156 Belvedere St 2013 zoning disapproval for pavers City�i of Atlantic Beach APPLICATION NUMBER
Buil I fing Department (To be assign7edjb the Building Department.)
800,1 eminole Road
Atlan ic Beach, Florida 32233-5445
Phon B(904)247-5826 - Fax(904)247-5845 te
routed:
E-me 1: building-dept@coab.us [EDate i
City*eb-site: hftp-://www.coab.us
APP�LICATION REVIEW AND TRACKING FORM
/Y f— Department review required Yes -No
Property Address�
'k k"
Yes
lanning &kni
Applicant: —41G
re ator
Project: Public Works
Public Utilities
Public Safety
Fire Services
Review or Receipt Date
Otherl Agency Review or Permit Required of Permit Verified By
Florida Dept. of Environmental Protection
Florid a Dept. of Transportation
St. Joins River Water Management District
Army iCorps of Engineers
Divisi�n of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Oth�e :
APPLICATION STATUS
Reviewing Departm! int First Review: FlApproved. ElDenied.
0
(Circle one.) 1� Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
_lDenied.
TREE ADMIN.
Second Review: ElApproved as revised.
PUBLIC WORKS Comments:
i
PUBLIC UTILITIES
Reviewed by: Date:
PUBLIC SAFETY
FIRE SERVICES i Third Review: FlApproved as revised. []Denied.
Comments:
Date:
Reviewed by:
Revised 07/27/10
APPLICATION
49 BuILDING PERMIT
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
JUN 14 2o13
Office (904) 247-5826 Fax (904) 247-5845
4&d, -Z Permit N
Job Address: L5(oA?16t er-4Z
Parcel 4
Legal Description I 'q
11 iAreaoF— 717 'n'(�n-heated/cooled
h ated/cooled
Valuation of Work$4�00�1041 Proposed Work e
Class of Work(circle on, New Addition Alteration (���pat) Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential N/A
If an existing structure,is a fire sprinkler system installed? (Circle.one): Yes No
Florida Product Approval#
For multiple products use produ`%t/ap4p_rov=aorm
i to be performed: ",0- lit aud Lal&t's-
Describe in detail the type of work —A
zl,5�, 130 9j5'R?aonQ
6a v e,4-A C
I
Property Owner Infor ation:
#A I Address:
Name: FIC
State EZip - n42:5 Phone
city r _ p_4_
E-Mail or Fax#(Optiona I)
Contractor Information:
6- F
I W
g",_0 Ak�lc-La Qualifying Agent: lrfl�V14 L11
Company Name: �AaLt ity_,)- 5_0yL&N p
Address: I K .2ZZuctj.Eax
q 4 Job Site/Cont�ct NINumbler
Office Phone '
State Certification/RegisTation
Architect Name&Phone#—
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
0 obtain a ermit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
Application is hereby made t )erformed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
a permit and that,all work will be I or aWeriod ofsixp6)months at any time after
Pf i e
issuance c_ f construction or work is su ended or abandonedf urnac s,Boilers,Heaters,
,nced within six(6)months, or i r,
and void ifwork is not comm t be securedfor Electrica Work,Plumbing,Sikns, ells,Pools,
work is commenced. I unde��tand that separate permits mus
Tanks and Air Conditioners'll etc.
WARN i ING 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.
th*s
ndcorrect. All provisions of laws and ordinances vernicneg, t i
road and examined this lication and know the same to be true a he
I hereb certify that I hav6 a The granting of a permit does not presume to give authority to violate r can
hether speciflild herein or not. A"provis'
resume
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typ e o7work will be complied with w n.
ot.p
'ct'o
Ir t n or the pe�formance of construction.
provisions of any otherjede�al,state, or local law regulatin construc zo
ctor
e ntra
Signature of Contractor
Print Name ...... ..... .....
Print Name je,"I ,,,(:5:,
.............................................................................
Before iqe
Before e 20 / 5 t is -iDay of 200-
this Day of
tary Public f*F omm ssion#DD 913547
E lire 11 12
Katherine Perry
my commission EE046194
. �13
44 -7019
nsurance 8S385
Expiras 02106/2015
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