1644 W Park Ter 2015 Foundtn repair . 11 SS\ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
FOUNDATION ONLY
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 15-FOUN-650
3ob Type: FOUNDATION ONLY
Description: FOUNDATION REPAIR
Estimated Value: $6,077.00
Issue Date: 4/7/2015
Expiration Date: 10/4/2015
PROPERTY ADDRESS:
Address: 1644 W PARK TER
RE Number: 172020-0164
PROPERTY OWNER:
Name: HARDMAN ESTATE, CHARLES H,
Address: 1644 W PARK TERR 1644 PARK TERR W
GENERAL CONTRACTOR INFORMATION,
Name: RAM JACK
Address: 2075 S US HWY QA ERLEWINE A SCOTT
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $80.39
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $40.19
STATE DBPR SURCHARGE $2.00
Total Payments: $124.58
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 (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
te?
.0
E-mail, building-dept@coab.us 0
Cityweb-site: http://www.coab.us [FDate routed:
APPLICATION REVIEW AND TRACKING FORM
Property Address:L6 Vy 4 r4f r De artment review required Yes No
Buil " I
Applicant: 2&—?n Planning&Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
Florida Dept. of Environmental Protection of Permit Veri i By Date
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: pproved. E]Denied.
(Circle one.) Comments:
(BUILDING
E�)
PLANNING &ZONING Reviewed by.- Date-.
TREE ADMIN.
Second Review: E]Approved as revised. E]Denie
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by.- Date:
FIRE SERVICES Third Review: DApproved as revised. ODenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
FILE COPY BuILDINC. PERNHT APPLICATION
CITY OF ATLANTic BEACII
80O.Sizininole Road.Atlantic Beach,Fl-32233 7E/r
Office(904)247-5826 Fax(904)247-5845
JobAddress:_CHARI FS HARDMAN Permil Number: FO IV-6
I.egal Deicriplion 34-51 09-2S-29E SELVA MARINA UNIT 06 LOT 16 BLK 6 Parcel#172020-0164
FTo—or Area of hifft. Sq.1-1
Valuation of Work S 6077.00 -Proposed Work heated/cooled 2560 non-heated/cooled
Class(if%Vurk(circle one): Nc%% Addition Alteration <2i��Nlovc Demolition pool/spa window/door
Use of c0stinWproposed structure(s)(circle onvi Commercial Residential
If an c0sting structure,Is afire sprinkler s)-aviii in%wiled?(Circle one): N'cN No N�A
Florida ProductAppro%aI4
For multiple products use product appro�al ftirin
Describe in detail[lie type ofwotk it)lie peri'0111jed: FOUNDATION REPAIR
Pronvi-t%()%%uvr Infortuailon:
C RLES HARDMAN —
Addr&:N.,. 1644 PARK TERRACE W
ATLANjjQj3EAQH Stale FL7irf 32233 pb,qj,. 904-249-3646
orl-ax#(Optional)__
Contractor Information;
Company Name: Qualifying Agoit. A SCOTIF WINE
-RAM JACK FOUNDATION REPAIR S JRLE
Address: 14403 N.MAIN-ST JACKRONVILLE State—FL Zip 32218
Office Phone 904-570-3651 Job Site, Contact Number Fax# 803-337-3202
State Certification'Registration st CGC1518926
Architect Name&Phone 4
lingincer's Name&Phone m SAUL MARTINEZ 843-839-1620
Fee Siniple'll'itle Holder Name and Address__
lttindiiigCompaiiyN;iinciindAddrcss__
Mortgage Lender Name and Address
Applitati.or;is hen-hr mink to(,blain a pt-roar fit ek;Me"yPrA andefstallatifini as indicated. ltri,tih-that#tit weirk fir 111,11allatIMI/fill Cam"WaLT1111rifir 11)ill('
tsguam-e ittiap,rmil amithat all mart will heperfin,medro"k-el llh�slivfdarjf"faillaws in th;%jurbdiethm lhi,pe-6114%ome,md/
aphl witl#'uark it nativirsiliewedivithinni,(6)months.or ifcomqrsicitim fir vivwk (6)monthi at any time afte,
%vrk ittommenced I faiderstaml that separate permits mutt hexecars-ilfipr Electricafffork.Pliaithiffiv.SIVAlf-Wells.ronals.Farnaces.HoUrrv.Heaters,
TanA%and.fir conditionsim rtc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAVINGTWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTENDTO OBTAIN FINANCING CONSULT WIT11
YOUR LENI)ER Olt AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certs All pravisom,it/laws an/ordt ths,
#that I how trail and etamineil this a
th ��'Ofa Permit Awl"Olf Presume to give drith"'Ify Ia cam-el the
aat,, ,r 1-al la.,'rKulating
Signature of Signature of Confiractor
Print Name It( /.:5 1-1-A Zj A Sco-rT EaEV.v1v&
#1� /-" VJVITIY Print Name
Sworn toond subscribed betbre Inc Sworn to and subscri f: -for* w
this th��Day of
-jabay of I
Notary PtihI6
_Mgod_��
Ilu
r!�N I
fa" ANGELA I BURDEN
IISSION#FF09U72
Februa�26,�j
td 7"!r ATOE WHIM MMISSION#FF09U72
t. S
FF121448
MYCO
EXPIRES February 26,201 a
0 'y . ic
[((407)3ga-ol53 FlorldallotarYService.corn
Lo
Doc # 2015055074, OR EK 17092 Page 1244, Number Pages: 1, Recorded
03/10/2015 at 04:02 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
FILE COPY
0 'No..
.34.51.0.9-2.$.AE.SELV.A.MARINA.*iJNI.T..jfi.Lb.T...16.BLK.6; ..16.4.4-.PARK.TERRACE.W...ATLARTIC.BEACki.............
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I....................................................... ...........................................w-................................
��,,.i.0-Ait.4fess..4..,H.,EN,R.fETrA HARDMAN 1644 PARK TERRACE W ATLANTIC BEACH FL 32233
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RAM JACK FOUNDATION REPAIR 14403 N MAIN.ST JACKSONVILLE FL 32218
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