122 Fleet landing skylights 11 SS 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-832
Job Type: RESIDENTIAL ALTERATION
Description: 2 SKYLIGHTS
Estimated Value: $2,500-00
Issue Date: 4/15/2015
Expiration Date: 10/12/2015
PROPERTY ADDRESS:
Address: 122 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE T LANDING BLVD
Address: 1 FLEET LANDING BLVD 1 FLEE
GENERAL CONTRACTOR INFORMATION:
Name: NCCRF
Address: JASON PAUL HOLDER JASON PAUL HOLDER
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $31.25
BUILDING PERMIT FEE $62.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $97.75
PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH ME COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office(904) 247-5826 Fax(904) 247-5845
Job Address: 121.Flcct Landing Blvd Atlantic Beach, FL 32233 Permit Number: 4914 A
Legal Description Parcel#
Floor Area of Sq.Ft.
Valuation of Work$ 2,500.00 Proposed Work heated/cooled nonllettc`��gd UZI
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa win
Use of existing/pro osed structureQ) (circle one):. Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#FL 13 3 03
For multiple products use product approval form
Describe in detail the type of work to be performed: 2 New Skylights
Property Owner Information:
Name:NCCRF dba Fleet Landing Address: I 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:I 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
A ca e e�. ade, bana e d he work and ns a la i Ind"ca rtify that no work or installation has commenced prior to the
m t t i t uo law ng construction in thisjurisdiction. This permit becomes null
f six months at any time after
nc I it 0 0 0 ed to mZt the tan a al is s Arnaces,Boilers,Heaters,
0
wo I f rm s t r6�1 k or abandonedfor a period o
0 S' in t 0 0 ti r pi be e
pp i i ,r y d ha al k r
o ape at, i, 6 in nt , orl c ns rc'on r or ctr
w t s p) 0 it t 0 t �or E e W Plumbing,Signs, Wells, Pools,
's' in t t d hin
wo 0, 0 co, ric i p r,�S, cur
and d k is n me e
, is c me c I u rst t t,P
k n ed nde and ha e arate e be e ed
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 here cer#fy 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
Vwork will be coMp ied with wheth granting of a permit does not presume to give authority to violate or cancel the
_1 er specified herein or not. The
provisions of any otherfederal,state,or local law re lating construction or the performance of construction.
Signature of Owner Signature of Contractor
Eo
Print Name Jason Ho der Print Name Jas.qn..49.1.der.................................... ........... ...........
..... ..............
........................................................................................................................................
Sworn to and subscrib d before me Sworn topnd subscribed before me
this ArDay of 20/5'— this Z�—Day of . 20./S—
ALA,0
SHARI R QUEST
CRI R QUEST 1111111��iit ry u ic
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No\W�Yublic my
COMMISSION*FF(M?47
My CC[MMjS8"j#MdA)47
............
EXPIRES November 4.20117 EXPIRES November 4 2017
(407) 153 FlorldsNotaryService.cOm
(407)398-0153 Florida NotaryService.corn
APPLICATION NUMBER
t:4dilding Deparph-kient (To be R i ed b th B 'Idi
/Spsin Y e U, ing D rt nt
800 Seminole Road Qaa me
-5445
Atlantic Beach, Florida 32233
Phone(904)247,5826 - �,qx(904)247 1-)845 Lted
-ig
IT E-mail: buildii -dept@bcoab.us Date routed.-
Cityweb-site littp://www.coab.LIS
APPIUCATON REVEW/Vi An HP0 TRACKNG FORPR/i
P'Top rty AddR-v-F:!,s;: /Z z A/ar ent review required Yes
B BLlil ing
Uil ing 01
Planning &Zoning
r��q
en- review re4_
&Zo
annin i ng
PI g
Tree Administrator
C� Public-Works -
Public Utilities
Public Safety
Fire Services
Review fee Dep'lSignature
0-ther Agency Review or Permit Required Review or Receipt Date
-_ of Permit Verified By
Florida Dept.of Environmental Protecti on
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:
APPL 'A "ION-STATU-5-
Reviewing Depariment First Review: pproved FIDenied
(Circle one.) (,omments:
(:U I L:DI DN
PLANNING&ZONING Reviewed by: Date.-
TREE ADMIN
Second Review: DApproved as revised. E]Denie�
PUBLIC WORKS Comments:
PUBL_IC UTILITIES
PUBLIC SAFETY Reviewed by.- Date-
FIRE SERVICES Third Review: DApproved as revised. ODenied-
Gornments:
Reviewed by: Date:
,�Wisad 07/27/-10