363 Atlantic Blvd 15-SIGN-1483 sign permit r---y\?`J j+ �s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
\ INSPECTION PHONE LINE 247-5814
•,---- .....2_}
SIGN PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 15-SIGN-1483
Job Type: SIGN PERMIT
Description: NEW SIGN UNIT 8
Estimated Value: $2,100.00
Issue Date: 6/26/2015
Expiration Date: 12/23/2015
PROPERTY ADDRESS:
Address: 363 ATLANTIC BLVD
RE Number: 169730-0000
PROPERTY OWNER:
Name: SHOPPES OF NORSHORE LLC
Address: P 0 BOX 330108
GENERAL CONTRACTOR INFORMATION:
Name: TAYLOR SIGN & DESIGN. INC.
Address: 4162 ST AUGUSTINE RD QA RANDALL ALAN TAYLOR
Phone: --
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Sign Erection $75.00
Total Payments: $79.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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CITY OE itl 'IC BEACH
' ° °' 1' `° '••i SEE PERMIT$#61tADDmONAL
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0 3 n°R.9 '° 1 'i i- REQUIREMENTS AND CONDITIONS
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH FILE COPY
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)2 -58,45
Job Address: 363 Atlantic Blvd. ' 'ta / PQ C`.,t rJ , �f` /5-_ S'/6-iii -/ e;
'�"" / t4 N' l� ermit Number:
/
Legal Descriptions"q� 2i -M-2)E l 5 -1a 'jf much Parcel# I �°1-7?).0—0 0 00
Floor Valuation of Work$ 100 Proposred Work heated/cooled tea non-heated/cooled
Class of Work(circle one): al, 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 sprinkler system i e one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form h 'n
Describe in detail the type of work to be performed:I/l,r�111a j oh O OF r1°v(y 1 t� I i t- ei'f a Y)�'C
kftcrs- hack-r 'Km)} 19'E�1wNlt )o k6.-1 " =- to
Property Owner Information:
Name: Shoppes of Norshore,LLC Address: P.O.Box 330448
City Atlantic Beach State FL Zip 32233 Phone 904-241-1151
E-Mail or Fax#(Optional) bsalcanapetramanagement.com
Contractor Information: r
Company N.j : A. IOYd i 1 A /k) V)C• Quali yin!.A:ent: marl I / 10 V
Address: it WA1W WPI:i/(%ItWK • City , 6 I V 1( tate P// Zip 0
Office Phone fucir 1 j Job Site/Contact Number 'J2 ZI!t' '•• .#S-2,-L -
State Certification/Registration# 2600111
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. !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 construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters,
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 hereby certify that!have read and examii tthis a placation and know the same to be true and correct. All provisions of laws and ordinances governing this
type of■work will be complied with whe speci�d herein or-not. The granting of a permit does not presume to give authority to violate or ca I the
provisions of any other federal, o cal law regulat'geoastruction or the performance of construction.
Signature of Ow ` Signature of Contractor _
•
Pr Print Name k" t f t(fit t --- Print Name gL1 Lll1 . __I... ,y...1 QJ___.._.---..._....
Sw AQ and subscribed before me Swo t.and subsc 'bed before •
ism Day of k]`(\j1/4_(._\ 20 15 this ' Day of 20
otary Public N. c �
Public
�Y
Revised 01.26.10
``�7'.' "" SHEILA CENIZAL
•a+ BETHANY I SALCAN I. `fit 1!) MY COMMISSION#FF066193
s`,�pIi∎ �• Notary Public-State of Florida Via;.-rte,:`•�
s
My Comm.Expires Apr 17,2015 ( •Roan- EXPIRES October 27,2017
4 %' ��, P�= Commission#EE 85067 (407)398-0153 FloridallotaryService.com
4 ''%F; °p'` Bonded Through National Notary Assn. P
LETTER OF AUTHORIZATION
Affidavit FILE COPY
To Whom It May Concern:
This letter authorizes Taylor Sign&Design,Inc.(or their Agents or Subcontractors)to act as
Agent,to secure permits or variances required by the local governing body, and to perform sign
or awning installations,removals,or maintenance at the property located at:
Property Address: 363 Atlantic Blvd.,Atlantic Beach, FL 32233
Company Name: Shoppes of Norshore, LLC Phone Number: 904-241-1151
Name: Chris Hionides Title: Officer
Addres do Petrnagement, Inc. P. O. Box 330448,Atlantic Beach, FL 32233-0448
j',�
LL �--
YGNATU (EE OF PROPERTY OWNER/AGENT
/
STATE OF i-1 Or\d,a
COUNTY OF -1)V+\(
_Sworn to and subscribed before me this ,DCJ day of tc. i1A cm k , ZOIS
1.. ---)\ Ok}0.0)..) ..
Signature of Notary State of V-1.01\1:AQk
AC-ANA ,‘ SC11 CG n c__.Q %c c3(0
Print or Type Commissioned Name of Notary Public
Personally Known(NA OR Produced Identification ( )
Type of Identification Produced: Commission Expires
(Notary Stamp or Seal Required)
,,t01 P 4 BETHANY L SALCAN
cg's Notary Public-State of Florida
' e My Comm.Expires Apr 17,2015
;,F--.1��,,� Commission#EE 85067
Bonded Through National Notary Assn.
�:I!—U�r, City of Atlantic Beach
j Building Department APPLICATION NUMBER
800 Seminole Road (To be assigned by the Building Department)
� Atlantic Beach, Florida 32233-5445 .Si°�. ff l Phone(904)247 5826 Fax(904)247 5845 _ 'jQ E-mail: building-dept@coab.us Date routed: 4rArf
City web site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: J1tJ Atin-46 4 'VJ Department review required Yes No
/y� r uilding�
Applicant: ! I� �e� �7' n 1 i� •= ning &Zoning
. .
Project: - k /n/' )Es/ Public Works
9 it Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN.
Second Review: ❑Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
,;'s1 32r . City of Atlantic Beach
<� Building Department APPLICATION NUMBER
s 800 Seminole Road (To be assigned by the Building Departure
+� Atlantic Beach, Florida 32233-5445 (� nt.}
Phone(904)247-5826 Fax(904)247-5845 -.+/��' 16r
J 3. , ur E-mail: building-dept @coab.us
Date routed: 41170 City web-site: http://www coati.us
APPLICATION REVIEW AND TRACKING FORM
RM
Property Address: i 7ero-4- •/Vcl Department review required ®'No
Applicant: 4 4Z =uilding
�, __9 ✓ Pr'':nnmg &Zoning _
Project: � ` In g - _ —
Public Works _
Public Utilities _n
Public Safety IEIEMEIIIIIIIIIIIIIIIIIIIIIII fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
Florida Dept. of Environmental Protection of Permit Verified By Date
iiillniall
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:
Approved. ❑Denied.
(Circle one.) Comments:
BUILDI
PLANNING &ZONING
Reviewed by:
Date: C� S/ ,/
TREE ADMIN. - - ��, __
Second Review: ❑Approved as revised. ❑DSied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
_ Reviewed by:
-- Date:
FIRE SERVICES Third Review: -- — —
❑Approved as revised. ❑Denied.
Comments:
Reviewed by:
—__`—_ Date:
ievised 07/27/10
S.
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