1927 Beach Ave row 2014 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RIGHT OF WAY PERMIT
MUST CAII Py 41214 FOR blr-= DA34 TNC12r-CT.TnN- -342-9814
JOB INFORMATION:
Job ID: 14-ROW-77
Job Type: RIGHT-OF-WAY PERMIT
Description: REPLACE DRIVEWAY AND POOL DECK
Estimated Value: $5,883.00
Issue Date: 10/2/2014
Expiration Date: 3/31/2015
PROPERTY ADDRESS:
Address: 1927 BEACH AVE
RE Number: 169691-0000
PROPERTY OWNER:
Name: TOVEY, KIRK A
Address: 13751 CLUB COVE DR
GENERAL CONTRACTOR INFORMATION:
Name: GBN CONSTRUCTION, INC.
Address:
Phone: - -
PERMIT INFORMATION: UTILITY DEPT.:
Avoid damage to underground water/sewer utilities. Verify vertical and horizontal
location of utilities. Hand dig if necessary. If field coordination is needed, call 247-
5834.
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible.
A sewer cleanout must be installed at the property line. Cleanout must be covered with
an RT1 concrete box with metal lid. Cleanout to be set to grade and visible.
FEES:
Fence/ROW $35.00
Building Flat Rate Fee $55.00
Total Payments: $90.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
P W7 APPLICATION NUMBER
City of Atlantic Beach
o be assigned by th2j�L flilding,Department.)
Building Department
800 Seminole Road SFP 7014 -77
Atlantic Beach, Florida 32233-5445 9A R2 S
Phone(904)247-5826 - Fax(904)247-5845 LDate r�oujteeZ
City web-site: http://www.ciDab.us Date routed:
APPLICATION REVIEW AND TRACKING FORM
-b—epart ;nt review required Yes No
.,4VC
Property Address: Building
Applicant: g rr1tC--17 Plannint '),,Zoning
Trq� inistrator
Project: Inc- W'4 V
ublic Utigl-eD
Ic
r
u 1c ety
Decv, T=
rFire Set �s
Review fee Dept Signature
CONTRACTOR EMAIL I IDRESS 0rr1*tt& AgAI&Asrr
CONTRACTOR CONTACT # qq3 -C) k70
APPLICATION STATUS
Reviewing Department First Review- �VApproved. []Deni(
(Circle one.) Comments.
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN.
Second Review: FlApproved as revised. []Denied.
PUBLIC Comments:
C:PIUBLIC UTILITI Reviewed by:_- Date:
PUBLIC SAFETY
FIRE SERVICES Third Reviev, ElApproved as revised. nDenieCr
Comments:
Reviewed by:_. Date:
REVISED 09252014
APPLICATION NUMBER
D ment.)
City of Atlantic Bea, 1 by the
# e ,41 ing epart
(To be issignid
Building Departme�,
800 Seminole Road 77
SEP 2
h, Florida 32233-5445
Atlantic Beac
Phone(904)247-5826 F-rlx(904)247-5845 Date routed:
City web-site: http://www. : )ab.us
APPLICATION REVIEW AND TRACKING FORM
1 14VO�' Department review required Yes No
Property Address: Building
0
8 Planning &Zoning
Applicant: Treg . . tor
_AdI31inistra
ubl ic Uti I I
Project: 7D-r I.�V -
u 1c a ety
0 Fire Services
Dept Signature
Review fee $_. -0-Y
j fi67-
CONTRACTOR EMAIL / IDRESS __I
CONTRACTOR CONTACT #
APPLICATION STATUS
I I� �� �/2�11
q(Approved. OlDenied.
i Reviewing Department First Review
(Circle one.) Comments'. C-
BUILDING h
PLANNING &ZONING Reviewed by-._�4-1 �:I ]
TREE ADMIN. Second Rev []Approved as revised. E]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES Reviewed by: Date:
PUBLIC SAFETY
FIRE SERVICES Third Revie%, DApproved as revised. OlDenied.
Comments:
Reviewed by: Date:
REVISED 09252014
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
goo seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
1qte-euze- Permit Number:
Job Addresi .. .. ... .. ... , 1,1'' ''' ;:I --,y-
I P' I . I'l V -
Lo-1 �cl Parcel#
pQ3, 5-7 b(,Ivll of-(
Legal Description 11 C I
or ea o t. non-heated/cooled_____�
Valuation of Work$21-�� ProposedWork heated/cooled___�
Class of Work(circle one): New Addition Alteration Repair Move Demolitio ol/sp window/door
Commercial (Jiesidenti
s 0
Use of existing/proposed structure(s)(circle one): on �eso N/A
If an existing structure,is a fire sprinkler system installed? (Circle e):
Florida Product Approval# -S"e- `7�t�`ke-j
For multiple products use product approval 1011 11111 +
Describe in detail the type of work to be performed e-
C�<-'
-�U2�e' -6��v�er i�nforma�tion-
Po T� 1.
jr i r Address: Cove 3,;L Z
Name: FLZip 3
���State�F--LZZiP:;L-
city r-,e-+
E-Mail or Fax#(optional) �J At eO A
A f,1
Phone�4
Contracto information: ing Agtnt: a-
Z.
Q�-`Lt I
Qualify
ompany Name:-G C2>k'� CO P, State f 1P
City 7
-v
Address: (cO�a�A�,-(6--� - f�o Fax# 01
Jo Site/C—olct Number
coffice Phone
st ion# 3 a
State Certification/Regi 01f
Architect Name&Phone#--- G 0
Engineer's Name&Phone#
Fee Simple Title Holder Name and Ad ss 0
Bonding Company Name and Address ------------
Mortgage Lender Name and Address —-----------------
)rk or installation has commenqd prior to the
as indicated. I certify that no�vo This permit becomes null
Application is hereby made to obtain a permit to do the work and installations fall laws regulating construction in this jurisdiction.
ended or abandonedfor aWeriod of siXP9 months at any time after
Boilers,Heaters,
d that all work will be pedbrmed to meet the standards o ells,pools, urnaces,
issuance of a permit an d within six(6)months,or if construction or work is st ip
and void ff work is not commence it that separate permits must be secured for Electric,I Work, Plumbing,Signs,
work is commenced. I understan
Tanks and Air Conditioners,etc. YOUR FAILURE TO RECORD A NOTICE OF
WARNING TO OWNER: ' UR F'AYING TWICE FOR IMPROVEMENTS
CONIMENCEMENT MAY RESULT IN YO BTAIN FINANCING CONSULT WITH
TO YOUR PROPERTY. IF YOU INTEND TO 0 CORDING Y&R.NOTICE OF
YOUR LENDER OR AN ATTORNEY BEFORE RE
COMMENCEMENT.
;ame to be true and correct. All provisions of laws and ordinances governing this
and examined thisap Iicatiqn and know ti.e f a permit does not presume to give authority to violate or cancel the
I hereby certify that I have read , ep
)rk will be complied ith whether speci ted herein or not. Tho granting o
type qf wc 1 law re I t, construction �r the pe�forrnance of construction.
provisions of any other e er )c-ee-
Signature of Owne Signature of contractor ..........
PrintName .... ................................ V... ...... ...... . ..................................
..........................................
............................
Print Name ...................................................... Sworn to and subscri bef re mq 204
Sworn. to and subscribq#betorp me this--13 Day oo
a,
Notary ic
ot&ry RjblO Revisc-C'01.26.10