3210 fleet Landing shower 2015 It CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
J - X ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
DIM'
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-413
Job Type: RESIDENTIAL ALTERATION
Description: SHOWER-SHOWER W/D AREA UNIT 3210
Estimated Value: $5,250.00
Issue Date: 3/4/2015
Expiration Date: 8/31/2015
PROPERTY ADDRESS:
Address: 1 FLEET LANDING BLVD
RE Number: 169397-0200
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BOULEVARD
GENERAL CONTRACTOR INFORMATION:
Name: NCCRF
Address: JASON PAUL HOLDER JASON PAUL HOLDER
Phone: - -
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 FILE
Office (904) 247-5826 Fax(904) 247-5845f
Job Address: 3c?/n On-616,11lchc+errc k1d, Permit Number: W,3
U
Legal Description Parcel#
Floor Area o Sq.Ft. q t
Valuation of Work$Sa5o Proposed Work heated/cooled_ non-heated/cooled
Class of Work(circle one): New Addition Alteratio Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s) (circle one): Commercial elide •
If an existing structure, is a fire sprinkler system installed? (Circle one): e No N/A
Florida Product Approval#
For multiple products use product approval orm
Describe in detail the type of work to be performed: *We, /o 40wrr f 'P� W s�!r/�r�•Py
Property Owner Information:
Name:NCCRF dba Fleet Landing Address• 1 Fleet Landing Blvd
City Atlantic Beach State FL_Zip 32233 Phone 904-246-9900 xt 431
E-Mail or Fax#(Optional)jholder@fleetlanding.com
Contractor Information:
Company Name:NCCRF dba Fleet Landing Qualifying Agent: Jason Holder
Address:1 Fleet Landing Blvd City Atlantic Beach _State FL Zip 32233
Office Phone 904-246-9900 xt 431 Job Site/Contact Number 904-219-4002 Fax#
State Certification/Registration#CBC 1254586
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 period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrics!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 CORDING YOUR NOTICE OF H
YOUR LENDER OR AN ATTO
CO
YOUREY BEFORE
type work wt that I have
be complread and ied with whethertpecihis led lhere�n or not.n and
The granting of pew the same to be true rmit does nd cnot preest. All rume�to gions veaauthority to ws and l violatenances gor cancel this
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Jason Hol Print Name Jason Hol er..
........................................................ .
Sworn to and subscribed before me Sworn tgand subscrld b ore me 2015^
this Day of Xl' 20 �S this Day of .--
l� ► i4
�a Nota
Notary Public
►"""" SHARI R QUEST '►AY.^°' SHARI R QUEST
70 .26.10
• MY COMMISSION#FFOFi8247 .; •t MY COMMISSION
EXPIRES November 4.2017 s�?;;� EXPIRES November 4.2017
OF. ' ••'. Floddallotaryservice.com
(407)39B-0153 FloridallotaryService.com 1407go1�