405 Skate Rd 2014 foundation repairs -j r�l`Jr
CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
FOUNDATION ONLY
MUST CAtt BY 4PM FOR NE)ff DAY!NSPEfflON. 24? 581:4
JOB INFORMATION:
Job ID: 14-FOUN-106
Job Type: FOUNDATION ONLY
Description: INSTALL PILINGS FOR FOUNDATION REPAIR
Estimated Value: $16,655.00
Issue Date: 10/7/2014
Expiration Date: 4/5/2015
PROPERTY ADDRESS:
Address: 405 SKATE RD
RE Number: 171530-0000
PROPERTY OWNER:
Name: PHILLIPS, ALFRED C
Address: 405 SKATE RD
GENERAL CONTRACTOR INFORMATION:
Name: RAM JACK
Address:
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $133.28
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $66.64
STATE DBPR SURCHARGE $2.00
Total Payments: $203.92
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
' x"�•l'�r9Kiy+ F'.seem+ta�'Sr;'�'t9^a¢�Htl'egs,:,�c?. _
BUILDiNGPERMITAPPLICATIONLCOPCITY OF ATLANTIC BEACH Ij
800 Seminole Road,Atlantic Beach,FI-32233 S 20 4
";`'^ .:;: �•
Office(904)247-5826 Fax(904)247-5845
doll :\eitlress: 405 SKATE RD ATLANTIC BEACH FL 32233 Permit Number:
I.coal Description 31-16 38-2S-29EROYAL PALMS UNIT 2A R/P LOT 11 BLK 18 Parcel N 171530-0000
Floor Area ot Sq.Vt. • q.•t
1044
Valuation of Work S 16,655 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration )(Repair Move Demolition poot/spa window/door
Use of existinWproposed structure(s)(circle one): Commercial XResidential
If an existing;structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approve orm
Describe in detail the type of work to be performed: INSTALLING PILINGS FOR FOUNDATION REPAIR
Property Owner Information:
Name:
ALFRED PHILLIPS Address: 405 SKATE RD
City ATLANTIC BEACH Stator"/.ip 233 Phonc,04-710-9362
E-Mail or Fax ll(Optional) -
Contractor Information:
Company Name: RAM JACK FOUNDATION REPAIR Qualifin A�cW. A.SCOTT ERLEWINE
Address: 14403 City JX& SWrELE State
Office Phone q04-380-8488 Joh Sitc,Contact Number Fax# $03-3=61
Statc Ccrtilicatiort/Registration# C C1_5.1.8926
Architect Name&Phone#
Engineer's Namc&Phonc# SAUL MARTINEZ 843-339-1620
Fee Simple Title Holder Name:and Address._
Bonding Company Name and Address
Mortgage Lender Name and Address _
Appin am+n is hen•hr made d+nhtum a permit to du the stork and imiallano"as+ndicau d 1 certtfs•that as.stork ar installation has commenced prior ro the
issuatr,a ofa permit and that till stork will he performed to meet the standards ofall laws regulating t onstructiun tit this jurisdu-twn. This permitbteomes null
and surd it stork is net commenced within six 161 months.or if ca m"ction or stork is suspended or abandoned far a/wrttul of sit t6i months at tan'time after
work is commenced 1 understand that separate permits must be secured jar Electrical Work,Plumbing,Signs,bells.Pools,Furnaces,Boutis,lltwten.
TanAs and Ah,Conditioners,err.
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 Y61JR NOTICE OF
COMMENCEMENT.
t lu reit certify that I hast'orad and rtainined this ayylicution ata/knost•the sa+ore w he tour and anrrrct. t 11 pn.vrnnns of lusec nml urdoann s gnsrrning dais
qpe of stork will ht complied with whither.s� -ci/ted herein or not. The gnuaing of a permit Bars not presume to Rise atithorin to vinlatr or cancel the
prrssxsnns of any t) r/rdrraf,start or local I<tw ran
regulating structian or the prrlorrmmcr of cansrnrrfinn.
Signature of Owncr -A _^ Signature of Contractor
IF
Print Name .11 -.. � �...............__........... Print Name .e...c5 -• �'.v!Y1.tY .._.. _ _
Sworn o and subs cr'nil h-fore n c Sworeand subsc 'bed -fore me
this Day of 20 Day of 2014
cviscd 01.26.10
SHANNON E.MURPHY .0.opu%SHANNON E.MURPHY
MY COMMISSION#EE872623 MY COMMISSION#EES72623
EXPIRES:FAY 07,2017 Febnu 01,2017
a or
City of Atlantic Beach APPLICATION NUMBER
JS �� Building Department (To be assigned by the Building Department.)
800 Seminole Road FOLArV
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
COM City web-site: http://www.coab.us LDate routed:
APPLICATION REVIEW AND TRACKING FORM
Property Address: �'�� SI Wl� �d D artment review required Yes No
Building
Applicant:
Planning &Zoning
Tree Administrator
Project: �-' 'y Public Works
F N Public Utilities
"�J Public Safety
Fire Services
Review fee $ Dept Signature
CONTRACTOR EMAIL ADDRESS
CONTRACTOR CONTACT # goLq590 60(8
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING ✓y�� Date:
Reviewed by: / `
TREE ADMIN.
Second Review: ❑Approved as revised. FIdgied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES
Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
REVISED 09252014