1834 GEORGE ST PAVED PARKING LOT X r ' 'I SS\ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
DRIVEWAY PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-DWAY-1 042
Job Type: DRIVEWAY
Description: REPAVE PARKING LOT FOR CHURCH
Estimated Value: $3,500.00
Issue Date: 5/18/2015
Expiration Date: 11/14/2015
PROPERTY ADDRESS:
Address: 1834 GEORGE ST
RE Number: 172252-0010
PROPERTY OWNER:
Name: TRIUMPH APOSTOLIC FAITH CHURCH
Address: 1834 GEORGE ST
GENERAL CONTRACTOR INFORMATION:
Name: ST JOHNS ASPHALT PAVING CO
Address: 505 23Rd St ST
Phone: - -
PERMIT INFORMATION: PUBLIC WORKS: UTILITY DEPT.:
Full erosion control measures must be installed and approved prior to beginning any earth
disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control
Inspection prior to start of construction. Silt fenced is required fully around construction.
All silt must remain on-site during construction.
If on-site storage is required, a post construction topographic survey documenting proper
construction will be required.
Full right-of-way restoration, including sod, is required.
Pond to be 1' in depth.
Pond to overflow to street.
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible.
A sewer cleanout must be installed at the property line. Cleanout must be covered with
I'ERMV&&P t,,�g 8&'Vt�lt THE FLORIDA
B I. V& ""
I SS\ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
FEES:
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address:
i'T � �" J/ Permit Number:
Legal Description .45117-�X 17-,,� 5 -2pg Parcel 9
Floor Area of S-qTt—. Sq.Ft—
Valuation of Work$ ele) Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial Residential
If an existing structure,is a fire sprinMr system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use produ`cta`p_prov_aTrWrm
Describe in detail the type of work to be performed: (5 3 r6we 1?rz fe A
q,�7 L/ 575 o4c,7 441K
Property Owner Information:
Name: 10 LAW1 10� Address:
city ------- �ta t �,Zipj4ZZ�j��hone O:K f '57"z
E-Mail or Fax (Optional J?
Contractor Information: CONTRACTOR EMAEL ADDRESS:
5�
Company Name.; 1�7 Oualifyi ;Agent: 10elpi V_-
Address: /L1, o1r Zo__6 /I State rZ Zip
-1 city!N
Office Phone OLI' �; _7"2K_Q,!7Job Site/Contact Number
It - Fax#
State Certification/Registratio-n 4
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication is hereby made to obtain apermit 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 construch.1 on in this jurisdiction. This permit becomes null
and void if work i's not commenced within six(6)months, or if construction or work is suspended or abandonedfor eriod ofsix�6)months at any time after
work is commenced I understand that separatepermits must be securedfor Electrical Work, Pluinbing,Sikns,Vells, Pools,Furnaces,Boileis,Heaters,
Tanks andAir 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 herelb certify that I have read and exami.ned thi's application and know the same to be true and correct. All provisions oftws and ordinances governing this
type ) work will be complied with whether specified herein or not. The granting of a permit does not presume to e authority to violate—or can,eel the
provisions of any otherfederal,state, or local law regulating construction or the performance of construction.
Signature of Owner 141el Signature of Cont ctor
ractor
Print Name
............... ...e*w............... Print Name
..................................................
................................. .-P..................
..................... .......... ........... . ....... ..
20 1-5 1
Be, in Be
tt i
h Day of 201E
S Hey L r
NetOrY PUIN e State of Florida M s
Notary Public Shirley L Graham 0 Expires 02/ / a
My Commission FF 086990
a 0 Axpires 02/14/201S s 01.26.10
City of Atlantic Beach
APPLICATION NUMBER
Building Department IR T170 F VVED (To be assigned by the Building De artment.)
RT
800 Seminole Road
At Z015 1.6�—jb &JA 2.1
]antic Beach, Florida 32233-54 X
hone(904)247-5826 - Fax(9 41 F247-5AM" 0 4 Z015 Aai� .0
r1it' E-mail: building-dept@coab.us Date routed: 0111111111'
City web-site: http-://www.coab.us
APPLICATION REVIEW AND TRACKING FORM "41
/4*fl.4 el
Property Address: Department review required Yes No
Building
Applicant: C;5 r Job/76 �JC*Ao 1114/r Planning&Zoning
r nistrator
Project: 61(s. ��61'/w 4�' Puwlia�
4-P_uMc Utilities ')I
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
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
Reviewing Department First Review: ff rApproved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN. Second Review: FlApproved as revised. ffDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
City of Atlantic Beach CF APPLICATION NUMBER
Building Department -'V (To be assigned by the Building Department.)
7MAY 0 420115
800 Seminole Road MAY 0 4 2015 16
Atlantic Beach, Florida 32233-5445
Phone(904) 247-5826 - Fax(904)2 45 Date routed:
E-mail: building-dept@coab.us �mm�
Cityweb-site: http-://www.coab.us
APPLICATION REVIEW AND TRACKING FORM/,O,,,,
I
Property Address: Department review required Yes No
r Building
Applicant: 7- Planning &Zoning-
1���nistrator
Project: Zd _1 _1�-Pu�� -
'4�11�Uic Utilities_3
Public Safety
Fire Services
Review fee Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
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
Reviewing Department First Review: ERA/pproved. F�Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN. Second Review: FlApproved as revised. ElDenied.
;��IC ORK Co ments:
PUBLIC UTKITIES,,
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. DIDenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
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