122 FLEET LANDING BATH CONVRSN 2015 I' ll sl\ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-659
Job Type: RESIDENTIAL ALTERATION
Description: BATH CONVERSION/STUCCO FROM DEN
Estimated Value: $9,000.00
Issue Date: 3/31/2015
Expiration Date: 9/27/2015
PROPERTY ADDRESS:
Address: 122 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name: NCCRF
Address: JASON PAUL HOLDER JASON PAUL HOLDER
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $47.50
BUILDING PERMIT FEE $95.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $146.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Department
800 Seminole Road (To be assigned by the Building Department.)
Atlantic Beach, Florida32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us IMP]
APPLICATION REVIEW AND TRACKING FORM
Property Address: entreviewrequiied Ye -No
uilding_,)
Applicant: &oejoc a ning &Zoning
Tree Administrator
Project: Public Works
i/V Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
VOther Agency Review or Permit Required Review or Receipt Date
Florida Dept. of Environmental Protection of Permit Verified By
Florida Dept. of Transportation
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D so 0 ot
ivision of Hotels and Restaurants
f I c
Divilsion of Alcoholic Beverages and Tobacco
Other
APPLICATION STATUS
iing D artment -]Denied.
Reviewing Department First Review: VApproved.
(Circle one.) Comments:
(:EL D I DNG o c_
PLANNING &ZONING Reviewed by.- Date.- 3
TREE ADMIN. Second Review: ElApproved as revised. DIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [-]Approved as revised. F]Denied.
Comments:
Reviewed by.- Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 FILE COPY
Office (904) 247-5826 Fax(904) 247-5845
Job Address: -lee-I 4af�d �, elvol Permit Number:
a
Legal Description Floor Area of Sq.Ft. Parcel# Sq.Ft
Valuation of Work$ 9 Proposed Work heated/cooled non-heated/cooled
6000
Class of Work(circle one): New Addition Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial �,_esiden�tia
If an existing structure, is a fire sprinkler system installed? (Circle one): 0 N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: idx_o� (7o-7.ey)�r j111?e,7,,ve 47 �k OAel,7
Property Owner Information:
Name:NCCRF dba Fleet Landiniz Address: 1 Fleet Landiny,Blv
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 thisjurisdiction. This permit becomes null
and void ff work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor a eriod ofsixP6)months at any time after
work is commenced. I understand that separate permits must be secured for Electricar Work, Plumbing,Sikns, W Its, 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 BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
7 k will be coMplied with whether specf'ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
type p. woj
provisions of any otherfederal,state,or local law regulating construction or the pe�yarmance of construction.
Signature of Owner Signature of Contractor e- .1
Print Name Jason o er Print Name Jason Hl��
.............................E...........................................................................................................
........................................................................................................................................
Sworn to and subscribed before me Sworn to and subscribed before me
this--a Day of 20 \S this Day of 20
Notary Public N�otary Public
"""A"CP SHARI R QUES7cvj ied 01.26.10
H RI R QUEST
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my COMMISSION#FF068P47
My COMMISSION#FF068?47
EXPIRES November 4.2017
EXPIRES November 4. 2017
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