1515 Ocean Blvd Trellis Denial Comments 4
",-;5L.:,,. ;;•4, City of Atlantic Beach
CJS . ��,, Building Department
r �.. 800 Seminole Road
APPLICATION
;`� , ��``„ ;, '' Atlantic Beach, Florida 32233-5445N NUMBER
(To be assign-d by the Building
Phone(904)247-5826 . g Department.
Fax(904)247-5845 rj
/��
':_ ±��,� E-mail: Buildin -de t _
City web-site: hgtt :p °@coab.us
p www.coab.us Date routed: ' 847 .6.—
APPLICATION REVIEW AND TRACKING FORM
Property Address: _../ /
if ev. Department review required � No
Applicant: 5 S d / ��
_ & _ll
Project: Tree Administrator --
Public Works --
Public Utilities --
Public Safety -M.
-
IMEMENINIMMIENem
Review fee $ Dept Signature
Other Agency Review or Permit Required Review r Receipt
Florida Dept. of Environmental Protection of Permit Verified By Date
Florida Dept. of Transportation _
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
1.11111111111111111111111111111111111
Division of Alcoholic Beverages and Tobacco
Other: 111111111111111111111111111
APPLICATION STATUS
Reviewing Department First Review:
(Circle one.) CApproved. ❑Denied.
Comments:
EILDIN
PLANNING &ZONING
TREE ADMIN. Reviewed by:
Second Review: 4 Date: 6 S'
PUBLIC WORKS Comments: Approved as revised. ❑Denied.
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by:
Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied.
Comments:
Reviewed by:
Date:
.vised 07/27/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH Imo^
800 Seminole Road, Atlantic Beach,FL 32233 FILE c/ i
Office (904)247-5826 Fax(904)247-5845
Job Address: /S-7S. 0 oto W Permit Number: /S - R i Di) -/ S'o/
Legal Description Parcel#
Valuation of Work$ ��Q, Floor Area of Sq.Ft. —7171
--------
Valuation 00 Proposed Work heated/cooled q
� non-heated/cooled
Class of Work(circle one): Addition Alteration Repair Move Demolition pool/spa P p window/door
el
Use of existing/proposed structures)(circle one): Commercial C0
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No
Florida Product Approval#
For multiple products use product approva orm
Describe in detail the type of work to be performed: %3„ ,-N 7:Zb 14'5
Property Owner Information:
Name: A/44...)1,-r-6� /
Address: /��� OG6/R6/�<�Z
City iit- State0jZip?22 41 Phone 242rZ— S Z 7- Z1 at 7 3
E-Mail or Fax#(Optional) �+
Contractor Information: CONTRACTOR EMAIL ADDRESS: T h c CP col,Co;K
Company Name: rt1)'Ufl C f ov`tCS crif t'l juts "Qualifying Agent: &.alive1 , fiat)
Address: 139'/ (3dr D t. City 5c 6. . Stat f). Zip 3 t V
Office Phone 024/-0002- Job Site/Contact Number 7/O -Vera Fax#
State Certification/Registration# C(L /2r(f9f /-00,,t
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 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 ElectricalWorlt,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
I
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 cert that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other feder, state, or local law regulating construction or the performance of construction.
tie:4;, 4ffilli , -
Signature of Owne
Signature of Contractor
Print Name p„, L.( P /.... - 6- ”-P,y,.... 4 g.. A Print Name cS.
Before me Befo
his 23 Day of )WI L , 20 IS thil' II, o �.1 ,2'A 20
MELISSA SERRIDGE �, r -
lotary Public - f'ioN4 vi.,...,-NOT E ppFLORIDA PUBLIC Aiw ub le
` • +
• fir.
Expires SJ22/2O18 Revised 01.26.10
FILE COPY
...______. _ ......_____
..
. _
.._
I -c---------------------„„.. ..
,...
,., _
........... ,. . .......
. ,
t
)---.. 1)s
ID
0-
c. r_
Ci-
J
r - ,
I
f
. , JOB COPY
THIS PLAN MUST BE
ON JOB SITE FOR
EACH INSPECTION
' REVIEWED FOR CODE COMPLIANCE
CITY OF ATLANTIC BEACH
PERMITS FOR ADDITIONAL a,,:
REQUIREITS`AND CONDITIONS -'
REVIEWED BY: %71 y ,DATE: G ---a s-1 S'
mob :
, �--
f
1-- 1).
e.
Com
•c ,
4-1
s I �v
T
C 4'rl
G
C/)
cit.