1810 SELVA GRANDE DR - GABLES, AWNING y ' cizll
!:=:. ,, City of Atlantic Beach APPLICATION NUMBER
Building Department
800 Seminole Road (To be as igned by the Building Department.)
1 /9 � /
Atlantic Beach, Florida 32233-5445 p/
Phone(904) 247-5826 Fax 247-5845
0
( ) Fax(904)247 5845
J. • E-mail: building-dept @coab.us Date routed: — Z
City web-site: http://www.coab.us LIMIIII
APPLICATION REVIEW AND TRACKING FORM
r
Property Address: /81a SçsJ f dg De•artment review required Yes, o
Applicant: TEAS J d Planning &Zoning 111■
Tree Administrator _-
Project: — /y,S I /020/7 /I J 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:
APPLIC •TION STATUS
Reviewing Department First Review: (§Approved.
❑Denied.
(Circle one.) Comments: / He'd
BUILDING Perna/a 71-o /x perm , f e' Se ra le IV,
PLANNING&ZONING O c
Reviewed by: it"' Y/3.-
TREE ADMIN. Date:
Second Review: QApproved as revised. ❑Denie f
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
CITY OF ATLANTIC BEACH FILE COPY
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 /1
Job Address: 1810 SELVA GRANDE DRIVE Permit Number:/5- R OD-- / '19
Legal Description 38-28 09-2S-29E SELVA TIERRA Parcel#
�.7oor Area of Sq.Ft. Sq.Ft
Valuation of Work$ b,icrJ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New 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 lire sprinkler system installed?(Cirde 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:
EXTEND FRONT ENTRY WITH GABLE ROOF AND POST,INSTALL 3 WINDOW/DOOR AWNINGS,1 GARAGE TRELLIS,1
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 Ceitifcation/Registration#CBC1258387
Architect Name&Phone#
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 made to obtain a permit to do the work and installations as indicated 1 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 lows regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six 16)months,or if construction or work is suspended or abandoned for a period of six i6)months at any time after
work is commenced. I understand that separate permits nisi he secured for Electrical Work,Plumbing,Signs Wells,Pools,Furnaces,Boilers,Hearers,
Tanks and Air Conditioners,ets
,1,..--w.:._ . 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.
/hereby certify that I have read and examined this plication and know the same to be true and correct.All provisions of laws and ordinances governing tins
type ofwork will be complied 'th whether specified herein or not. The granting of a permit does not presume to give auihonly to violate or cancel the
provisions of any other federal. e,or local!ow ;dating constriction or the performance of co nsbuction. /
Signature of Owner I,_ / _ / /
Signature of Contractor L- _ — ��-
Print Nam- -IC♦ L'• -PER Print Na. - KEVIN P FITZGE'°LD Al,
Swo. ind su ri e 1 Saco• ,n���jj,,QQ��ubscribed
th'•� Da,.r f 20 ill'. 'J_of /� / 20
`sty 's lie ik lv,.: n►.
Nay S'cvised0l.26.l()
cog Poe( Notary Public State of Florida '
a : Shirley L Graham eV Notary Public State of Florida
"4` tf My Commission FF 086990 y ! ; Shirley L Graham
' or nO Expires 02/14/2018 C- I My Commission FF 086990
• Foci Expires 02/14/2018
1
LJ j i`J�
CITY OF ATLANTIC BEACH
K r; , 800 SEMINOLE ROAD
'" - clr ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
''�01t19r'
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
I
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.
s 'K ,. n� CITY OF ATLANTIC BEACH
i
tr .,„ ...,
A 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.
(-----
rS t>c,
AL_or. S, CITY OF ATLANTIC BEACH
r' ^ `. - ) 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
____} INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
3OB INFORMATION:
Job ID: 15-RAAR-1865
Job Type: RESIDENTIAL ALTERATION
Description: PERGOLA
Estimated Value:
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
GENERAL CONTRACTOR INFORMATION:
Name: KMS SYSTEMS INC
Address: 1301 PENMAN RD STE C KEVIN FITZGERALD
Phone: 904-568-4211
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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