5306 FLEET LANDING BLVD INTERIOR SHOWER ALTER CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
s 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-1230
Job Type: RESIDENTIAL ALTERATION
Description: SHOWER TO SHOWER CONVERSION
Estimated Value: $8,500.00
Issue Date: 6/1/2015
Expiration Date: 11/28/2015
PROPERTY ADDRESS:
Address: 5306 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 $46.25
BUILDING PERMIT FEE $92.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $142.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach
��1 Building Department APPLICATION NUMBER
800 Seminole Road (To be assigned by the Building Department.)
_I Atlantic Beach. Florida?-SM 32233-5405
Phone(buil)247-SM Fax(904)247-584.5 �T BAR
E-mail: buildingJfp1/ r�c ,cab 2l0
City web-site: http//www coabus Date routed:
APPUCAVON REVBEW AND TRACKING FORM
ProperiY Address: 5–;E�O Lp f=l
p�//��. rtment review required Yes No
Apppoeant: N�i t Building
�t� � g&Zoning
Project: c--� vC./�JY ., ,}.b_ ' ,^ — Tree Administrator
V� 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 Verified B 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: �t,_
(Circle one.) KrAPProved' Denied.
Comments:
BUILDING
PLANNING&ZONING
?REE ADMIN. Reviewed by:___T
Second Review: `�—Date: S 2t rq
PUBLIC WORKS Comments: []Approved as revised. QDenied.
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by:
FIRE SERVICES Third Review: Date:_
DApproved as revised.
Comments: QDenied.
Reviewed by:
Date:
ised 07127n0
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904) 247-5826 Fax(904) 247-5845
Job Address: 5306 Fleet Landing Blvd Atlantic Beach FL 32233 Permit Number:
Legal Description Parcel#
Floor eao q. t. qq t
Valuation of Work$ 8,500.00 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 sprier system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approve orm
Describe in detail the type of work to be erformed: (2)SHOWER TO SHOWER CONVERSIONS & SHEETROCK
REPLACING STUCCO C� OLD REAR PORCH
Property Owner Information:
Name:NCCRF dba Fleet Landing Address: 1 Fleet Landing Bevd
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:l 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 cerdfythat no work or installation has commenced prior to the
issuance ofa permit and that all work will he pepaned to meet the standards ofall laws regulating construction in this jurisdiction. This permit becomes null
and void h work is not commenced within six(63onths,or ifconsouckon or work is suspended or abandonedfor o period ofsir/6)months at any time after
work is commenced. I understand that separate permits most be secured for Electrics! Work Plumbing,Signs, Was,Pools, Furnaces, Boilers, Hearers,
Tanks and Air Conditioners,ere.
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 hereby certify that/have read andesurnmed this o licadonandknow the same lobe true and correct Allprawrions oflaws and ordinances governing this
type o) work will be complied with whether specified herein or not. The grunting of a permit does act presume m gme authority to wolate or cancel the
pro"sures ofany other federal,stare,or local law regulating construction or the performance ofconstraction.
Signature of Owner /%4/ Signature of Contractor
Print Name Jason Holder Print Name Jason Holder
Sworn to��nnd subscdbedbefore me Sworn to3n�nnd subscribed b&ejfppre me
this L/"Day of illi . 20/,� this _,AeDay of i'n1
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