1900 SEMINOLE RD SIDING `S, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
i J F31 9'r
SIDING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SIDE-904
Job Type: SIDING PERMIT
Description: REPLACEMENT
Estimated Value: $2,499.00
Issue Date: 5/1/2015
Expiration Date: 10/28/2015
PROPERTY ADDRESS:
Address: 1900 SEMINOLE RD
RE Number: 169527-0010
PROPERTY OWNER:
Name: PARMAN II, HAROLD L
Address: 1900 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: HERBENICKS CONTRACTING INC
Address: 35 OAKWOOD RD QA JEFFREY JOHN HERBENICK
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 ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH233 FILE COPY
800 Seminole Road, Atlantic Beach,FL 32
Office (904) 247-5826 Fax (904) 247-5845
/000 Permit N tuber: / 57 ' S' IDE-7-
JobAddress:
�5�1 q
q _1S,•aC� LST 3 1�J2 C �1 R arcel#
Legal Description oor Area o q. t. q. t
Valuation of Work
Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repa1 Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one):. Commercial identi N/A
If an existing structure,is a fire sprinkler system installed? (Circle one): es
Florida Product Approval#
For multiple products use product approva orm �� �
Describe in detail the type of work to be performed: M /
Propert! Owner Information:
�, "l,'A (��('(� Address:
Name: ., �� �� State _Phone
City ";: q p
E-Mail or Fax#(Optional)
Conactor Information: CONTRACTOR EMAIL ADDRESS: !�bin �-�' a ` o
tr
,^,!!'' L Quali ing Agent. J��F L l
Y J6
Company Name: Kin �� ,,,lk State�—Zip ZZ
w^ ��• Ci
Address: r1
Office PhonewH )A4 – �-+t�#t
Job Site/Contact Numbc!E'Y�5 6 FaxState Certification/Regis rat tion ' G
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
t no work or installation has commenced prior to the
as
becomes
Application is hereby made to obtain ill be e�o�med tothe omeet the standardsrk and ofall latwstre regulating
abandoned for aon in this
l�iod of six(6)Tmo hispermit
attany time after
issuance of a permit and that all work performed
and void if work is not commenced within six(6)months, or if construction o work is suspe
work is commenced. 1 understand that separate permits must be secured for Electrienl Work,Plumbing, Signs, ells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILUREING TWICE CEORD NOTICE OF
OR IMPROVEMENTS
COMMENCEMENT MAY RESULT IN YOUR ING C NOTICE I
O YOUR PROPERTY. IF YOU INTEND TO OBTBEFORE RAIENCFINANCING CONSULT WITH
T YOUR LENDER OR AN ATTO COMMENCEMENT.
EMENT.
nanees governing thh
Efuthority t violate or cancel the
I hereb certify that I have read and examined tphis plication and know,the he same to be tr o;t Pres Public-S of orida
type o worok awill be complied
with statewhetheror law regulating construh e rein or ction or pe�forma e�= � not presunublic-S 018 A
provisions ofany f = ;• My Comm.Ex 974
' Se
• g
s, `oma: Commi
Sign of F 'irtg ' n.
Signature of Owneramo= "I
.1."!..` ....................................................
Print Name �,e.. ...................................................
Print Name ..._..
Before e 20
Befor L 2p this \ Day of rt
this Day of`_
Notary tblic
Notary Pu 1' •• . = C,omn ission N EE 142824 Revised 01.26.10
Exgres Novcnlb�29,2015
ander T(w 7my Fig MW�e 6*385-7019
APPLICATION NUMBER
Blding Department
(To be assigned y the ui
)/
t��rr City of Atlantic Beach �����
Building Department
800 Seminole Road
r� Atlantic Beach,Florida 32233-5445 Z►Q
� Phone(904)247-5826 - Fax(904)247-5845 Date routed:
E-mail: building-dept@coab.us
City web-site: http:llwww.coab.us
IEW AND TRACKING FORM
APPLICATION REV
a /� Q/ De artment review required Yes No
Address: /_a. fht, Bui din
Property &Zoning
Planning
Applicant: Tree Administrator
Public Works
Public Utilities
Project: Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified By
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
Department First Review: Approved.
❑Denied.
Reviewing
(Circle one.) Comments: (�
BUILDIN
G yt Date:
PLANNING &ZONING
Reviewed by:
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS
Comments:
PUBLIC UTILITIES Date:
Reviewed by:
PUBLIC SAFETY ❑Approved as revised. ❑Denied.
FIRE SERVICES
Third Review:
Comments:
Date:
Reviewed by:
Revised 07/27/10