4116 FLEET LANDING BLVD INTERIOR SHOWER ALTER YYS iy1,`1 j7'
CITY OF ATLANTIC BEACH
j 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
70B INFORMATION:
]Ob ID: 15-RAAR-1231
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: 4116 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
Building le Boa en¢ APPLICATION NUMBER
800 Serinotic Beach,
Road (To be assignetl by the Building Department.)
��.. Atlantic Reach Florida 32233-5445
�- Phone(004)247-1826 FaxFax(9(904)4)247-$945
E-mCity webuddingih,// coab.us
City web-site: hdpl/wwpwgcoab.usAPPLIDate
TRACKING routed: ®M
REVIEW AND
Property Address:41 I LP FI it c-- Lard yL„
/`� ,� r ent review required Yes No
Applicant: N�.L.Il T Building
1��,y &Zoning
Progert: •0 Iv{fU�Y to Tree Administrator
Public Works
Public Utilities
Public Safety
Fire Services
Review fee$ Dept Signature
Other Agency Review or Permit Required Review or Receipt
Florida Dept.of Environmernal 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: Q��
(Circle one. PJePProved.
) comments: ODenied.
BUILDING
PLANNING&ZONING
TREE ADMIN. Reviewed by: "j _
41 . �'
Second Review: QApproved as revised.
PUBLIC WORKS Comments; Denied.
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by:
FIRESERVICES Third Review: EJADate:
PProved as revised. ---
Comments: Denied.
Reviewed by:
Date:
sed 07/2IN0
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904) 247-5826 Fax (904) 247-5845
Job Address: 4116 Fleet Landing Blvd Atlantic Beach, FL 32233 Permit Number:
Legal Description Parcel#Floor Area of q
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/propused structure(s)(circle one): Commercial Residential
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: (2)SHOWER TO SHOWER CONVERSIONS
Property Owner Information:
Name:NCCRF dba Fleet Landing Address: 1 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: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 Certifrcation/Registmtion#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 ins[a//ations as indicated I certify that m"rk or installation has commenced prior m the
issuance ofa permit and that all work will butte armed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void f work is not commenced within sk(6 months,or ifconstrucdon or work is suspended or abamloned for a period ofsix//6J months at any time oiler
work is commenced. /understand that separate permits most be securedfor Electrics!work, Plumbing,Signs, Welk, Pods, Fumaces, Boilers,Healers,
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.
!hereby certify that/have read and examined tM1k fZlication and know the same to be true and correct All prowsions oflam and ordinances governing this
type o work will be complied with whether s�i red herein or mi. The granting of a permit does not presume to gree authority to violate or camel the
prowdons ofany other federal,state,or Iota/ aw regulating construction or the performance ofconsuaction.
Signature of Owner Signature of Contractor
Prim Name Jason Holder Print Name Jason Holder
Sworn to and subscribed before me Sworn to and subscribedbefore me
this Z4"Day of .�'Y .20,/S'— this r/'7sy of -f9' .Notary Public =�'W
Nota Pu
QUEST ry /�r •,� 9HAR1 R QUESTNJ AFF119fi20'/ MyCOMMISSIQNI�a�a�s® 26.10
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