1633 BEACH AVE - ALTERATION r r,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
X ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
J�JJnifJ
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2373
Job Type: RESIDENTIAL ALTERATION
Description: remodel - to close out permit
Estimated Value: $100.00
Issue Date: 10/20/2015
Expiration Date: 4/17/2016
PROPERTY ADDRESS:
Address: 1633 BEACH AVE
RE Number: 169651-0000
PROPERTY OWNER:
Name: FARR, JAY AND MARY, *
Address: 1633 BEACH AVE
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $55.00
Total Payments: $59.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
rs�r'>>v%,_. City of Atlantic Beach
APPLICATION NUMBER
`~' � Building Department
(To be assi ned by the Building Department.)
Atlantic tic Seminole Road
51-069/1E g 373
�� Atlantic Beach, Florida 32233-5445
r c , � Phone(904)247-5826 • Fax(904)247-5845 /
�,;t19/ E-mail: building-dept @coab.us Date routed: / d
City web-site: http://www.coab.us
! �/
P
APPLICATION REVIEW AND TRACKING FORM
Property Address: 433 „egiteA /1j/e Department review required Yes No
uilding_.)
Applicant: 6 4t./ 7744 anning &Zoning
Tree Administrator
Project: cl o.`7 E oit-7 p Gl'/x C Public Works
Public Utilities
i/ di L Public Safety
,` Fire Services
Review fee $ Dept Signature _
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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
-Vr-Reviewing Department First Review: roved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING ,/y�
Reviewed by: / 1 ' Date: /O'/O•/$r
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
PUBLIC WORKS 1 Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH n! r•
800 Seminole Road,Atlantic Beach, FL 32233 1b i..,,;,,•; lauri
Office (904)247-5826 Fax (904)247-5845
Job Address: I 6 ; ca.)--\ ,
Legal Description
Permit Number: 5
Parcel#
Valuation of Work$ oor • ea o q. t
Proposed Work heated/cooled t
non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pools a wind '-
Use of existing/pro osed structure(s)(circle one): p ow/door
If an existing structure,is a fire sprinkler system installed? (Circle one):Residential
allo
Florida Product Approval# N/A
For multiple products use pro uct approva orm
Describe in detail the type of work to be performed:
Property Owner Information
Name: 5 C f/
City �I' V Address: ( y Z'� BQc4
E-Mail or Fax#(Optional) ti tat _Zip Phone �, 3—1 S S7
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name:
Address: Qualifying Agent:
Office Phone City e
State Certification/Registration# Job Site/Contact Number . - Zi'
Architect Name&Phone#
IiIINIMMAIMMIER
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address -� IP ' -Adimprm
Bonding Company Name and Address
Mortgage Lender Name and Address %lll�����
Application is hereby made to obtain a permit to do the work and inst• ations as indicated. I certifil that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet the •ndards 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-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
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCIG CONSOULT WIT!!
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF H
COMMENCEMENT.
I hereby cert jj that I have read and examined this a plication • • he •me to be true and correct. All provisions of laws and ordinances governing this
type of work will be comp!':. with whether specified herein o
provisions of any other fede • state,o ocal taw regulating co • anting
performance of a nce o permit does not presume to give authority to violate or cancel the
� 8 r e performance ofconstruction.
signature of Owner • x F(2-i;
Signature of Contractor
Tint Name ° "
�a If 03r v
„3,r c Print Name
3e3efo � e 'o fl,
ay o N T iv s Before me
16.
— 20 r _ a this Day of. II-- 6 20
lotary Pub — —
Notary Public
Revised 01.26.10