872 AMBERJACK LN - SIDING PERMIT ,, rS�:��`J J
r , CITY OF ATLANTIC BEACH
,.:r- J 800 SEMINOLE ROAD
JF y ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
\J;31
SIDING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SIDE-2255
Job Type: SIDING PERMIT
Description: HARDI LAP SIDING
Estimated Value:
Issue Date: 9/28/2015
Expiration Date: 3/26/2016
PROPERTY ADDRESS:
Address: 872 AMBERJACK LN
RE Number: 171146-0000
PROPERTY OWNER:
Name: MCKENZIE, JEROME & CHARLENE, *
Address: 509 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: PLUMBING BY JOSH
Address: 5677 FLORAL AVE THOMAS R PORTER
Phone: - -
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.
rr' . ., -��� CITY OF ATLANTIC BEACH s.
M. 4 ''°s 2 800 SEMINOLE ROAD
JV 4 ATLANTIC BEACH, FL 32233
.N INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2141
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR REMODEL , 2 BATHROOMS, KITCHEN. AND LAP
SIDING
Estimated Value: $10,500.00
Issue Date: 9/28/2015
Expiration Date: 3/26/2016
PROPERTY ADDRESS:
Address: 872 AMBERJACK LN
RE Number: 171146-0000
PROPERTY OWNER:
Name: MCKENZIE, JEROME & CHARLENE, *
Address: 509 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: PLUMBING BY JOSH
Address: 5677 FLORAL AVE THOMAS R PORTER
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $51.25
BUILDING PERMIT FEE $102.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $157.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
r" 7 COPY CITY OF ATLANTIC BEACH .
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 I S-K\iR_Z 14
Job Address: f7' ,=c it f. !Ac L& Permit Number:/
2- 5 , H/
Legal Description Parcel#
Floor Area of Sq.Ft. t
Valuation of Work 0 1 , Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval #
For multiple products use product approval orm
Describe in detail the type of work to be performed: A-La i ,v-rErz, o e_ pne-T,•tV LdAi_L$; t'V `i4+,
2- N.i c _ S �,W. �- ,,, , d 1,
Property
Owner Information: .
Name: SALT A I R- Po mC I K C • . Address: 22 4, " -i—Lv
City ..\A R E` State&Zip 5,2240 Phone %A(— 333— 660i
E-Mail or Fax#(Optional)
•
Contractor Information: CONTRACTOR EMAIL ADDRESS:
AD
Company Name: / /1/1141,17 4>' �o, (7 ,��C Qualifying Agent: �!7/tAS i %�
Address: St!2 72 F/oft / 4 Je- City :s X State F2 Zip J.2?- '/
Office Phone 7,?3-?co v Job Site/Contact Number Fax#
State Certification/Registration# r 4C/k5A37,X
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 work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod of six(6)months at any time after
work is commenced I understand that separate permits must be secured for Electrical ;York,Plumbing,Signs, Wells,Pools, Furnaces,Boilers, Heaters,
Tanks and Air Conditioners,etc. r
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 cert� of that I have read and examined this application and know the same to be true and correct. All provisions laws and ordina es gov ruing this
type ofwork will be complied with whether specified herein or not. The granting of a permit does not presume to giv. author' to ate o ancel the
'rovisions of any other federal,state,or local law regulating construction or the performance of construction.
gnature of Owner 00 i J4�J .
Signature of Contract°• _AAA. / ,
'rint Name QLI V 9-- ViZW -- Print Name O 7
3ef r m- / Befor ,1:
zis ay of MA/ ,20 this b/ of .r' .�•# - - - i /�
rotary - ,� Y .,.,- 14 ..41NIMPIM
Shi -y L Graham 'otary Pub iC •mmission FF 086990
c I My C•mmission FF 086990 sires 02/14/2018
'�io;0av' • •res 02/14/2018 -% . ‘ .
-_1�rJr
,s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
SIDING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SIDE-2255
Job Type: SIDING PERMIT
Description: HARDI LAP SIDING
Estimated Value:
Issue Date: 9/25/2015
Expiration Date: 3/23/2016
PROPERTY ADDRESS:
Address: 872 AMBERJACK LN
RE Number: 171146-0000
PROPERTY OWNER:
Name: MCKENZIE, JEROME & CHARLENE, *
Address: 509 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: PLUMBING BY JOSH
Address: 5677 FLORAL AVE THOMAS R PORTER
Phone: - -
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.
01..A4;.,, City of Atlantic Beach APPLICATION NUMBER
6s '' Building Department (To be assigned by the Building Department.)
r ,` 800 Seminole Road
r Atlantic Beach, Florida 32233-5445 S R R (�-z
Phone(904)247-5826 • Fax(904) 247-5845 (37_91i
o;llc' E-mail: building-dept @coab.us Date routed: 3_
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: x;72. PmaEizSIAc_c LK) Department review required YrNo
,„ euildin•
Applicant: PLOMEi&)q �� Li S pS E-( - -nni
-.as..,mli�.
Project: 1 N)-C. -.12._10 R., Rir- c p L Public Works
Public Utilities
n 2 VtY4d - Public Safety
} Pr Fire Services
Separa e Perm- G S;o4,sy oy-a?S•/ -
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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: Proul U-f beg w ,ytc j C. /No0 S,A S Co eil p l;an r.t yyLP.I hecJ
BUIL ID N "cre'm t-x•Sj %4S r3,,id CcrJe> pravdi Covo✓ ss) J4 c.,,:_14, Coal.-c
p.F.r PvPni c/ : -PiooiL Ptan s P)c Vms cc p r 01,0 TPa
PLANNING &ZONING 5,�5-
Reviewed by: Date:
TREE ADMIN. econd Revi ❑Approved as revised. ['Denied.
PUBLIC WORKS Comments: N o c , Sep rn-k. P_e r i 4-- � c d nC
i J
PUBLIC UTILITIES Q
PUBLIC SAFETY Reviewed by: 1711 Date: / ?75
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
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