2243 BEACHCOMBER TR - INTERIOR REMODEL f------jJ, '<I;, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'�0YI)`
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2233
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR REMODEL - BATHROOM
Estimated Value: $11,000.00
Issue Date: 9/24/2015
Expiration Date: 3/22/2016
PROPERTY ADDRESS:
Address: 2243 BEACHCOMBER TR
RE Number: 169463-0166
PROPERTY OWNER:
Name: STEVENS WARD F AND JANE E, *
Address: 2243 BEACHCOMBER TR
GENERAL CONTRACTOR INFORMATION:
Name: CORNELIUS CONSTRUCTION CO.
Address: 71 19TH ST QA MARGARET S. CORNELIUS
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $52.50
BUILDING PERMIT FEE $105.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $161.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
..
BIJILDING PERMIT APPLICATION r COPY
CITY OF ATLANTIC BEACH
800 ;eminole Road, Atlantic Beach, FL 32233 R
Office (904) 247-5826 Fax (904) 247-5845 1 '+~ a��-z�j
Job Address: 224 i ' _ -• I, » _ 6 I ! r t , �'1'' �l 1
Legal Description ■{2- 1 0? 2 5 —2 9>r p ain 1 I ! ' 11 11
Valuation of Work$ 11 Q b Proposed Work he ted/coole i '' , J
1 . q heate�.11/ dJ�A
Class of Work(circle one): New Addition Alteration cagaaia • . . . . .... .
•ow/door
Use of existing/proposed structure(s) (circle one): Commercial C_ Re 'd •
If an existing structure,is a fire sprinkler system installed? (Circle one): es No N/A
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed: jr vie.,. ('A$l x$ 1,,(Ki�(( 5m
Property Owner Information:
Name: WES ST-Evmi,js Address: 2243 $CACNCi130k 1 ,},IL
City fiuvoic 13cJ State ELZip 32233 Phone 8."53•4,10Z
E-Mail or Fax# (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name:aptyE.1.tU5 Gf s-risi x--lpt Qualifying Agent: tAme,t A le.Er re;et,3EJ-t1-5
Address:P.O.$ok 33011 e City errall1n C 'Bc 3 State Fi Zip 2.233
Office Phone 2qg•a7o(p Job Site/Contact Number p
State Certification/Registration# Lgco�91 Il'7 Fay
Architect Name&Phone# —
Engineer's Name&Phone# —
Fee Simple Title Holder Name and Address 1tiE.3 .3-r KVF
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 ofa 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 !Fork,Plumbing,Signs,a 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 hereb certify that I have read and examined this a placation 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
9rovisions of any other federal,state, or local law regulating construction or the performance of construction.
II
signature of Owner ik, . ��-
��_ Signature of Contractor /i�// ,,/jam'
'rant Name { �� i •
�J e.- Print Name j Atple.F.,..r C.) _Fte,..#40_5
ief: e
7 Be . •.
its Da of 20•otar ubliv I1 Shirley raham 1r, mis.r.nFF086990
�j y Commission FF 086990 Notar 417,
"T. Expires 02/14/201e
•2/14 01a
• , +1.26.10
`;i_i;,,y City of Atlantic Beach
Building Department APPLICATION NUMBER
i :- ' ' (To be assigned by the Building Department.)
- 800 Seminole Road
;� - Atlantic Beach, Florida 32233-5445 s z 23
Phone(904) 247-5826 Fax(904)247-5845 J
��%>��rti�fr E-mail: building-dept @coab.us Date routed: 9/z � f 1 ityweb-site: http://www.coab.us r
APPLICATION REVIEW AND TRACKING FORM
Z y3 /3eoc4 co.,d P,- Tea:
Property Address: D- • - •• IIent review required Yes o
Buildin.
Applicant: CORN EL. I OS eor.,..,-, • _ ng&Zoning
Tree Administrator
Project: ) f' TE2(OK R E tiobe_L. 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: I Zroved. ❑Denied.
(Circle one.)' Comments: //^^��
GILDING V
PLANNING &ZONING y Date: 7 "023%S—
Reviewed b
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