention of local setback requirements or zoning or buil&g cockL This permit and public notice shaU be pooled on the site immediately upon issuance and sW remain poolled along wirth local approval until the 00111100bw of any aclivity auffmaod by do pm& Other special condifions Of dkig mmit include. STANI)ARDP9RM1ff COND11TIONS APPLICANT INFORMATION: I hereby certify that I am cftw. (Is)the owner of the suticet property (1b)I have the ownes cwWW to this permit on the ownees bch4 mW that(2)1 slid ablain any ap0beable beam or parnits which may be required 6yC6A..d dd16 sounty,or munxqm law pnor to commmeement of the aulhorized waft (3)1 ackwmAodge that the aulhormad wark is what 1 4110* for compliance with all parrut conditions. Applicanfe Signature Twq 4'r Applicanfs Printed Name If appficant is an agent: prbfkd name ofpropirty pvpw*y bwxorls address pwpaly owner's Ickphow na DEPARTMENT FINAL ACTION AND FILING AND ACKNOVIIAMMSM: 71tis field permit is approved an behalf of the Dopecloned of Enwronmental Protection by the undcogned staff designee, arid filed on Stis dab,pursuam so mcbon 120.52,F-S.,with lhc urAcn*W dmknW Deputy Ckik,mccipt�' fiwhich hereby wkww6i*. &ffDesigneelDeputy Ckrk Primaled Name ofDasifflwaVepiary CFa�-- Dase PUBLIC NOTICE IS ON THE BACK OF THE PERROT. EXPULATION DATE: (Emergency permits issued PU!Mw to Section 62B-33.014,F.A.C.,we vallid for no more than ninely dar and other field permits are valid no more thm 12 months. ;!;staff oemgnee'ruy specify a shorter time limit) EMMGENCY PSWT:13 YES 13 NO Approved plans are atlached: E�ES 0 NO A" PUBLIC NOTICE CONSPICUOUSLY ON TM SITE DEP form 73-122(Updated 01/06) Phile Cqp-),,7o1h*a=e Office] [YeflowCopy-Applicmal [Pink Copy-StaffDesignee] FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION Bureau of Beaches and Coastal Systems 3900 Commonwealth Blvd-MS 300 - FL A t Tallahassee, FL 32399-3000 Perrmil Nuniber. i 21 wat ON a 1%21%ft ON ON~-%. (850)488-7708 No.ofPages A nached.- FIELD PERMIT PURSUANT TO SEC'FION 161.053 or 161.052,FLORIDA STATUTES FINDINGS OF FACT AND CONCLUSIONS OF LAW: The request for a permit was considered by the staff despee of the Department of Environmental Protection and found to be in compliance with the requirements of Chapter 62B-33,Florida Administrative Code(F.A.C.). Approval is specifically limited to the activity in the stated location and by the project description,approved plans(if any),attached standard conditions,and any special conditions stated below pursuant to Paragraph 161.053(5),Florida Statutes. This permit may be suspended or revoked in accordance with Section 62- 4.100,F-A.C. PROJECT LOCATION: PROJECT DESCRIPTION: SPECIAL PERMff CONDITIONS- This perrnit is valid only after all applicable federal,state,wid local permits am obtained and does not audxxizc contravention of local setback requirements or zoning or building codes. This permit and public notice shall be posted on the aft immediately upon issuance and shall remain posted along with local approval until the completion of any activity authorized by this permit Other special conditions of this permit include: STANDARD PERM11T COND][TIONS: The permittee shall comply with the attached standard field permit conditims. APPLICANT INFORMATION: I hereby certify that I am either (la)the owner of the subject property 2[ (lb)I have the ownct's consent to secure this permit on the owner's behalf,and that(2)1 shall obtain any applicable lk=ws or permits which may be required by federal,state,county,or municipal law prior to commencement of the authorized worlc� (3)1 acknowledge that the authorizzd work is what I requested;and(4)1 accept responsibility for compliance with all permit conditions. A,le Appficanfs Signature Date Telephone No. Applicant's Printed Naim Address If applicant is an agent ptwed narne ofproperty owner property owner's addiness property owner's telephone no. DEPARTMENT FINAL AMON AND FILING AND ACKNOWLEDGMENT: This field permit is approved on behalf of the Departinent of Environmental Protection by the undersigned staff designee, and filed on this date, pursuant to section 120.52,F.S.,with the undcraigned designated Deputy Clerk,receipt of which is hereby wknowledged. StaffDesig"ee,T)eputy Clerk Printed Name ofDesigneelDeputy Cler* Date PUBLIC NOTICE IS ON THE BACK OF THIS PERMIT. EXPIRATION DATE: (Emergency permits issued pursuant to Section 62B-33.014,F.A.C.,arc valid for no more than ninety days and other field permits arc valid for no than 12 months. The staff designee may specify a shorter time limit.) Em[ERGENcy PEkmrr:0 YES 13 No Approved plans are attached: OM ONO AND PUBLIC NOTICE CONSPICUOUSLY ON ME SITE DEP form 73-122(Updated 01/06) Vhile Copy-Tallahassee Office] [Yellow Copy-Applicant] [Pink Copy-StaffDesigneel DATE: 5/23/13 PLAN REVIEW CORRECTIONS REPORT PAGE CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 ------------------------------------------------------------------------------ APPLICATION NBR . . : 13-00002677 ADDRESS . . . . . . 2209 ALICIA LN APPLICATION DATE 5/15/13 APPLICATION TYPE DECK/PATIO ------------------------------------------------------------------------------ OWNER . . . . . . . MARSHALL DUANE F & LYNN L. 500 CHERRY POINT RD WOOLFORD MD 216771311 CONTRACTOR . . . . . MATHIEU BUILDERS 15899 SHELLCRACKER RD 675 ATLANTIC BLVD (SIGN) JACKSONVILLE FL 32226 ------------------------------------------------------------------------------ AGENCY NAME: PUBLIC WORKS DATE ACTION ACTION BY ------------------------------------------------------------------------------ 5/23/13 DISAPPROVED DEBBIE WHITE Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities . Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Shappelle ' s and Waste Management . ) Provide copy of Homeowner' s Association approval . City of Atlantic Beach Building Department 800 Seminole Road Atlantic Beach,Rodda 322-33-5445 Phone(904)247-5826 - Fax(904)247-584� E-mail: buiIdlng-dept@coab.Us City web-site-- hftp://www.coab.us APPLICATION REVIEEM AND TRACKING Fq'RM Property Add partment review roquired Y No Applicant: PI—arIning&Zonind r Project: P bF_ u ic Safety Fire Services Other Agency Review or Permit R6quired Review or Receipt Date of Oermit Verified By Florida Dept of EnvirotImental 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: gleApproved. FIDenied. (Cirde one.) Comments: (��DING) PLANNING&ZONING Reviewed by: /22 Date: TREE ADMIN. Second Review- DAppmed as revised, [31)Aed. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by- Date: FIRE SER\ACES Third Review: [:]Approved as revised. MDenied. Comments: Reviewed by: Date: Revised 071Z7110 City of Atlantic Beach Building Department 800 Seminole Road Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 - Fax(904)247,-64� E-rnail: bui1d1n"ept@coab.us City web-sitw hftJhvww coab us APPLICATION REVIEW AN� TRACKING F 'RM Property Add A,L- 4 �L- Oapar#nent review roquired Yes No Pkinne & Rind Applicant- I gy" Project lic UfiffW I PHb�l c:�Safety Fire Services Review or Receipt Other Agency Review or Permit Riquired lo Date of Oermit Verified By ent r4 jr 'g P' _b .1� -i1c --J� fPublic Saf v Florida Dept of Enviror-Mental Protection Florida Dept:of Transportation St Johns River Water Management Mstft Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco odw. APPLICATION STATUS 1 Reviewing Department Firtt Review: E�A�pproved. F—]Denied. (Circle one.) Comments: P PLANNING&ZONI Reviewed by: -Date: TREE ADMIN. Second Review- DAppmved as re0sed. ODenled. PUBLIC WORKS Comments: PUBLIC UTILMES; PUBLIC SAFETY Reviewed by: Date: FIRE SER%4CES Third Review-. OApproved as Wised. ElDenied. Comments: ReWawd Date: Revlwd 07WI10 BUILDING PERMIT APPLICATION MAY CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 FR I=5 �_ 3 Job Address: Ime'lld? Z9 ne Permit Numbe el Legal Description Y, ithlw�ldf �Parc_ Sq pV FloorAreaot —S g.Ft. of Work Sj/, Proposed Work eated/cooled n�n"-heated/cooled Valuation Class of Work(circle one): (��_ew Addition Alteration Repair Move Demolition Commercial Ge s Zid e n:ti a�l Use of existing/proposed structure(s)(circle one): If an existing structure,is a fire sprinkler system installed9 (Circle.one): 0 N rFILE COPY Florida Product Approval# For multiple products use produ t approval form Describe in detail the type of work to be performed: Property Owner Information: -re_42e, ,4Ad�dress: —2.210 4? 4111,4 Name: Zipj Phone� city E-Mail or Fax#(Optional- Contractor information: Company Name: 9 le Quali A nt, State 4, Address: city Zip Job Site/Contact Number 4?dP a le Fax# Office P ne State Ce ica ionfRegistration Architect Name&Phone# AK q OYA-dr. 3 Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and 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 commencedprior to the fa permit and that all work will be pedbrmed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null issuance o, or work is suspended or abandonedfor aWeriod ofsixfi months at any time after and void ffwork is not commenced within six(6)months, or ifconstruction i work is commenced I understand that separate permits must be securedfor Electricar work Plumbing,Signs, ems,Pools, urnaces,Boilers,Heaters, Tanks and Air Conditioners,etc WARNING TO OViFNER: 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 YOUi NOTICE OF COMMENCEMENT. flaws and ordinances governing this I hereby certify that I have read and examined this a lication and know the same to be true and correct. Allprovisionso 0,cance,the f . ty to violate p ,p type p�work will be coTplield with whether i ied herein or not The granting of a permit does not presume to give authori sfg f construction. provisions of any otherfederal,state, or local regulating construction or the peTformance o Signattire of Own Signature of Contractor___4 a.. Print Name —42 rt t-L ac,ch v)-e� Print Name (................................................................. ......................I.............9............................................................................................... Befo*- gle- 2 Befor t t, 20 this of 120 th it, P PAOLA GIL Notary ic Notary Public-State oTTI rids otary s Jun 23, 015 mycoMMI I DD957760 my Comm.Expire #fi& 10.24.12 EXPIRES�::,tery Commission*EE 105915 ubkA I OFF" Bonded Thru t WOTECM1 FLORIDA DEP fffff-ep- PROTECTION Bureau of Beaches I 3900 Commonweal Pkv Number: FL A Tallahassee,FL 32 %&* (850)488-7708 C PY u0Z _MOW No.ofPages A nached. FIELD PERMIT PURSUANT TO M �ORIDA STATUTES i FINDINGS OF FACT AND CONCLUSIONS OF JAW: The requed for a permit wu considered by the staff designee of the Department of Environmental Protection and found to be in compliance with the requirtanents of Chaptzr 62B-33,Florida AdminWrative Code(F.A.C.). Approval is specifically limited tolthe activity in the stated location and by the project description,approved plans(if any),attached standard conditions,and any special conditions stated below pursuant to Paragraph 161.053(5),Florida Statutes. This permit may be suspended or revoked in accordance with Section 62- 4.100,F.A.C. FROJECI LAP%-j%IION- MOJECT DZSC1tWrION: A 7 >) SP&CIAL PERMIT CONDITIONS: This permit is vrM only after all applic"fedcraL statc,and local pennits m obtained and does not authoriza sontravention of local setback requu=ncntB or zonft or building codes. This permit and public notice sha be poded on Ac site immediately upon innnee and shall remain posW along with hxW app a =6*a cornpletion of my wtivily a0mizad by this pmk Odw opMW emblions of this permit include: A *A,-- i7�4-t 'A STAMA"FERW CONDITIONS: The parnitice shall cmply%th the a#wUd staklard fieW pamd conditions. i ApPtiCAW INP16PMATION: I hernby certify that I on either. (1a)the owner qf the wjl*d propar�,,VX (1b)I bove the owna-'s rwriont h;w=r this permit on the ownces belolt and U'W(41)1 dall obtain any - Il I -----a or pamits vfth aq be requirwl byfedwiL d1k county,or municipal law prior to commenament of the airthorized work (3)1 aciu�Sat Go m*mized wook is v4W I requesick mW(4)1 nospit responsibibly for sow4ijance with aH permit conditions. AppBeffints Signature Date Applicanfs Printed Name Addrws Ifapplicant is an agent: ' ZiLt P*W mme ofpropffty ownff PVPWiY wnws ad*vw POPWOO 0"W& I-1 A no. DEPARTMENT FINAL ACTION AND FILING AND ACW40WLZDGPAWr.- This field perind is approved an behalf of the Depwisnant of Environmental Protection by the undersigned daff"pun,and filed on this dde6 punniant lo section 120.52,F.S.,with the undersigned den4oded Deputy Clerk,roccipt of which is hereby acknowledged. StaffDesigneelLkepuly Cla* Prmsed Name ofDosifflevoTArpaq Ckrk Date ?UBLIC NOTICE IS ON THE BACK OF THIS PERMIT. EXPBLATION DATR: —ts am QW or no MGM (Emergency pWmts issued pursuant to Section 62B-33.014,F.A.C.,am valid for no mom than ninety doys and odier fidd Fwnu f thin 12 months. The kaff designee nay spm*a shorter time fimit.) EWERGENCY PERM:13 YF—S 0 NO Approved pians am aftiched: 11M ONO AND PIJBIJC NOTICE CONSPICUOUSLY ON TM SITE DEP form 73-122(Updated 01/06) Mile Copy-TalkAmme Office] [Yeflow Copy-ApplicaWl Pink Copy-StaffDosigneel BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Permit u e Job Address: Legal Description Parcel 4 Floor e�a o /c 40orZ Valuation of Work ,' Prnnowf�T no $14�0_dd 1,;�' Proposed Work heated/cooled Class of Work(circle one): cie:w:) Addition Alteration Repair Move Demolition pool/spa o /door Use of existing/proposed structure(s) circle one): Commercial 1[,'e s Zid en:ti a�l If an existing structure,is a fire sprinMr system installed? (Circle.one): 0 N/A Florida Product Approval# For multiple products use�r­oduct approval form Describe in detail the type of work to be performed: Property Owner Information: 41 41; 1"(`6 Address: Name: '—hone city State ipTLO �Phone E-Mail or Fax 9(optional, Contractor Information: Company Name: uali g A ent: 4544 Address: city L, State 4-- �Zip �� Office P ne Job Site/Contact Number !?_VV 9J_? 74 '(-.4-_Fax# State Ce ication/Registration ,,�; - Architect Name&Phone# Engineer's Name &Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and 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 be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null ofa permit and that all work wdl or work is s ended or abandonedfor a eriod ofsix(6)months at any time after and void ffwork is not commenced within six(6)months, or if construction If work is commenced I understand that separate permits must be securedfor ElectricylWork Plumbing,signs, ens,Pools, Airnaces,Boilers,Heaters, Tanks and Air Conditionery,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 YOV1k NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type pj work will be coTplied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the Ff ns ru provisions of any otherfederal,state, or local law regulating construction or the pe ormance of co t ction. Signatdreofownm Signature of Contractor ntj��AAW -- Print Name 04--c—Ohl V) ',� Print Namee ............................................................. .............................................................................................. B t�efopjg­e Befor t i, Rr-of 20 this of 220 L ky PAOLA GIL o ary lorida ;6 C EXPIR' U Notary b ic Jun 23,2015 14: w MMI My Comm.Expires ES-. 10.24.12 Commission#EE 105915 ....... BmdedThruNo,tsryPuNcU%Q I OFV, 1� P. T'-T- City of Atlantic Beach f Building Department 8DO Seminole Road Atlantic Beach,Florida 32233ZW X) Phone(904)247-5M6 - Fax(V E-mail: bui1dng-dept@cwb.us EN �R City mmb-s& htIpJAww co2b us APPLICATION R ND TRACKING FqRM Property Address: /I _711 Department review roquired Yes No Dee,--- Applicant: A P antning 8.; ishlator Project: FP__1J_b_ric 3 ge t y I [-Fire Se Review or Receipt Other Agency Review or Pennit Required of Oermit Verifl6d B Date _y Florida Dept of Environmental Protection Florida DepL of Transportation St.Johns Mver Water Management DisM Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco APPLICATION STATUS �JApproved. Reviewing'Department First Review. [3Denled. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: Da*te: 43 . TREEADMIN. Second Review: ElApproved as re0sed. DDenled. nt Comments, S 3 15- _/ i I Reviewed by- Date: PUBLIC SAFETY FIRE SERMCES Third Review: DApproved as revised. DDenled. Comments: Reviewed by Date: Ravised 07WI10