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1619 Beach Ave 2014 deck pavers Vi ,`��j CITY OF ATLANTIC BEACH Is1 J 800 SEMINOLE ROAD 1 r� ATLANTIC BEACH, FL 32233 J V INSPECTION PHONE LINE 247-5814 RESIDENTIAL ALT/OTHER JOB INFORMATION: Job ID: 14-00001074 Job Type: DECK/PATIO Description: REMOVE/DISPOSE OF EXISTING DECK/INSTALL PAVERS Estimated Value: $25,000.00 Issue Date: 10/3/2014 Expiration Date: 4/1/2015 PROPERTY ADDRESS: Address: 1619 BEACH AVE RE Number: 169648-0000 PROPERTY OWNER: Name: MOODY, DOUGLAS W Address: GENERAL CONTRACTOR INFORMATION: Name: CHARLES WILLIAMSON MASONRY,INC Address: Phone: - - PERMIT INFORMATION: PLANNING AND ZONING: PUBLIC WORKS: per dr Full right-of-way restoration, including sod, is required. Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Republic Services, 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. The City understands pavers being installed are not pervious and no stormwater credits are requested now or in the future. FEES: BUILDING PERMIT FEE $175.00 STATE DCA SURCHARGE $2.63 PLAN CHECK FEES $87.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. STATE DBPR SURCHARGE $2.63 NOTICE OF COMMENCEMENT State of %711 County of J�/,r�/ � Tax Folio No. To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: Address of property being improved: /V01f j¢�y ���,�/�,J� �� r�T��7 � 4 General description of improvements: Owner:���� � � Address: Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): /y�I Name: Contractor: 'e r ,_ l j_11b%1a/l/ Address: 2 �'t7� /�/!�� ;;/ Telephone No.: 9a1l Fax No: Surety(if any) Address: Doc#2014268721,OR BK 16989 Page 1461, Telephone No: Fax No: Number Pages:1 Recorded 12/01/2014 at 09:52 AM, Name and address of any,person making a loan for the construction of the imprc Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY Name: RECORDING$10.00 Address: Phone No: Fax No: Name of person with/inn the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Address: W i/�Q Jw L �zZ� Telephone No: 9d7'��5' /��� Fex-i'd6: e?11 ql/ 3 f—�, In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Floridi���esn. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: ! Date: Before me this a 4 day of_iu ov . 2l0 L cF in the County of Duval,State •;;s*:�y, KATRINA HATCHER Of Florida,has personally appeared_Douc%jCt S w- IM cod u Commission#EE 188131 —� a. Expires April 10,2016 Personally Known: or a goMtdihuT�oyFain lnsixante800-385-7019 Produced Identification:t= _ _ 4 el_a Notary Public: - My commission expires: �},r,�0 i 00 1 in `I, CITY OF ATLANTIC BEACH 1 s) 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Total Payments: $0.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH f 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 r ' r INSPECTION PHONE LINE 247-5814 TLANTIC BEACH PERMIT DESCRIPTION: REMOVE/DISPOSE OF EXISTING DECK/INSTALL PAVERS PERMIT NUMBER: 14-00001074 ADDRESS: 1619 BEACH AVE OWNER: MOODY, DOUGLAS W FEES DUE: BUILDING PERMIT FEE $0.00 STATE DCA SURCHARGE $0.00 PLAN CHECK FEES $0.00 STATE DBPR SURCHARGE $0.00 Totals: $0.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICAT' N ^a CITY OF ATLANTIC BEACI- j rI �I0Z 0 (1f 800 Seminole Road, Atlantic Beach, FL '- ' 233 I Office (904) 247-5 6 Fax (904) 247•. ;45 cr it Number. Job Address: JJ Legal Description LO n -� # g p oor Area o q. t. q. t Valuation of Work$ SO& Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): ('' ewe Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial If an existing structure,is a fire sprinkler system installed? i one): Yes No N/ Florida Product Approval# te For multiple products use pro act approval form y p cop Describe in de it the type of work to be performed: ffn t 10 � SLX t? JLr:;1) c. dcr i4ji ick N- Property Owner Information: 2-67—67— Name: Address: City o i Ce L State Zip , ? Phone E-Mail or Fax#(Optional- Contractor Informattion: Company Name: L,YI ma_S I iIayiw�'0 �i 1 p Qualifying Agent: _ Address: ��`�,` c- 1 City I 'Sv : +:it-L State L Zip 221 Office Phone Q ob Site/Contact Number� y� 4�Lb Fax State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone Fee Simple Title Holder Name and Address t. 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 tiv 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 coriaaction 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 abart oned for a period of six(6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,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 BEFR ENTCO ,GING YOUR NOTICE OF COMI hereb cert that 1 have read and examined this plication and know the same to be true and corre (ll provisions of laws and ordinances governing this type p.workwill be complied with whether speci ie herein or not. The granting of a permit doe. presume to give authority to violate cancel the provisions of any other federal,state, or local law regulating construction or the performance of const >n. Signature of Owner Signature of Contractor � Print Name _ _`!$ ' ....... .Qd. ..............._.............. Print Name (} ��.: ........1._����....l..l.�... �. r_.�............ Swo d subscribed before me Swo o and subscrib fo a me 20 this Day of 20 this ay of N 11C ��" Notary Public State of FIon O b is Shirley L Orahhm My commission Fit oaeopo Revised 01.26.10 Expires 02/14/2010 FILE COPY Ci of Atlantic Beach APPLICATION NUMBER SEP 12 201 . Building Department \ o be assigned by the Building Department 800 Seminole Road -2- S� I L4 — 10� / Atlantic Beach, Florida 3223 4 Phone(904)247-5826 Fa '141 ,l' J t)� E-mail building-dept@coab.us Date routed: City web-site http-//www coah us APPLICATION REVIEW AND TRACT%ING FORM Property Address: rtment review required Yes No Buildi Applicant: (��`-�S lJv 1 I � anning &Zoning ,,//�� Tree Ad -us Project: I'�cryw -_�CIS �Puibl'blic V -ks I Q� w! ��� cl hies / Pu Ic. .aty Fire Ser es Review fee $ Dept Signature Other Agency Review or Permit Required Review or Recfof Permit Verifir-, -y Date Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers j Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco I Other: I - APPLICATION STATUS Reviewing Department First Review: ❑Approved. DeniE (Circle one Comments: BUILDING PLANNING &ZONING Reviewed by: Date TREE ADMIN. Second Review: ❑Approved as revised. ❑Deni- PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. Comments: Reviewed by: Date: I FILECOPY ' PUBLIC WORKS PIAN REVIEW COMMENTS a Date: 8-6-14 Initials: PN ML Project Name/Address: 1619 Beach Ave. Application Permit#: 14-1074 Check Box Check Application Tracking Comments to Add Box to Comment "Print" IMPS Provide table of impervious surface calculations for entire lot(existing and post ❑ construction). X ESCP Provide erosion and sediment control plans with installation details and r9aintenance Ml's ❑ schedule. 5Il-1— r pfpbt: () ey6AVr�no0 i�(zeA .fin fton / DPLN Provide drainage plans showing site topography(flow arrows,etc.) ❑ ❑ RMRO All runoff must remain on-site. Cannot raise lot elevation without measures to retain ❑ ❑ runoff. CSMP Provide construction site management plan,including Right-of-Way Permit if using 13right-of-way for construction parking. (�h S J I ' TSUR Provide a pre-construction topographic survey prepared by a Florida Licensed Professi al ❑ ❑ Land Surveyor,showing V contours. Section 24-66(b)of the Land Development Regulations requires on-site storage for LDCS increased run-off if adding 400 SF or more impervious surface. Delta volume calculations ❑ and on-site retention required per Section 24-66(b). City will calculate required storage m from Impervious Surface added. HOW M A&H W A-1- 2 $T0Zq9C PCTS If on-site storage is required,a post construction topographic survey documenting proper construction will be required. Y1d hf- RWPM A Right-of-Way Permit must be obtained for use ❑ ❑ REPM A Revocable Encroachment Permit must be obtained. ❑ ❑ PLWP Pool—Wellpoint(if used)must discharg r ❑ ❑ drainage feature(swale,structure or lag All concrete driveway aprons must be 5" DAPR pavement to the property line. Reinforc ❑ way. (Commercial driveways—6"thick.) Any utility cuts in the road must be repai URCT overlaid 10 feet in each direction from th ❑ ❑ plans. RWRS Full right-of-way restoration,including so Roll off container company must be on Ci n ROFF City right-of-way. (Approved:Advanced D Management). Full erosion control measures must be inst g any earth ECIN disturbing activities. Contact Public Works( 47-583 for rotin and Sediment Control 2Inspection prior to start of construction. �C,A- /L— I hS ffdu it MEET Recommend Owner/Contractor meet with Public Works Director to discuss proposed ❑ ❑ + construction. Cali 247-5834 to make an appointment. Provide installation details if 50%impervious credit for pavers desired. ❑ o� FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION Bureau of Beaches and Coastal Systems _ _ + 3900 Commonwealth Blvd—MS 300 Permit Number. W FLOR A Tallahassee,FL 32399-3000 (850)488-7708 No.of Pages Attached: FIELD 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 Environmental Protection and found to be in compliance with the requirements of Chapter 62B-33,Florida Administrative Code(FA.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,FA.C. j� PROJECT LOCATION: / �5�,' f G `� t► ` t� PROJECT DESCRIPTION: ; l /W► j i�t f ' �k� c� l SPECIAL PERMIT CONDITIONS: This permit is valid only after all applicable federal,state,and local permits aro obtained and does not authorize contravention of local setback requirements or zoning or building codes. This permit and public notice shall be posted on the site 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: L c �. STANDARD PERMIT CONDITIONS: The permittee shall comply with the attached standard field permit conditions. APPLICANT INFORMATION: I hereby certify that I am either. (la)the owner of the subject property or (lb)I have the owner's consent to secure this permit on the owner's behalf;and that(2)1 shall obtain any applicable licenses or permits which may be required by federal,state,county,or municipal law prior to commencement of the authorized work; (3)I acknowledge that the authorized work is what I requested;and(4)I accept responsibility for compliance with all permit conditions. ` 9 Y 3 y�yg�o .�.fr; Applicant's Signature -.�/ZtL�. Da6e n� Telephone No. Applicant's Printed Name Ih rv?M�Mree 7 /Y If applicant is an agent: [ l 1 "0 / printed name of property owl* property owner's address property owner's telephone no. DEPARTMENT FINAL ACTION AND FILING AND ACKNOWLEDGMENT: This field permit is approved on behalf of the Department of Environmental Protection by the undersigned staff designee,and filed on this date,pursuant to section 120.52,F.S.,with the undersigned designated Deputy Clerk,receipt of which is hereby acknowledged. ��4ffDesignee,Depulya Printed Nan►eofDesignee/DeputyClerk Daly PUBLIC NOTICE IS ON THE BACK OF THIS PERMIT. EXPIRATION DATE: (Emergency permits issued pursuant to Section 6213-33.014,FA.C.,are valid for no more than ninety days and o er pemuts rd or no more than 12 months. The staff designee may specify a shorter time limit.) EMERGENCY PERMIT:❑ YES D NO Approved plans are attached: DYES ,�NO AND PUBLIC NOTICE CONSPICUOUSLY ON THI✓.SITE DEP form 73-122(Updated 01/06) Vhite Copy-Tallahassee Office] [Yellow Copy-Applicant] (Pink Copy-Staff Designee] Al/rVERMEV ARCHITECT 420 S. THIRD ST. 246-1 150 Aff JACKSONVILLE BEACH, FLORIDA September 9, 2014 City of Atlantic Beach Department of planning and Development Project , 1619 Beach Avenue, Atlantic Beach, Florida The following is a Calculation of the impervious surface areas : 1. Total site area= 19931.76 sq. ft. 2. House footprint= 2553.5 sq. ft. 3. Driveway= ; 2097 sq. ft. 4. Detached garage= 728 sq. ft. 5. Patios, decks and walkways replace with pavers= 2109 sq. ft. Total lot coverage existing = 7487.5 sq. ft. = 37.5% Please call if I can answer any questions. S , cerely, �t6erarc Vermey TREMRON I WE MAKE IT, EASYr- t SECTION 02780 NOTE: THIS IS A GUIDE SPECIFICATION FOR THE CONSTRUCTION OF TREMRON INTERLOCKING CONCRETE PAVERS AND BEDDING SAND OVER A DENSE-GRADED, COMPACTED AGGREGATE BASE. THIS SPECIFICATION SHOULD BE EDITED BY AN ENGINEER/ ARCHITECT TO CONFORM TO PROJECT CONDITIONS AND LOCATION. NOTES ARE PROVIDED ON THE USE OF A COMPACTED AGGREGATE BASE UNDER THE BEDDING SAND AND PAVERS. OTHER BASE MATERIALS MAY BE USED. THE USER SHOULD REFER TO INTERLOCKING CONCRETE PAVEMENT, INSTITUTE ICPI SOFTWARE, ZAPHERS T'^ DETAIL AND SPECIFICATIONS FOR INTERLOCKING CONCRETE PAVEMENT, FOR VARIOUS GUIDE SPECIFICATIONS AND DETAILED DRAWINGS. TREMRON A 1 Y PART 1 - GENERAL 1.01 Section Includes A. Concrete Paver Units B. Bedding and Joint Sand C. Edge Restraints 1.02 Related Sections Tech Data: A. Glossary of Terms used in the Production, Design, Construction, and Testing of Interlocking Concrete Pavement- ICPI Tech Spec#1 B. Construction of Interlocking Concrete Pavement - ICPI Tech Spec#2 C. Edge Restraints for Interlocking Concrete Pavement- ICPI Tech Spec#3 D.Structual Designing of Interlocking Concrete Pavement for Roads and Parking Lots- ICPI Tech Spec#4 E. Cleaning and Sealing - A Maintenance and Protection Guide-ICPI Tech Spec#5 F. Application Guide for Interlocking Concrete Pavements- ICPI Tech Spec#10 1.03 References NOTE: Pavements subject to vehicles should be designed in consultation with a qualified civil engineer, in accordance with established flexible pavement design procedures, Pavespec Software, and in accordance with the ICPI "Tech Spec"Technical Bulletins. A. American Society of Testing and Materials (ASTM): 1. C 33. Specification for Concrete Aggregates. 2. C 136. Method for Sieve Analysis. 3.C 140. Sampling and Testing Concrete Masonry Units. 4. C 144.Standard Specification for Aggregate for Masonry Mortar. 5. C 936. Specification for Solid Interlocking Concrete Paving Units. 6. C 979. Specification for Pigments for Integrally Colored Concrete. 7. D 698.Test Methods for Moisture Density Relations of Soil and Soil Aggregate Mixtures using a 5.5 Ib. (2.49kg) Rammer and 12 in. (305 mm) drop. 8. D 1557. Test Methods for Moisture Density. 9. D 2940. Graded Aggregate Material for Bases or Subbases for Highways or Airports. B. Interlocking Concrete Pavement Institute(ICPI): 1.Tech Spec Technical Bulletins. 1.04 Qualify Assurance A. Installation shall be by a contractor and crew with at least one year of experience in placing interlocking concrete pavers on projects of similar nature or dollar cost. B. Contractor shall hold a current'certificate from the Interlocking Concrete Pavement Institute Concrete Paver Installer Certification program. C. Contractor shall conform to all local, state/provincial licensing and bonding requirements. 2 TREM-RON WE MAKE IT EAS" 1.05•#'r'€/t3mittals A.Shop or product drawing and product data. B.Full size samples of concrete paving units to indicate color and shape selections.!color will be selected by ArchitectiEngineerfLandscape Architecl/Owner from manufacturer's available colors. C.Sieve analysis for grading of bedding and joint sand. D.Test result from an Independent testing laboratory for compliance of paving unit requirements to(ASTM C 936)(CSA)or other applicable requirements. E.Indicate layout,pattern,and relationship of paving joints to fixtures and project formed details. 1.06 Mock-ups A.Install a 7 ft.x 7 ft.(2 m x 2 m)paver area as described in Article 3.02. B.This area will be used to determine surcharge of the bedding sand layer,joint sizes,lines,laying patterns),color(s),and texture of the job. C.This area shall be the standard from which the work will be judged and it shall be incorporated Into the work. 1.07 Delivery, Storage, and Handling A. Deliver concrete pavers to the site In steel banded,or plastic banded,or plastic wrapped cubes capable of transfer by fork lift or clamp lift.Unload pavers at job site In such a manner that no damage occurs to the product. B. Cover sand with waterproof covering to prevent exposure to rainfall or removal by wind. C. Coordinate delivery and paving schedule to minimize interface with normal use of building adjacent to paving. 1.48 Environmental C©nditiurts A. Do not Install sand or pavers during heavy rain or snowfall. B. Do not Install sand or pagers over frozen base materials. C. Do not Installfrozen sand. 3 TRAVERSE LINE ONLY 100.56' 5 SO4'14'24"E 100.58' d ' eb �- 1' /101 00 WOOD DECK 1��fzeMpl e ,..... r� f, _ �. E COPY N 110.3' fV' d _ 2.7� `4.7' at 7 1 ; `CO ED- 1w o -C C,""-- _ o �i� W o ro - ,_ m �II i t� 45.7' �� 1 N 04 / •�0 / 1—STORY FRAME I M �� #161900 c u Z a 3 a FINISH FLOOR ELEVATION 21.87 3.0' i 7� 12.8 23 ^ U Q •�I r- q �2.0'� �� 5.7'a w 9.3' ni Q \ b B.6 ' a. o b r a e O o � I � �� oo•c� 17.3' f. I 8471 a 20.3' O. N 10.8' I v Fes'N Na T v,� _ ,r , vy �V Y. ••, .y. ��+ M U CONC. W MAW si yr •v r V. r• V Yo p0' 31.4 e. �'•. N - 3 o '80 - o� W iM I 0,8' WIDE ". �v Q .Szo I u7 b- BRICK PAVERS ti IM Q ..� O im nDo N V a� I J2.5' 00 v .!t/ W n p�p yrj Q I J-J COVERED WOOD U ��Q VV. io do WOOD STEPS � - • ,' ow W to I VI I � ++ 11.3' C 0.7' Go M a 3Z QaZ ' ' co a O o°' 3Lu W '° p moa o — ---� --- i --i — WJt I{Zit W l �.Y+I n&n' 0.17{ - CITY OF ATLANTIC BEACH Building Department 800 Seminole Road s1 Atlantic Beach,Florida 32233 (904)247-5800 FILE COPY PLAN REVIEW COMMENTSt,R -zP k Permit Application # /G/— /07 Property Address: ,�l 9 �ae A Applicant: C�CI�^�='S �r �1 A�'�' San a 3 0 4 Project: f�°vr►dv� /�r c R- lace w f �A lie v This permit application has been: Approved ❑ Reviewed and the following items need attention: CG Ile `T r a- dc� c a (p d .e- 9%/0 rYr IQPVi 3'oy -f r r T.- -�� }, lily 1 < r Please re-submit your application when these items have been completed. U Date: Reviewed By: z BUILDING PERMIT APPLICATION �Ae CITY OF ATLANTIC BEACH r 1 FILL 800Seminole Road, Atlantic Beach, FL 32233 I �'t oz 0 n r , Office (904) 247 lov ,. -5826 Fax(904) 247-5845 Permit Number: _ Job Address: r Legal Description Lo n. T# Parcel# 61 Q , oor Vea ot q. t Valuation of Work$ Proposed Work heated/cooled _ non-heated/cooled 0/_4____ J 00. 00 Class of Work(circle one): ew Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one):. Commercial Re � If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No Florida Product Approval# For multiple products use pro uct approve form �� h / Describe in de '1 the type of work to be performed: ? L G L z6r` Property Owner Information: Name: � (�(� Address: + '.AC U City C p tate Zip 3 :33 Phone E-Mail or Fax#(Optional) Contractor Informiattion:l /, Company Name: �C Crl�i�c� ru14,m_) m Qualifying Agent: Address: City SO t lG State L Zip 22 Office Phone D - 3 ob Site/Contact Number Qf?�- 43` �Z�---Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Addres Bonding Company Name and Address Mortgage Lender Name and Address vork or commenced that no isthe puatncetioonas hereby nmdad �allbwork will bett to do the performed toork and meet the standarull ds of slaws rction or work is peegulatintions as indicated I g onstruct:on in thpiinstallation juaisdict'on This permit becomerior s n and wk void commenced of 1 understand tthat separate permits mor ust be secured for Electrical Workd P/umbin8,Signs,aWor abandoned ells,Pools,eriod Xl�u�rnaces montBolle�rstHea1 Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR OBTAIN FINANCING, CONSULT WITH PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND YOUR LENDER OR AN ATTORNEY BEFORE YOUR NOTICE OF COMENCEME 1 hereob,,Yywork cthat I have read ertify be c ph'ed with whetherpt eci�edhis llherein or not.�The granting of a per doesthe same to be true and ct. All notpresumT elons o givflaws e authority of violatecesgovcanc�l this he type.1 provtstons of any other federal,state,or local law regulating construction or the performance of construction. Signature of Owner Signature of Contractor o v �4J....... .00.� ............................... Print Name t'f S........J.. ... ........_�....rT�� ............ Print Name .5. o eSwo d subscribed before me Swo and subscrib fo a me 20 this Day o 2 this 'Day of N 11C SOTNotary Public State or Floribi0 is Shirley L Graham Revised 01.26.10 My Commlailbn fir Oboe" Expires 02/1412010 y City of Atlantic Beach APPLICATION NUMBER J , Building DepartmentR�C j J signed by the Building Department.) r i 800 Seminole Road L4 0 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 AUG 0 6 2014 E-mail: building-dept@coab.us Daterouted: City web-site: http://www.coab.us BY:. _ APPLICATION REVIEW AND TRACisING FORM Property Address: I w 6C a C 1 Fkvt rtment review required Yes No ( �( � Buildi Applicant: aYI.�,S t/" , I I`Q 's anning &Zoning Tree Ad , its Project: �� CIL blic V -ks L14 Ohlvcys %bli,c U �ities PX-OQ�- / s. • aty Fire Seri :es Review fee $ Dept Signature Other Agency Review or Permit Required Review or RecE Dateof Permit Verifir - i 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 Reviewing Department First Review: []Approved. DeniE (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: P Date: ('A.- TREE ADMIN. Second Review: ❑Approved as revised. D45eni• PUBLIC WORKS Comments: ���� F PUBLIC UTILITIES Reviewed by: Date: PUBLIC SAFETY FIRE SERVICES Third Review: Approved as revised. QDenied. Comments: Reviewed by' Date: Revised 05/14/09 f y�ay- City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 14 800 Seminole Road ' — 10-7 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 Q� E-mail: building-dept@coab.us Date routed: V City web-site: http://www.coab.us if APPLICATION REVIEW AND TRACKING FORM Property Address: I U l C4 e 0,CP-) AwI _ Department review required Yes No n I `' uilding Applicant:��a r l.�S U"��) •�q�� nning & ZoPor (��( Tree Project: Rex�)ov� (j er ublic Works Y- C� rs u is ilities r�-� al r--) Y) - - " " Fire Services 2 Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Dateof Permit Verified B 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 Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: l! Date: TREE ADMIN. Second Review: ❑Approved as revised. ❑Deniej_ 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 y- City of Atlantic Beach N :Daterout!ed: LICATIOOER Building Department ned by the 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Q� �, ;Fire .ent review required Yes No Property Address: 1 .VJ A /� y� ' �US Wff �� mat —M► �1 i Zonin " Applicant: r��inistrator ��+ �L ,,rk Project: efyx 11 AA 11 l.•i Y `I�C-Q, V"I �� ,fety al n�� g as Review fee $ Dept Signature Review or Receipt Date Other Agency Review or Permit Required of Permit Verified B 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 Reviewing Department First Review: Approved. Denied. (Circle one.) Comments: BUILDING Date: PLANNING &ZONING Reviewed by: TREE ADMIN. Second Review: ❑Approved as revised. ❑ enied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by:— Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denie^ Comments: Reviewed by:_ Date: Revised 05/14/09 ri,ray; City of Atlantic Beach Ir APPLICATION NUMBER o be assigned b the Building Department.) �s Y« Building Department RFi 0�TN TTI—T) �® g y g p 800 Seminole Road L4 — I Q� Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)2 7-584!AUG 0 b 2014 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us Lay, APPLICATION REVIEW AND TRACKING FORM Property Address: �.� �/t� \ 4mteview required Yes No Applicant: W W I l tCkM5�1 Plannining Q r or Project: ��iYY74� L ublic� Public Utilities RykCk h�' wf Po. V�`� Public S:,fety 4- / f'1-6i y)e of (� fiuV( Fire Se „yes Review fee $ -t9 Dept Signature Other Agency Review or Permit Required Review or Receipt Dateof Permit Verified B 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: AP PLICATION STATUS Reviewing Department First Review: ❑Denie (Circle one.) Comments: BUILDING p PLANNING &ZONING Reviewed by: I IQDate: TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. APB C Comments: U ILITI PUBLIC SAFET Reviewed by: Date: FIRE SERVICES Third Review: [-]Approved as revised. ❑Denie . Comments: Reviewed by: Date: Revised 05/14/09 Car7r,foz" Mary o� oN �XT` ��r�r�noW r,Fftr&-p per-(I Nd 40 SZr`' R,�Qawp oolwe llvlt4 - �iIN� P7�✓// /mos/�XJ G'ort�aG mC-RS�,c�Es irnr� .;Z�,�=mon