1698 MARITIME OAK DR - NEW HOME PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
,;. r� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
vJ1119;�
SINGLE FAMILY DWELLING NEW
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SFR-1460
Job Type: SINGLE FAMILY RESIDENCE
Description: NEW 4320 SQ FT SFR
Estimated Value: $511,827.00
Issue Date: 7/28/2015
Expiration Date: 1/24/2016
PROPERTY ADDRESS:
Address: 1698 MARITIME OAK DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: TOLL BROS.,INC
Address: 250 GIBRALTAR RD STEVEN R MERTEN
Phone: - -
PERMIT INFORMATION:
FEES:
ENG REV RESIDENTIAL BLD $100.00
PLAN CHECK FEES $851.83
UTIL REV RESIDENTIAL BLDG $50.00
BUILDING PERMIT FEE $1,703.65
STATE DCA SURCHARGE $25.55
SEWER SDC-SYSTEM DEV CHG $4,050.00
STATE DBPR SURCHARGE $25.55
tgcvm t-.rt,Ap ,, 5itsvkNc 9stm.00,1, on of ATLANTIC REACH ORDINANCES AND TIIE FLORIDA
h "1:> CITY OF ATLANTIC BEACH
-f 800 SEMINOLE ROAD
e ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
4J.13
WATER CROSS CONNECTION $50.00
WATER SDC-SYSTEM DEV CHG $1,140.00
Total Payments: $8,366.58
PERMIT IS APPROVED ONLY IN ACCORDANCE mull l'll AI.L CI'T'Y OF ATLANTIC l.ANTIC BEACII ORDINANCES AND '1'111•: FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATIO
CITY OF ATLANTIC BEACH JIJN
FIlii. COPY 800 Seminole Road,Atlantic Beach, FL 322 .�
Office (904)247-5826 Fax(904)247-584;:y
Job Address: 1698 Maritime Oak Drieve: Atlantic Beach, FL 32233 Permit Number: 1 -.SFK- 1440
Legal Description Lot 119 Atlantic Beach Country Club Unit 2 67-132-08-2S-29E Parcel
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 511,827 Proposed Work heated/cooled 4320 non-heated/cooled 749
Class of Work(circle one): CIO Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed installed?(circle one): Commercial Residential
i
If an existing structure,is structure, fire sprinkler system nstalled. (Circle one): o N/A
Florida Product Approval#See attached
products For multiple pro use p roduct approval form
Describe in detail the type of work to be performed:New Residential Construction
Property Owner Information:
Name: TOLL FL VI LIMITED PARTNERSHIP Address: 160 Cape May Avenue
City Ponte Vedra State FL Zip 32081 Phone 904 217-0739.
E-Mail or Fax#(Optional)mlieberman @tollbrothersinc.com
Contractor Information: CONTRACTOR EMAIL ADDRESS: mliebermanna tollbrothcrsinc.com
Company Name:Toll Bros.,Inc.Qualifying Agent: Steven R. Merten
Address: 160 Cape May Avenue City Ponte Vedra State FL Zip 32081
Office Phone 904 217-0739 Job Site/Contact Number 904 386-6472 Fax#
State Certification/Registration#CGC 1510225
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 Electrical Work, Plumbing,Signs, Wells,Pools, Furnaces, Boilers,
Heaters,Tanks and Air Conditioners,etc.
DO NOT WRITE BELOW- OFFICE USE ONLY
Applicable Codes: 2010 FLORIDA BUILDING CODE
Review Result circle one):
Approved Disapproved pproved w/ Conditions
Li iv
Review Initials/Date: .
Development Size
Habitable Space y3,20 S',17 Non-Habitable %ti 9O s 1=
Impervious area
Miscellaneous Information
Occupancy Group 4
Type of Construction 3t' i
Number of Stories Z
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
Flood Zone A
Conditions/Comments:
_�_�_ F!!. !' COPY
�irL,,;���� TREE & VEGETATION AFFIDA ; T�-
�� , City of Atlantic Beach - .
`_:s) Department of Community Development JUN 1
" Planning&Zoning Division
800 Seminole Road Atlantic Beach,FL 32233
fA :_—(P)904 247-5800 (F)904 247-5845 • :I• IT# r
SECTION I-APPLICANT INFORMATION (j7 Owner(s) r Legal Authorized Agent*
NAME OF APPLICANT 76(__L- VI ) (gyp
NAME OF COMPANY Tol i i� . t INC.
ADDRESS OF COMPANY I U20 M1 LEI Avers u t lln�e Vecjrq 1 Ft- 3-Log I
PHONE CIDLI -ail `J EMAIL a►YCgers etoI1brath&S,COM
CONTRACTOR CERTIFICATION NUMBER 0,6--IC i 6 10225
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION II-SITE INFORMATION 2
STREET ADDRESS OF PROPERTY I s9 maritime,me, Oak DOW, AfIQVlt c,Be X I1, FL 32233
If an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address.
LEGAL DESCRIPTION Liar i 10I / -ti An-r)C RegG'1 Cour ry Club tint Z, 1-0-132DB-t5-It
LOT 11 q BLOCK P- SUBDIVISION A CrAn �f. 1_
REAL ESTATE NUMBER LOT OR PARCEL SIZE: 1011403 SQ FT AC
RESIDENTIAL x' COMMERCIAL OTHER(SPECIFY)
I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation"of the Municipal Code of
Ordinances for the City of Atlantic Beach,FL and/or I have participated in a pre-application meeting with the Administrator of those
regulations. Subsequently,I a that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
from the above-described ,/..,'Ill properties in conjunction with this project.
SIGNATU t OF O SIGNATURE OF OWNER
Signed and sworn before me on this 19 day of June , ' - ,by State of PU
S�!ev 1 ACHek) County of S' Jay,'\Q-
Identificationverified: azInc 1c .f l.l.Vl.,
Oath sworn:VYes r No :;=oiPp;;;",:�.,_ MELISSA LIEBERMAN
. •€ MY COMMISSION#FF055605
'--Q.-•' .qr°or4 p' EXPIRES September 18.2017
Notary Si• ature 398101 53 FloridallotarySery ice.com
REV TA v10.12 My Commission expires: 9\14 1
V (4O7i gg
R.O.W. Permit Attachment of for
R.O.W. Permit# issued , 2015 Atlantic Beach, FL 32233
Owner's Name: Toll FL VI, LP
Property Address: 1698 Maritime Oak Drive
COPYAtlantic Beach, FL 32233
Subdivision: Atlantic Beach Country Club
Lot#/Block#: 119
R.E. #: 169505-1890
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
, 20 , by Atlantic Beach, Florida, a municipal corporation organized and existing
under the laws of the State of Florida,hereinafter referred to as"CITY"and Toll FL VI, LP of Atlantic
Beach, Florida, hereinafter referred to as"USER".
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the
right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of
Atlantic Beach Right-of-Way/Easement permit numbers noted above (copies attached).
This work is generally described as: Pavers in the Right of Way for the driveway.
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted
remains subject to relocation or removal on thirty (30) days notice by CITY to the USER, said notice to
USER shall be given by certified mail,return receipt requested, to the following address: 160 Cape May
Ave. Ponte Vedra, FL 32081.
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USER's proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in
the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe
condition.
In the event it is necessary for the CITY or the City's approved representative or other franchised
utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's
sole expense, any and all material necessarily displaced during the action of maintaining, repairing,
operating, replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider.
The facilities allowed by the permit shall meet the current requirements of the City Code, Building
Codes, Land Development Code, and all other land use and code requirements of the CITY, including
City Code Section 19-7 (h) which states "Driveways that cross sidewalks: City sidewalks may not be
replaced with other materials, but must be replaced with smooth concrete left natural in color so that it
matches the existing and adjoining sidewalks."
Page 1 of 2
EP! 7
CCYJ
The USER, prior to making any changes from the approved plans and/or method, must obtain
written approval from the City of Atlantic Beach, Public Works Department, for said change. The
USER shall, at the discretion of the CITY, be requested to submit as-built drawings showing the change
within thirty(30) days after the day of completion.
This permit shall inure to the benefit of, and be binding upon, the USER and their respective
successors and assigns.
USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY
laws and/or specifications, to include utilities locate requirements and use limitations/requirements of
public rights-of-way and other public land. USER further agrees that the CITY and its officers and
employees shall be saved harmless by the USER from any of the work herein under the terms of this
permit and that all of said liabilities are hereby assumed by the USER.
DATED and SIGNED is /, day of JuNC , 2015.
By:
Stew erten, Toll FL VI, LP.
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this 19th day of June , 2015, personally appeared before me, a Notary Public in and for said
County and State, St. Johns, Florida , the property owner of 1698 Maritime Oak Drive, Atlantic
Beach, Florida, known to me to be the person(s) described in and who executed the foregoing
instrument; who acknowledged to me that he or she executed the same freely and voluntarily and for the
uses and purposes therein mentioned.
2�'`'a'`a�:: MELISSA LIEBERMAN
Not P 1c • for said Count and State MY COMMISSION#FF055605
y EXPIRES September 18.2017
town. P
CITY OF ATLANTIC BEACH, FLORIDA, a t407k 398-0153 FloridallotaryService.com
municipal corporation:
Approved:
Doug Layton, Public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Nelson Van Liere, City Manager
Page 2 of 2
moll Architecture { COrN
MEMO
TO: Stacia Moore
Atlantic Beach Ambassador
160 Cape May Avenue
Ponte Vedra, Florida 32081
CC: Steve Merten
FROM: Shannon VanCleave,AIA
Toll Brothers, Inc.
DATE: June 8, 2015
RE: Atlantic Beach Ambassador- Lot 119 Catalina/Shingle—Revision#109680
On the above referenced lot,this letter shall be used to revise or clarify the following condition(s):
1. Revised ceiling height at Covered Lanai by Master Bedroom to be 9'-8"; clouded and tagged
on Sheet A2.62,A3.62, A5.1.62,and A5.2.62.
2. Revised the slope at Covered Balcony from 1/8"to 1/4"; clouded and tagged on sheet A3.62.
If you have any questions regarding this letter feel free to contact me at Toll Architecture(407)-248-
5800.
Sincerely,
Shannon M.VanCleave,AIA
AR97080
FLORIDA DIVISION
2966 Commerce Park Drive Suite 100 • Orlando,FL 32819 • (407)248-5800 • FAX:(407)248-5899
PHILADELPHIA•ORLANDO • DALLAS • SEATTLE
A Toll B1Vther'S COMPANY
i.OTICE OF COMMENCEMEN 1 flLE COPY
State of: FLORIDA Tax Folio No. I(0q506 I p90
County of: DUVAL A ,. k c-0-702 # l 5 1 s F W' /q6 c)
c)
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: Lot 119 Atlantic Beach Country Club Unit 2,67-132 08-2S-29E
Address of property being improved: 1698 MARITIME OAK DRIVE,ATLANTIC BEACH,FL 32233
General description of improvements: NEW HOME CONSTRUCTION
Owner:TOLL FL VI LIMITED PARTNERSHIP Address: 250 GIBRALTAR RD. HORSHAM,PA 19044
Owner's interest in site of the improvement: FEE SIMPLE
Fee Simple Titleholder(if other than owner):
i' Name: _._
D"Q Contractor: TOLL BROS.,INC.
1013 1 Address: 160 CAPE MAY AVE.PONTE VEDRA,FL 32081
Telephone No: 904-217-3852 Fax No: 904-460-2683
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be
served: Name: STEVE MERTEN
Address: 160 CAPE MAY AVE. PONTE VEDRA,FL 32081
Telephone No: 904-217-3852 Fax No: 904-460-2683
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified): 4/30/18
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: •S7 /'y1�n7eM Date: 1/z3+/-�
Before me is L day of Aclu t_ i -the County of Duval,State
Of Florida,has personally appeared
Doc#2015110443.OR BK 17166 Page 209, Notary Public at Large,State of lord. County of uva•
Number Pages. 1 My commission expires: - g 1.
Recorded 05/14/2015 at 09:14 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Personally Known:
or
COUNTY Produced Identification:
RECORDING$10.00
j.,,0 'z t `''. `- ''
-•:
V, MY COMMISSION 4FF065605 (.9
,, �
,,.,,o:;• EXPIRES September 18.2017
(107)3G8 0153 Floridallotaryservice.com
Property Appraiser- Property Details Page 1 of 1
TOLL FL VI LIMITED PARTNERSHIP t"J Primary Site Address Official Record Book/Page Tile#
250 GIBRALTAR RD 0 MARITIME OAK DR 17127-02416 9408
HORSHAM, PA 19044 Atlantic Beach FL 32233 FLE C0 MARITIME OAK DR
Property Detail Value Summary
RE# 169505-1890 2014 Certified 2015 In Progress
Tax District GS Value Method CAMA CAMA
Property Use 0000 VACANT RES Total Building Value $0.00 $0.00
#of Buildings 0 Extra Feature Value $0.00 $0.00
67-132 08-2S-29E Land Value(Market) $0.00 $259,000.00
Legal Desc. ATLANTIC BEACH COUNTRY CLUB UNIT 02 Land Value(Aaric.) $0.00 $0.00
Subdivision 06884 ATLANTIC BEACH COUNTRY CLUB UNIT 02 Just(Market)Value $0.00 $259,000.00
Total Area 10376 Assessed Value $0.00 $259,000.00
The sale of this property may result in higher property taxes.For more Information go Cap Diff/Portability Amt $0.00/$0.00 $0.00/$0.00
to Save Our Homes and our Property Tax Estimator.'In Progress'property values, Exemptions $0.00 See below
exemptions and other supporting information on this page are part of the working tax
roll and are subject to change.Certified values listed in the Value Summary are those Taxable Value $0.00 See below
certified in October,but may include any official changes made after certification
Learn how the Property Appraiser's Office values property,
Taxable Values and Exemptions—In Progress*.J
If there are no exemptions applicable to a taxing authority,the Taxable Value Is the same as the Assessed Value listed above in the Value
Summary box.
County/Municipal Taxable Value SJRWMD/FIND Taxable Value School Taxable Value
No applicable exemptions No applicable exemptions No applicable exemptions
Sales History .J
Book/Page i Sale Date Sale Price Deed Instrument Tvoe Code Oualifled/Unaualified 1 Vacant/Improved
17127-02416 1 4/9/2015 $460,500.00 SW-Special Warranty Unqualified I Vacant
00067-00132 1 11/21/2014 $100.00 PB-Plat Book I Unqualified I Vacant
Extra Features.J
No data found for this section
Land&Legal!J 3.71 O
Land ILegal
LN Code Use Description Zoning Front Depth Category Land L;;I1sl Land LN Legal Description
Units IyJZg Value
1 67-13208-2S-29E
1 0150 RES GOLF LD 3 7 UNITS PUD 70.00 120.00 Common 70.00 Front $259,000.00 ATLANTIC BEACH COUNTRY
PER AC Footage 2 CLUB UNIT 02
3 LOT 119
Buildings! J
No data found for this section
2014 Notice of Proposed Property Taxes Notice(TRIM Notice)
Property Record Card(PRC)
The PRC accessed below reflects property details and values at the time of Tax Roll Certification in October of the year listed.
No information available
•To obtain a historic Property Record Card(PRC)from the Property Appraiser's Office,submit your request here: .)
More Information
•ontact Us I Parcel Tax Record I GIS Map I Mao this property on Goonle Maps I City Fees Record
http://apps.coj.net/pao_propertySearchBasic/Detail.aspx?RE=1695051890 4/28/2015
ss CITY OF ATLANTIC BEACH
L . PUBLIC UTILITIES
1200 Sandpiper Lane
X13 S� . ATLANTIC BEACH,FL 32233
(904) 270-2535 or(904)247-5874
NEW WATER/SEWER TAP REQUEST
Date: 6- ZZ-!S Project Address: /40 9 g /1, /Tt N I t 649) 1)K:-.
No. of Units: Commercial Residential V Multi-Family
New Water Tap(s)&Meter(s) Meter Size(s) '/7
New Irrigation Meter ✓ Upgrade Existing Meter from to (size)
New Reclaimed Water Meter Size 3� L--
�{ New Connection to City Sewer
Name:
Applicant Address:
City: State: Zip
Phone Number: Cell Number:
Email Address Fax:
Signature:
(Applicant)
CITY STAFF USE ONLY
Application# lam- SW-g— /'/(,r
Water System Development Charge $ / Q
Sewer System Development Charge $ USA OD
Water Meter Only $ /,c3 co
Reclaimed Meter Only $ /85: 00
Water Meter Tap $ (notes)
Sewer Tap $
Cross Connection $ 573. CO
Other $
TOTAL $./ WO.O. vv
APPROVED: Kayle Moore, PE Z
(Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE
APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED
01.:,.-5,4 City of Atlantic Beach
b, ti A Building Department j APPLICATION NUMBER
800 Seminole Road `L•��j� (To be assigned b th Building Department.)
��� ` Atlantic Beach, Florida 32233- 445 •
Phone(904)247-5826 - Fax/(904)2 0 ' �"�
\-<--?' u� E-mail: building-dept coati. 2 z
City web site: http://w@wwcoa O15 Date routed: (o E1
APPLICATION REVIEW N
/TRACKING FORM
Property Address: !toge MMI 11 i
' +ment review required Yes No
Applicant: -mu.- egos . = ildin. _-
Plannin• &
Project: ��� � al" °••,-ms ra or ==
_ _ / .lic Work _-i Public ti'ties 'V_—
Fire Services __
Review fee $ 3--c, Dept Signature
5C o,.%_
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
Florida Dept. of Environmental Protection ■ .1 .11 _I _IIIIIIIIIIIIIIIIIII
Florida Dept. of Transportation
MIMIMMIMMIIIMMIIINIIIIIIII
St.Johns River Water Management District _1111111111
Army Corps of Engineers
IMINEMEMIllaillilll
Division of Hotels and Restaurants
MIIIMIIIIIIIIIIIIIIIII
Division of Alcoholic Beverages and Tobacco
Other:
APPLICA ION STATUS
Reviewing Department First Review: 1
(Circle one.) pproved. ❑Denied.
Comments:
BUILDING
PLANNING&ZONING
_ Reviewed by: �'.- PL-- 2-9 /4"---TREE ADMIN. Date:
• Second Review: ❑Approved as revised. ['Denied.
Ol4.--. ..-.4-.
)3LIC WOWS Comments:
f' BLIC UTILITIES
40-72--/,3-
UBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review:
['Approved as revised. ❑Denied.
Comments:
Reviewed by:
Date:
revised 07/27/10
1 ;1.
City of Atlantic Be ` `1 `:a`
Beach 1;,. ---___
Building Department i r xy�: APPLICATI
'. ` 800 Seminole Road i,r,�, ON NUMBER ___
a-� �, - (To be assigned b th Building'Department.)
r r Atlantic Beach,Road
32233-5445 i': "`'
- �' Phone(904)247-5826 Fax(904)247-5845 . 11.16_0_
( 14)247 5845., +
•
��: :: E-mail: building-dept @caab.us -,_-. -
..--W______
City web-site: http://;vw+,v.coab.US Date routed:
APPLICATION REVIEW AND TRACKING FORM
ZIAND
Property Address: I lige MMI TI
1, •- meet review required— Yes -No-I
Applicant: I��/`/ OS • • a ildin. __ __
I Plannin• &Zonin.
Project: �EW '�� — r!_ • a i'nis ra or - —- _
4 • . is Work ________
Fire Services --
1
Review fee $ __ Dept Signature
•
Other Agency Review or Permit Required Review or Receipt pat- I Alb 2 6 --.1 1• • i
Florida Dept. of Environmental Protection ___ of Permit Verified By TP0711.1 C.
Florida Dept.of Transportation 'Y
— -' ~■„„�ra —t Sf.Johns River Management District
Army Corps of Engineers —
Division of Hotels and Restaurants — _
Division of Alcoholic Beverages and Tobacco -- --
other ---_..._______
•
APPLICATION STATUS
i Reviewing Department First Review: -_-.
Approved. • Denied. j
! (Circle one.) Comments: I
BUILDING ��' l �,//.._,,D I
'PLANNING&ZONING f
_ Reviewed by: 4 l G_-- Date: 6 Ze +
TREE AMI N. —� � te. /�
,- _ _--`_� Second Review: Approved as revised. Denied. —_
PUBLIC WORKS Comments:
Joe tt4 d a-
PUBLIC UTILITIES I
PUBLIC SAFETY �� I
Reviewed by: L ���_ �•_ Dare: 7 G / �
FIRE SERVICES Third Review: - ----- __ _._.__-=_J
❑Approved as revised. 111 Denied.
Comments: j
I
Reviewed by;_ J
Date: i
- ___
:eviserr 07/27/10 ---- �___ .__1
, City of Atlantic Beach
Building Department APPLICATION NUMBER
-- .'' 800 Seminole Road (�o be assigned b the Building Department.)
:),;(.:,,
v "+'" Atlantic Beach, Florida 32233-5445 16a. Fe .. I 1 /
Phone(904)247-5826 • Fax(904)247-5845 �/�,�
,);09r E-mail: building-dept @coab.us �/� •
City web-site: http://www.coab.us Date routed: �i/
APPLICATION REVIEW AND TRACKING FORM
Property Address: I LjCS MM' 1 i 4 II- ._ .ment review required Yes No
� • ildin• ��
� _-
Applicant: dos 6 1 Plannin• &Zonin. 11111111111
NEW SF�
4 -- e•u ra or _-
Project: • .• is Work k _-
4 Public ti sties 1111111111111111111
- • . - +
Fire _-
e 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: . nDenied.
(Circle one.) Comments: \l/
BUILDING /01S 1
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN.
Second Review: ❑Approved as revised. nDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
siD:T,; , City of Atlantic Beach
,1 * Building Department APPLICATION NUMBER
800 Seminole Road (To be assigned b the Building Department.
ti� `•' Atlantic Beach, Florida 32233-5445 is �, ' )
t Phone(904)247-5826 • Fax(904)247-5845 •�r
9J;+3 9� E-mail: building-dept @coab.us
(01Ur
City web-site: http://www.coab.us Date routed:
APPLICATION REVIEW AND TRACKING FORM
Property Address: nage MI I TI
• +ment review required
�� �� ' • e ildin. ==
Applicant:
Project: ��W � 6 - _+ii.nis ra or _=
- -------_-_-__ 4 ; +lic Work _-
4 Public ti'ties IIIIIIIIMENIIIIIIIII
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or 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
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review:
❑Approved. Denied.
(Circle one.) Comments: ^^ '' / '
BUILDING
PLANNING&ZONING
Reviewed by: , �� I
TREE ADMIN. Date:
Second Review: A ��
pproved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by: /�-...___� 7 2 It
Date:
FIRE SERVICES Third Review:
['Approved as revised. ❑Denied.
Comments:
Reviewed by:
Date:
revised 07/27/10