1800 MAYPORT RD - SIGN PERMIT City of Atlantic Beach APPLICATION NUMBER
Building DepaUtBYiu�'s To be assi ned b the Building De artment.)
800 Seminole Road g y
— /'' Atlantic Beach, Florida 32233-5445 I d j`/� �`j
Phone(904)247-5826 • Fax(904)247-5845 �.
E City web-site: http://www.coab.us late routed: J j
1' P UCA TIN REV EV° AND T l",), : K-e
Property Address: //GAO Mhy (r /ed' Dep. r1 dent review required Yes No
Applicant: t 'Ianng Zoning
ree Administrator --
Project: lJ Public Works
Public Utilities
Public Safety
Fire Serviced ...:..
Review fee $ Dept Signature
CONTRACTOR ENTAIL ADDRESS
CONS'
1� fur -rur rna ��U � oh
110w Q. -14 ac ed
i eviewinl 40 V I ��(NT ! ------
(Circ
BUI 1 p\
PLANNIN■ C / 2 3
TREE �?/' "`"" _ nA44 q P --- Date:
� vt� n� c.`91\
•
PUBLIC
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES
Third Review: [lApproved as revised. DDenied.
Comments:
Reviewed by:__ Date:
VISED 0925201;
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1800 Mayport Road/CL Customs, Inc. dba Dirtbag Choppers Permit Number: /9 -S;34 -651
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ c)`3/ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): 4I Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): m Residential
instal an existing structure,is a fire sprinkler system nstal e . ircle 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: Tenant building signage—Front sign 6 x 3/Side Sign 5 x 3.
Property Owner Information:
Name: Ossi Klotz, LLC Address: 645 Mayport Road, Suite 5
City: Atlantic Beach State: FL Zip: 32233 Phone: 904-247-5334
E-Mail or Fax#(Optional)
Contractor Information: C
Company Name: �� � -✓z S Qualifying Agent:
Address: 1 Uti c . City •1( State i=(, Zip "S z 2 33
Office Phone f7 -S 1 ? b Site/Contact Number Fax#
State Certification/Registration#
Architect Name&Phone# c) a)/1 ep
Engineer's Name&Phone# il■ i1 Y`.! _
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 f 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 I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied wit 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 federal.st ,or local law regulating construction or the performance of construction.
Signature of Owner Signature ofCont . or
Print Name: Nicole Conner-As agent for owner Print Name \ it , - C {'P c'v S
Sworn to and subsc 'bed befo a me Sworn to and subscribed befo • I e
this ' Day of IC.0.0123 Y ,20 1I this Day of 20
�I Ar_____�I
Notary Public — Notary Pu. is
o�!"'�.� CINDY DUNGAN
=r !� MY COMMISSION#FF073701 Revised 01.26. 0
�,„� EXPIRES:DEC 01,2017
1 1
1 I
.. . . , . .. . . __. .
, 1
1---
II '
,r.....
z .
\ 1
i .
0 I r
{-
\ 1
/
41
..
.,,
1 r
. _..... - -i-.
... , , . .., .
, _...
iii(
1 .-__' -. i •#:• .:
' 7.,_.,-. ,...•* ..."
---- -;,/ i 1
,. .
/I 44 . ' at 0
■ff"-----: "N f N '%-.:
I
/1...' ■,. \\r' • . i 7
Ilak .
1 71....
, 4 *ija t.•
' a'.1;*■,. %.*14. '
11. .-
.....
I t
/
1 , LIR 1 I
' t r
10
, .
I i
1 • .„;04,....
/
1. I(ell I e 44: .•,/..
.. ,
.. Pm .
7-
6 ii ..41
A . ,-0
a y;
ti
:
. . s
E'e
..
. ,
, , lira al
. ;a:
F
. t
\ /4 P
, .
. _, ,,...._...
010(
) .... . . . .. ... _. .. . . .,
. . . .. .
, ...
. . . ......
........ .......... .....,. ......„,....
.. O..
. .... .. ...... .... .,....,...
. ,
joil ._., , . . ..... . ., . •. ..
..
f
.•..:,
. j
1 U
,A,._ \
i/
:'
v
Foc4-
-t
• S ,rSN
z
0 „,