765 Sabalo paver patio voided 2013 City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
r 800 Seminole Road
Atlantic Beach, Florida 32233-5445 / Q
Phone(90 4)247-5826 • Fax(904)247-5845 !
E-mail: building-dept@coab.us Date routed: / ZJ
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 71 ,< DgjLartment review required Yes No
Applicant: Q it) 111254 Planning & oning
Tree minis ra or
Project:
� � �� Public Works
�� �� //1� f!�
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 C�
Reviewing Department First Review: ❑Approved. ❑Denied. `
(Circle one.) Comments: ` /0 i DW
BUILDING \/ ;�/J
PLANNING &ZONING
Reviewed by: 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 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 7 .5a 46 ,t 1-6 Permit Number:
Legal Description Parcel#
FloorArea of Nq.Ft. 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): Commercial 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 approvaorm—
Describe in detail the type of work to be performed:_ �/� / ( �G�. 0 /w op sAe
ProveProvertv Owner Information:
Name: F Addre s
City t L fl State Zip Z one
E-Mail or F #(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Q ifying Agent:
Address: ty State Zip
Office Phone Job Site/Contact N er Fax#
State Certification/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. 1 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 if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a_period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, Furnaces,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.
I herebycertify that I have read and exa inSoorhi s a icat' and know the same to be true and correct. All provisions of laws and ordinances governing this
type owork will be complied w' w th eci ie ein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, ate, I 1 re ting onstruction or the performance of construction.
Signature of Owner Signature of Contractor
Print NamePrint Name
.........................................................................................................................................
.................. ...................................................................................................................
Bef Before me
tris Day of 20 � this Day of 20
is Notary Publi
Revised 01.26.10
MAP SMOWNG SURVEY OF
LOT 8, BLOCK 9, ROYAL PALMS UNIT TWO AS RECORDED IN PLAT BOOK 30, PAGES
94 AND 94A, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
LOT 14
Lor 1$
LOT 16
_ FFNCF
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10 2,0 40
SCALE: 1" = 901
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rS_Vi y., City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
>1 800 Seminole Road AF 3g
x Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax(904)247-5845 !
E-mail: building-dept@coab.us Date routed: ZJ
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /�Q �o DQuartment review required Yes No
Applicant: O Nile Planning & oning
Tree minis ra or
Project: ��/ Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or ReceiptDate
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:
7AYPPCATION STATUS
Reviewing Department First Review: ved. ❑Denied.
(Circle one.) Comments:
BUILDING
PL NNING &ZONING Reviewed by: /"(r Date:
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 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: 7 .5a B *,1-a Permit Number:
Legal Description Parcel#
oor Area of So.Ft. Sq, 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/pro osed structure(s)(circle one): Commercial 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 approval orm
'✓Describe in detail the type of work to be performed:_ e /p �i� `� d l77
Property Owner Information:
Name: F Address
City Z L N State Zip 2 341one
E-Mail or F #(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Qifying Agent:
Address: ty State Zip
Office Phone Job Site/Contact N er Fax#
State Certification/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 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 if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a__pperiod ofsix6)months at any time alter
work is commenced I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, We11s,Pools, urnaces,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.
I hereb certify that I have read and exa ine his ica ' and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied w' w th e i to ein r not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, ate, I 1 re ting onstruction or the performance of construction.
Signature of Owner Signature of C/ntractor
Print Name Print Name
.........................................................................................................................................
Bef Before me
1kis Day of 20 this Day 20
is Notary Publi
Revised 01.26.10
MAP SH OW N G SURVEY OF
LOT 8, BLOCK 9, ROYAL PALMS UNIT Two AS RECORDED IN PLAT BOOK 30, PAGES
94 AND 94A, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
LOT 14
LOT 1g
LOT 16
i
6 w000 FENCE (S_85'33'46;X81,43'_FIELD) at,uNAl
_ FOUND o�' N?ON ,., 8 85 37 27 E� 80.6$'_- _ -Foam;1r`ic _,canes
4' ,4`p{/11NUNK FFNCE PK NO CAp
u 2.0'� 6' iYl7pO FENCE `` �� _ 0. S' 4,, Ai NK FF)10E
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PIPE. NoF 1;2' o" tV85 4 �" K FENCE o.r' —
37 27"W 80.65' �Nce � ��- IRON - -
(N85 37'27-W 80.68' FIELD) ON UNE NO CAP
SAeALO DRI VF
60' RIGHT OF WAY PUBLIC PAVED ROAD
10 20 40
SCALE' 1' = 20'
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