CE 363 ATLANTIC BLVD #22612 2015 RE #:/69 7,3e' —ODGh
CODE ENFORCEMENT LETTERS
Case # zaGA-z
Address of Violation:
Property Owner:
Phone#
Letter Addressed to: - j C)��
Action Taking: Letter of Violation Notice V Letter of COEB Notice:
Re-inspection Date:
Information needed in letter: ifs.
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CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
oil PHONE (904) 247-5855
March 23, 2012
CERTIFIED MAIL RETURN RECEIPT REQUESTED
Shoppes of Norshore LLC
P.O. Box 330108
Atlantic Beach, Florida 32233
RE: Notice of Violation—City of Atlantic Beach, Code of Ordinances - Signs
363 Atlantic Boulevard Unit 1, dba Poe's Tavern, Lots 7 to 18, Pt Lot 19, Atlantic Beach
RE#169730-0000
Case#22612
Dear Mr. Hionidies:
Please be advised, Atlantic Beach Code Enforcement has found your property referenced above
to be in violation of the City of Atlantic Beach, Code of Ordinances, Chapter 17, Signs, Permit
required and Calculation of permitted sign size to wit:
VIOLATION
CITY OFA TLANTIC CODE OF ORDINANCES
Section 17-61. —Permit Required
It shall be unlawful for any person to install, erect, place, alter or relocate any sign
without first obtaining a sign permit with payment of the required fee to the city. Sign permits
shall be required for any sign requiring a permit under Section 3108.0.3, Florida Building Code.
A sign permit shall not be issued prior to issuance of the appropriate business tax receipt as
required for the activity on the property for which the sign permit is sought, except as set forth in
section 17-299c) of this chapter. (Signage installed without proper permits as required)
This letter requests that application be submitted with to the City of Atlantic Beach,
Building Department with necessary documents required as outlined in the attached within
fifteen (15) days of the receipt of this notice and that full compliance be achieved by
obtaining a sign permit, paying the appropriate fees and removal of any signage that
exceeds the maximum allowed, if any, and call for an inspection to verify compliaice th
thirty (30) days of receipt of this notice.
Page 2
Poe's Sign Violation '
363 Atlantic Boulevard Unit 1
March 23,2012
A re-inspection will be done on or before April 25, 2012. To avoid having this case be referred
to the Code Enforcement Board, all listed violations on this notice must be in compliance on or
before the date established by Atlantic Beach Code Enforcement. The Board may impose fines
up to two hundred fifty ($250.00) per day for continuing violations. Upon completing the
corrective action(s) required, it is your responsibility to contact Atlantic Beach Code
Enforcement and arrange for an inspection to verify compliance.
It is our goal to enforce the codes and ordinances of the City of Atlantic Beach and protect the
health, safety and welfare of the City, and accordingly, your cooperation in this matter is greatly
appreciated. Please contact Atlantic Beach Code Enforcement at 904 247-5855 if you have any
questions or need additional information.
Sincerely,
Kathy Stiles
CODE ENFORCEMENT OFFICER
KS/dw
Attachment
Cc: Poe's Tavern—363 Atlantic Boulevard Unit 1 - Tenant
Municode Page 1 of 2
Sec. 17-61. - Permit required.
It shall be unlawful for any person to install, erect, place, alter or relocate any sign without first obtaining a sign
permit with payment of the required fee to the city. Sign permits shall be required for any sign requiring a permit
under the provisions of Section 3108.1.3, Florida Building Code. A sign permit shall not be issued prior to issuance of
the appropriate occupational license as required for the activity on the property for which the sign permit is sought,
except as set forth in section 17-29(c)of this chapter.
(Ord. No. 60-02-12. §2, 9-9-02)
Sec. 17-62. - Application.
Before a sign permit shall be issued, a design and stress diagram containing necessary information to enable
the building official to determine compliance with the provisions of Section 3108 of the Florida Building Code shall be
submitted. Such information shall be included as part of the sign permit application and shall be submitted to the City
of Atlantic Beach Building Department using a sign permit application as provided by the city. The application for sign
permit shall contain or have attached thereto the following information:
(1) The name, mailing address and telephone number of the applicant.
(2) If applicable, a copy of a valid and current occupational license for the property where the sign shall be
placed.
(3) In the case that the applicant is not the property owner, an owner's authorization to apply for a sign
permit.
(4) A survey depicting the location of the requested sign(s) and the location of all structures and access
points on the property. An elevation drawing,with dimensions, depicting the size, height, location and
relation to other existing signs. Plans shall be drawn at a legible scale, depicting materials to be used,
method of construction, attachment or installation as appropriate and type of illumination, if any.
(5) The name and contractor information of the person erecting or installing the sign.
(6) An electrical permit, if required.
(7) Registered engineer's drawings as may be required by Section 3108, Florida Building Code.
(8) Such additional information as may be required by the building official to determine compliance with this
chapter, any other applicable laws and ordinances of the City of Atlantic Beach and the requirements of
Section 3108, Florida Building Code.
(Ord. No. 60-02-12, §2, 9-9-02)
Sec. 17-63. - Calculation of permitted sign size.
Sign face area, sign display area, width of sign and height of sign shall be calculated as defined within article I
of this chapter. In the case of freestanding,fascia and projecting signs,the sign face area shall be used in calculating
the permitted size of sign. In the case of marquee, canopy or awning signs, the sign display area shall be used in
calculating the permitted size of the sign.
When computing sign face area and sign display area, only one (1) side of a sign containing two(2) sides shall
be included in the calculation of the permitted sign size.
(Ord. No. 60-02-12, §2, 9-9-02)
Sec. 17-64. - Fees.
Fees for the issuance of a sign permit shall be determined as follows. (Electrical permits and required fees
shall also be required for signs with electrical components.)
(1) Thirty-two(32) square feet or less of sign display area or sign face area, as appropriate: Thirty dollars
($30.00).
(2) Larger than thirty-two(32) square feet:An additional ten dollars($10.00)for each square foot
exceeding thirty-two (32) square feet of sign display area or sign face area, as appropriate.
(3) Freestanding signs constructed in accordance with the provisions of section 24-171(d), commercial
corridor development standards: Freestanding signs constructed of a solid material such as wood,
masonry or high-density urethane, and externally-illuminated in a manner that washes the sign in
indirect light from a fluorescent ground source shall be entitled to a fifty(50) percent reduction in sign
permit fees.
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http://library.municode.com/print.aspx?clientID=10377&HTMRequest=http%3a%2f%2fli... 3/22/2012
Stiles, Kathy
From: Hall, Erika
Sent: Thursday, March 22, 2012 9:53 AM
To: Stiles, Kathy
Cc: Griffin, Michael
Subject: Poe's Tavern ( sign permit requirements
Attachments: Poe's Tavern signs; FW: Poe's Tavern signs; Poe's Tavern signs/permits required
Kathy,
See attached emails for my previous correspondence with owners/managers of Poe's regarding signs.
For BUILDING SIGNS, including those painted directly on walls of buildings and bracket signs, the following
provisions apply:
Sec. 17-61. - Permit required.
It shall be unlawful for any person to install,erect, place, alter or relocate any sign without first obtaining a sign
permit with payment of the required fee to the city. Sign permits shall be required for any sign requiring a permit under the
provisions of Section 3108.1.3, Florida Building Code.A sign permit shall not be issued prior to issuance of the
appropriate occupational license as required for the activity on the property for which the sign permit is sought,except as
set forth in section 17-29(c)of this chapter.
/Ord Vn 60-02-12, §2 Q-9-n`t
Sec. 17-62. -Application.
Before a sign permit shall be issued, a design and stress diagram containing necessary information to enable the
building official to determine compliance with the provisions of Section 3108 of the Florida Building Code shall be
submitted. Such information shall be included as part of the sign permit application and shall be submitted to the City of
Atlantic Beach Building Department using a sign permit application as provided by the city.The application for sign permit
shall contain or have attached thereto the following information:
(1)
The name, mailing address and telephone number of the applicant.
(2)
If applicable, a copy of a valid and current occupational license for the property where the sign shall be
placed.
(3)
In the case that the applicant is not the property owner, an owner's authorization to apply for a sign
permit.
(4)
A survey depicting the location of the requested sign(s)and the location of all structures and access
points on the property.An elevation drawing,with dimensions, depicting the size, height, location and
relation to other existing signs. Plans shall be drawn at a legible scale,depicting materials to be used,
method of construction,attachment or installation as appropriate and type of illumination, if any.
(5)
The name and contractor information of the person erecting or installing the sign.
(6)
An electrical permit, if required.
(7)
Registered engineer's drawings as may be required by Section 3108, Florida Building Code.
1
Property Appraiser- Property Details Page 1 of 2
SHOPPES OF NORSH'ORE LLC Primary Site Address Official Record Book/Page nk
PO BOX 330108 363 ATLANTIC BLVD 2-14 14858-01983 9421
ATLANTIC BEACH, FL 32233 Atlantic Beach FL 32233
363 ATLANTIC BLVD
Property Detail Value Summa
RE# 169730-0000 _ _..__ _ 2011 Certified 2012 In_Progress
Tax District USD3 Value Method Income Income
Property Use 1692 SHDP CTR NBHD Total Building Value $0.00 $0.00
#of Buildings 3 Extra Feature Value $0.00 $0.00
Legal Desc 5-69 21-2S-29E 1.65 Land Value(Market) $1,796,131.00 $1,796,131.00
�._ --
ATLANTIC BEACH Land Value_(Aark:.) $0.00 $0.00
Subdivision 03101 ATLANTIC BEACH Just(Market)Value $3,192,400.00 $3,192,400.00
The sale of this property may result in higher property taxes.For more information go Assessed Value $3,192,400.00 $3,192,400.00
to Save Our Homes and our Property Tax Estimator.Property values,exemptions and Cap Diff/Portability Amt $0.00/$0.00 $0.00/$0.00
other information listed as'In Progress'are subject to change.These numbers are ------
part of the 2012 working tax roll and will not be certified until October.Learn how the Exemptions $0.00 See below
Property Appraiser's Office values Property. Taxable Value $3,192,400.00 j See below
Taxable Values and Exemptions-In Progress
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 SIRWMD/FIND Taxable Value School Taxable Value
No applicable exemptions No applicable exemptions No applicable exemptions
Sales History
Book/Page Sale Dade Sale Prim Deed IrrstrrrrrrentType-Code Qualified/Unqualified Vacant/Improvved
14858-01983 3/31/2009 $100.00WD-Warranty Deed Unqualified Improved
14831-01215 3/31/2009 $3,850,000.00 WD-Warranty Deed Qualified Improved
09344-01233 5/25/1999 $2,469,800.00 WD-Warranty Deed Qualified Improved
07708-01113 10/23/1993 $100.00 WD-Warranty Deed Unqualified Vacant
06935-00666 7/23/1990 $800,000.00 WD-Warranty Deed Qualified Vacant
03282-00578 10/19/1971 $13,400.00 MS-Miscellaneous Unqualified Improved
Extra Features
i LN Feature Code Feature Description Bldg. Length Width Total Units Value
1 PVAC1 Paving Asphalt 1 0 0 28,891.00 $15,774.00
2 FWDC1 j Fence Wood 1 0 0 21.00 $46.00
3 LPMCI i Light Pole Metal 1 0 0 3.00 I$913.00
4 LITC1 Lighting Fixtures 1 0 0 5.00 $850.00
5 FWDC1 f Fence Wood 2 0 0 67.00 $196.00
6 PVC0 I Paving Concrete 2 0 0 600.00 $619.00
7 PVACl #Paving Asphalt 3 0 0 9,154.00 $5,236.00
8 PVCci Paving Concrete 3 0 0 914.00 $943.00
9 LPMCI Light Pole Metal 3 0 0 1.00 $304.00
10 LITCl Lighting Fixtures 3 0 0 i 1.00 $170.00
11 WMCCI Wall Masonry/Concrt 3 0 0 1448.00 $1,027.00
Land&Legal
Land Leal
IN ,fode !Use Description - Zoning Front Depth Category Land Units Land Value -'1 LN Legal Description
1 1000 COMMERCIAL ACG 0.00 0.00 Common 71,874.00 $1,796,131.00 ( 1 5-69 21-2S-29E 1.65
2 ATLANTIC BEACH
3 LOTS 7 TO 18,PT LOT 19 RECD
4 O/R 14858-1893 BLK 1
Buildings
Building 1
Building 1 Site Address ;Element Code Detail
363 ATLANTIC BLVD
Atlantic Beach FL 32233 Exterior Wall 17 17 C.B.Stucco
Roofing Structure 4 4 Wood Truss
Roofing Cover 4 4 Built Up or T&G
Interior Wall 15 5 Drywall
http://apps.coj.net/pao_propertySearchBasic/Detaii-aspx?RE=1697300000 3/22/2012
Stiles, Kathy
From: Hall, Erika
Sent: Wednesday, November 30, 2011 3:56 PM
To: eevaul14@gmail.com
Cc: Griffin, Michael; Stiles, Kathy
Subject: Poe's Tavern signs
Importance: High
Hi Eric,
Michael Griffin, Building Official and Director of Code Enforcement asked that I contact you regarding the on the exterior of Poe's
Tavern. According to Mr. Griffin, no permits were issued for those signs, and he has asked that I relay sign standards specific to your
property so that you apply for a sign permit and ensure that your signs are in compliance.
• For fascia signs, or signs affixed to the side of buildings with single occupants,the size permitted is one(1)square foot of sign
face area per linear foot of building that faces the front of the lot, up to a maximum of sixty(60)square feet. The width of your
building facing the front of the lot(Atlantic Blvd) is 84',so your maximum sign area is 60 square feet. Where fascia signs
are placed on more than one side of the building, the combined sign face area cannot exceed this maximum.
• According to a photograph provided to me, I estimate the"Poe's Tavern" painted on the west side of the building to measure
approximately 15-9"x 3'-3",or 51.2 square feet.
• In reviewing your building permit file, I noticed two bracket signs shown on the elevations submitted during the remodel...one
measuring S-0"(w x 4'-6"(h),or 13.5 square feet, hanging from the eaves of the cupola;and, one measuring 2'-4"(w)x 3'-6"
(h),or 8.2 square feet, hanging from the eaves over the outdoor dining area. These signs too must be permitted, if they are
installed and are to remain. Please be aware that the total sign face area for these bracket signs also counts towards that
maximum sign face area stated above.
If you have questions regarding the permit process, you may contact the Building Department at 247-5826. Thank you very much for
your prompt attention to this matter.
Sincerely,
Erika Hall
Principal Planner
City of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233
(T)904.270.1605
(F)904.247.5845
ehall@coab.us
PLEASE NOTE: Florida has a very broad public records law. Your e-mail communications may be subject to public disclosure.
1
(8)
Such additional information as may be required by the building official to determine compliance with this
chapter, any other applicable laws and ordinances of the City of Atlantic Beach and the requirements of
Section 3108, Florida Building Code.
(Ord. No. 60-(u s
Sec. 17-63. -Calculation of permitted sign size.
Sign face area, sign display area,width of sign and height of sign shall be calculated as defined within article I of
this chapter. In the case of freestanding, fascia and projecting signs,the sign face area shall be used in calculating the
permitted size of sign. In the case of marquee, canopy or awning signs,the sign display area shall be used in calculating
the permitted size of the sign.
When computing sign face area and sign display area, only one (1)side of a sign containing two(2) sides shall
be included in the calculation of the permitted sign size.
Sec. 17-29. -Signs permitted within commercial and industrial zoning districts.
Subject to the provisions as set forth within this section,the following signs shall be permitted within commercial
professional office(CPO),commercial limited(CL),commercial general(CG), central business district(CBD), and
industrial, light and warehousing(ILW)zoning districts. Except as specifically exempted in ;.ection 17-26,and further
subject to issuance of a sign permit, no other signs or advertising device shall be displayed or erected within the city.
(a)
Fascia signs.
(1)
Fascia signs for buildings with a single business or occupant.
a.
Size permitted:One(1)square foot of sign face area for each linear foot of the
building width that faces the street frontage, provided that the total signage shall not
exceed two hundred(200)square feet of sign face area, including buildings on corner
lots. (For example, if the width of the building facing the front of the lot is fifty(50)feet,
the maximum total sign face area for all fascia signs is fifty(50)square feet.) If the
building is on a corner lot,then the widths of the building facades facing multiple street
frontages can be added together to determine the total signage area, but in no cases
shall the total fascia signage exceed two hundred (200)square feet, nor shall an
individual sign exceed the square footage corresponding to the linear width of the
building side on which that sign is posted. In no case, shall any individual sign as
described above, exceed one hundred (100) square feet in sign display area except
for buildings that face the front lot line, as defined in this Code, by a distance of more
than one hundred(100) linear feet,which may have an individual sign display area up
to a maximum of two hundred (200)square feet depending on the amount of building
frontage.
(2)
Number of fascia signs permitted:Not more than three (3)fascia signs shall be allowed on any
one(1)side of the building.Where fascia signs are placed upon more than one(1)side of the
building,the combined sign face area shall not exceed the amount permitted by subsection
(a)(1)a. above.
I(3)]
Fascia signs for buildings with multiple businesses or occupants.
a.
Size permitted:One(1) square foot of sign face area for each linear foot of the unit(s)
occupied by one(1)business or occupant, provided that the total signage shall not
exceed two hundred (200)square feet for any one(1) business. If the business or
2
occupant is on the corner,then the widths of the unit(s)occupied by the business or
occupant that are facing multiple street frontages can be added together to determine
the total signage area, but in no case shall the total signage for particular business or
occupant exceed two hundred(200)square feet, nor shall any individual sign exceed
the square footage corresponding to the linear building footage. (For example, if the
width of a unit or several units,occupied by one(1)business is twenty-four(24)feet,
then one(1)sign, a maximum of twenty-four(24)square feet of sign face area is
permitted.) In no case, shall any individual sign as described above, exceed one
hundred (100)square feet in sign area except for buildings that face the front lot line,
as defined in this Code, by a distance of more than one hundred(100)linear feet,
which may have an individual sign display area up to a maximum of two hundred
(200)square feet depending on the amount of building frontage.
b.
Required spacing between signs on buildings:Fascia signs shall be separated by a
minimum distance of seventy-two(72) inches.
(b)
Bracket or marquee signs. In lieu of the above described fascia signs, a business or permitted use may
install a single bracket sign or marquee sign in accordance with the following provisions:
(1)
Size permitted:The maximum size of a bracket sign or a marquee sign shall be determined in
the same manner as a fascia sign, provided that no such sign shall have more than sixty(60)
square feet of projected sign face area.
a.
There shall be no more than twelve(12) inches of clear space adjacent to the building
wall,and such signs shall not extend or project from the face of the building more than
ten (10)feet.
b.
No portion of such sign shall extend above the height of the roof.
C.
No portion of such sign shall be closer than eight(8)feet to any sidewalk or
pedestrian walkway, and no closer than five(5)feet from any street side property line.
All such signs shall be securely anchored to a wall and shall in no manner be
connected to or suspended from the roof of any building.
(2)
Within the central business district only. In addition to other permitted signs, uses limited only
to retail establishments, restaurants,cafes and coffee shops,may install a single bracket sign
extending above a public sidewalk or pedestrian walkway.The purpose of this provision is to
provide appropriate and consistent signage for the unique pedestrian environment of the town
center area. Such signs shall be located only in accordance with the following provisions and
upon issuance of a sign permit:
a.
May be located only above first floor entryways or first floor windows with no portion of
the sign display area exceeding ten (10)feet above the established grade of the
adjoining sidewalk or walkway;
b.
Shall provide minimum vertical clearance of eight(8)feet above the sidewalk or
walkway;
C.
Shall provide minimum clearance of six(6) inches from the building facade;
d.
Shall be separated from any other such sign by a minimum of twenty(20)feet;
e.
Shall not exceed three(3)feet in horizontal width and two(2)feet in vertical depth;
f.
3
ti -
Shall give the appearance of traditional wood routed or sandblasted signs. Materials
such as high density urethane(HDU) and recycled high density polyethylene (HDPE)
plastics, which give a similar appearance, shall be acceptable substitutes;
g.
Shall be externally illuminated only and shall contain no electrical components; and
h.
Shall create no safety hazard or obstruction to the public's use of the sidewalk or
walkway as determined by the director of public safety.
ErLkalffaW
PRINCIPAL PLANNER
City of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233
(T) 904.270.1605
(F) 904.247.5845
ehallkcoab.us
PLEASE NOTE: Florida has a very broad public records law. Your e-mail commun cations may be subject to public disclosure.
4
1
Stiles, Kath
Hall, Erika
From: Tuesday, March 27, 2012 3:50 PM
Sent: Stiles, Kathy
To: Griffin, Michael
Cc: Poe's signs
Subject:
Kathy,
Poe's has submitted for their sign permit(painted fascia signs).
most recent revision of sign code)up to 96 square feet of sign area—that is the
They are allowed(according to square feet,for a total of 98.32
width of the building on the
Atlantic Blvd side. The sign on the west measures 3'-3"x 17'-2", or 55.1
exceeding the allowed 96 square feet is within the 5%that
i an be
square feet,while the sign on the south fascia measures 2'-8 x 16'-2",or 43. q 1
q
square feet. The additional 2.32 square feet ex
'vel waived, and it is my recommendation to grant that administrative waiver;however,
administratively
Michael's authority to do so-
f V-&-al U MU/
o.frikalUMU/
PRINCIPAL PLANNER
City of Atlantic Beach
800 Seminole Road
Atlantic Beach,FL 32233
(T)904.270.1605
(F)904.247.5845
ehallnu coab.us
cry broad public records law. Your e-mail communications may be subject to public disclosure.
PLEASE NOTE: Florida has a v
1
Ci of Atlantic Beach
City APPLICATION NUMBER
�S r � Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 ( I
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: c /�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM _
6& '�A odefiwAl
Property Address: k`�fi ✓cl l Department eview required Yes No
Applicant: -P�e IA vi anning & oning
re® mitra or
Project: - G s Public Works
Public Utilities
Public Safety
Fire Services
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:
BUILDING
PLANNING & ZONING Reviewed by: Date:
TREE ADMIN. Second Review: A roved as revised.
❑ pp [—]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/90
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 f—f��----
Office (904) 247-5826 Fax (904) 247-5845i F0
15 J
!��( �� civ1AR 2 7 2012
Job Address: �so3 +� i� r Permit N �Lr:
Legal Description Parcel# JE3v-
Floor
rea of Sq.Ft.
Valuation of Work$ 21�pO' 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): Colntnercia E> Residential
If an existing structure,is a fire sprinkler system nista a irc a one): Yes No N/A
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed: f?u«fci4 s tJN s
tiTgGiot 0-6" c- V//< ��3rr (�� O p✓I GJPe�q C,�t2tr x z 0�0 It 1}) S.0A CtnY
Property Owner Information:
Name: Si,Ppel o f tj-'-sto✓cL LLC- Address: Po, 33 0ld10o
City an /c, State Zip 3 2 Z 13 Phone
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: Jo�'S `[�aJ C.Iti Qualifying Agent: �'° ',` 1� Lq-,L`4
Address: 3G 3 'G Vt- `" e- City Af a�✓fi�'�- �3 GL eh State _Zip 3 2Z 33
Office Phone 10 J-3. Zlv- --q 3 3 3 Job Site/Contact Number Fax#
State Certification/Registration 4
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 rf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six6)months at any time after
work is commenced. l understand that separate permits must be secured for E[ectricn Work, Plumbing,Signs, Wells, 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.
1 hereb certify that l have read and examined this a plication and know the same to be true and correct. A11 provisions of laws and ordinances governing this
type of work will be complied with whether speci red herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
g
Signature of Owner
Signature of Contractor
Print NamePrint Name i
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