1810 SELVA GRRANDE DR -ALTER GABLES & AWNING Sr��yr
fijk S CITY OF ATLANTIC BEACH
r "`' 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ADDITION
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RADD-1819
Job Type: RESIDENTIAL ADDITION
Description: GABLES AND AWNING
Estimated Value: $6.500.00
Issue Date: 8/10/2015
Expiration Date: 2/6/2016
PROPERTY ADDRESS:
Address: 1810 SELVA GRANDE DR
RE Number: 169542-5004
PROPERTY OWNER:
Name: CARPER. RICKY L
Address: 1810 SELVA GRANDE DR
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $82.50
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $41.25
STATE DBPR SURCHARGE $2.00
Total Payments: $127.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
F I W.7 cf:,:ly CITY OF ATLANTIC BEACH
• 800 Seminole Road,Atlantic Beach,FL 32233 pi�ia6 F Copy
r
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•
Office(904)247-5826 Fax(904)247-5845 1 e ,)S
Job Address: 1810 SELVA GRANDE DRIVE Permit Number /W4 4
Legal Description 138-28 09-2S-29E SELVA TIERRA (Parcel#
Floor Area of Sq.Ft. Sq.k t
Valuation of'Work$ bt r.Ct`-.1C`J Proposed Work heated/cooled non-heated/cooled
.Class of Work(circle one): N6 w. Addition' Alteration Repair Move Demolition pool/spa window/door
" °�4" ' 'n':. Use of existing/proppoossed.stnicture(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 prodducts use'product approval form
run,..-h ;n datail the type:of work to be performed:
• PERGOLA AS I'CR rh4N.
Property Owner information:
Name:RICKY L CARPER Address:1810 SELVA GRANDE DRIVE
City ATLANTIC BEACH State FLZip 32233 Phone 904-545-3125
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:KMS SYSTEMS,INC. Qualifying Agent:KEVIN P FITZGERALD
Address:1301-C PENMAN ROAD City JAX BCH State FL Zip 32250
•
Office Phone 904-435-5018 Job Site/Contact Number 904-568-4211 FaX# 888-583-3480
State Certification/Registration#CBC1258387
Architect Name&Phone if
Engineer's Name&Phone.// CLEVE DRYDEN 904-955-6302
• Fee Simple Title Holder Name and Address
Bonding Company Name-and Address
Mortgage Lender Name and Address
Application is hereby mode to pbtayn a permir.ro do the work and:installations os indicated. I cent y that no work or installation has commenced prior to the
Issuance of a permit and that all work will be p orn,d to meet the standards of all laws regulating construction.in thisjurisdiction. This permit becomes null
and void ifwork is not.commeiced within six(6!months,or if construction or work is suspended or abandoned for aperiod of six f6)months at my time after
work is commenced. I w,derstand that separate permits must be secured for Electrical-Work,Pl unbing,Sign%Wells,Pools Furnaces,Boilers,Healers,
Tanks wndAir Conditioners etc
rr .�,;s,- WARNjNG:TO.O.WNER: 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.
Ihereby ceriify!hall have read and examined this application and know-the same to be true and correct.All provisions of laws and ordinances governingthis
type of work will be complied 'th'whether speci�d herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any.other fedei at;B e,or local owe 'lacing construction or the performance of construction.
Signature of Owner Al /.. Signature of Contractor
Print Nam -IC• L • -PER Print Na. KEVIN P FITZGE-• LD
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'rrary 'u.lic ""art — illits-ft,-7---,:fe...,..7 . - um.
• �'evised 01.26.10
mipset°u� Notary Public State of Florida
�•t Shirley L Graham N Notary Peak Stare of Florida
A My Commission FF 086990
or FW' Expires 02/14/2018 Al My Commission FF 086990
ciO Expires 02/14/2018
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TRI—STATE LAND SURVEYORS, INC.
8411 BAYMEADOWS WAY SUITE #2, JACKSON WLLE, FLORIDA 32256 (904) 731-7235
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/ HEREBY CERTIFY THAT THE ABOVE LANDS WERE SURVEYED UNDER MY
• caw. R£SPONSIBILE SUPERVISION AND DIRECTION, THAT THERE ARE NO
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""C1P#u""/ HEREON MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH BY THE
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PURSUANT Tip SECTION 472.027, FLORIDA STATUTE'S
LILL /WING RLS7NC77 LINC
t'9t7 LASDIENT LARRY C. EDDY, P.L.S. No. 4144
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TRI—STATE LAND SURVEYORS INC.
8411 BAYMEADOWS WA Y SUITE' 12, ,11:, '"X5ONVILLE, FLORIDA 32256 (904) 731-7135
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I HEREBY CE.Rrirr THAT 7HE .J.,9:7 v..'..- LANDS *ERE SVRVEYED UNDER MY
RESPON.VBILE SUPERVISION AM DIREC770N, 77-IAT THERE ARE NO
g> pal co;
ENCROACWMEN TS EXCEPT AS .:•,...A•i OM AND THAT 771E SURVEY SHOWN • . . . .
HEREON ME,.."7S THE MINIA10.4 r?-7TY-INICAL. STANDARDS SET FORTH BY THE •
FLORIDA .1141
, ORIDA SI A 7 L. BOARD OF PRt„:4'ESWONAL SUR ‘VEYORS AND MAPPERS
!aw.i.t,..',,UVAI 1• PURSUANT m ssy..-170?•/ *7.02' .;:-t.( 'DA SrATUTES.
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ORDFP No. (-/ 517,..‘)
a4-12.:Art,f City of Atlantic Beach APPLICATION NUMBER
Building Department
(To be assigned by the Building Department.)
800 Seminole Road ��� J I
'---_"" Atlantic Beach, Florida 32233-5445 (�
a v
/ Phone(904)247-5826 • Fax(904)247-5845
--'�/ E-mail: building-dept@coab.us Date routed: Eli
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address' el O5C IvoiGireirde,Cfr I _ • ent review required Yes No
Applicant: N •.i jICYYS rev. P anning & oning
• - or
Project: pey43014%. Public Works
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:, ....4 Z/�--. Date: Opf
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
BUILDING PERMIT APPLICATION
rcl CITY OF ATLANTIC BEACH �.
SOO:Setninole Road,Atlantic Beach,FL 32233 1 ...r w. >�
Office(904)247-5826 Fax(904)247-5845
Job Adci,ress: 1810 SELVA GRANDE DRIVE -
Permit Number: �Q, j�
Legal Description 138-28 09-2S-29E SELVA TIERRA
Valuation of.Work$ k7/ `'
lour Area of Sq.Ft. (Parcel# S..Ft
S. Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
'" -''. `--•• : Use ot.existingfproppoossed•strgcture s (circle one): Commercial
If an existing.sfructure,is a firespnnklersystem installed?(Circle one): Yes ua No N/A
Florida Product.Approvai#
For multiple products use pibcduct approva urm
r,°^^^ ;n rintail the type.of work to be performed:
PERGOLA AS rcR PLAN.
Property Owner Information:
Name:RICKY L CARPER Address:1810 SELVA GRANDE DRIVE
City ATLANTIC BEACH State FLZi 32233
E-Mail or Fax#(Optional) p Phone 904-545-3125
Contractor Information:
CompanyName:,KMS SYSTEMS,INC.
Address:1301-C PENMAN ROAD
Qualifying Agent: KEVIN P FITZGERALD
Office Phone 904-435-5018 City JAX BCH State 5 Zip 3225p
State Certification/Registration Job Site)Contact Number 904-568 4211 Fat# 888 Sg�3480
n/ite�straGon#CBC1258387
Architect Name&Phone#
• Engineer's Name&Phone.# CLEVE DRYDEN 904-955-6302
Fee Simple Title.Holder Name and Address
Bonding Company Nameand Address
Mortgage Lender Name and Address
Application is hereby made to obtain.a permit to do the work and installations as indicated. 1 cent that no work or installation has commenced prior to the
and issuance of apermit erred that all warkw//be p��e�Jjr'orreed to meet the Standards°fall lines regu/alit,g.construction.in lhisfnr/sdtetton. Thtspermit becomes null
Turk is�tAl,C ed, io Conditioners,etc.
understand.that six(07 permits be nc�red or or El c! suspended or abandoned hr a_per7al ofsix�months at any time after
Tanks comet Conditioners e f cal Work, Signs, Wells,Pools Furnaces,Boilers,Heaters,
>ni:t-iii WARNING•:T.O.OWNER• YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RE tJLT 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 this application and know the same to be tone and coned.All provisions of laws and ordinances governing this
type of work will be complied 'th'whether specified herein.or not. The granting of a permit does not presume to give ewlhority to viol,e or cancel the
provisions of any.other fede, e,or local low r •'toting construction or lh,,performance of constitution. ei.,....„. (7)
Signature of Owner I /: