167 MAGNOLIA ST - ALTERATION PERMIT !...t\i`J:-1--- .
r CITY OF ATLANTIC BEACH AL_
;, ;,,,w ■ 800 SEMINOLE ROAD
.,∎‘1.. r ATLANTIC BEACH, FL 32233
J to,
/ INSPECTION PHONE LINE 247-5826
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2401
Job Type: RESIDENTIAL ALTERATION
Description: north side of duplex only
Estimated Value: $25.000.00
Issue Date: 10/22/2015
Expiration Date: 4/19/2016
PROPERTY ADDRESS:
Address: 167 MAGNOLIA ST
RE Number: 170625-0500
PROPERTY OWNER:
Name: ATKINSON, W R
Address: 5666 WELAKA CT
GENERAL CONTRACTOR INFORMATION:
Name: CANTRELL CONSTRUCTION, INC
Address: 1015 ATLANTIC BLVD QA MARK FRANCIS CANTRELL
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $175.00
STATE DCA SURCHARGE $2.63
STATE DBPR SURCHARGE $2.63
Total Payments: $180.26
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
�S r Building Department (To be as d by the Building Department.)
td Road /
)
800 Seminole Roa , / , Q
iII
Yj;. .�� Atlantic Beach, Florida 32233-5445 '� )
Phone(904)247-5826 • Fax(904)247-5845
'on ,r E-mail: building-dept @coab.us Date routed: /Q rAC
City web-site: http://www.coab.us
APPLICATION REVIEW ANID TRACKING FORM
Hriii ,.C,41 of Zity/tx only
Property Address: 147 g n044., trr Department review required Yes No
Applicant: £lR•n7TC5 /I ()Q/' 7(, e4/UY1 Planning &Zoning
/ Tree Administrator
Project: 7'{� / d 9EilO ih F,QQ.C, Public Works
Public Utilities
V ms 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 S TATUS
Reviewing Department First Review: f'proved. ❑Denied.
(Circle one.) Comments: / " 0
:UILDIN
PLANNING &ZONING Reviewed by: /7 Date:10 '/9 J$
TREE ADMIN.
Second Review: ['Approved as revised. ❑ ied.
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 OFFICE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
1 .1 q N•un+
Job Address: .l.69'Magnolia St., Atlantic Beach FL 32233 Permit Number: /5' 'R/JO OW)/
Legal Description/ ' /Q 1, rat, i`b.3 at I ft:6rac&c dit Ic tic MAP Parcel# t 701;25 -D5 DO
Floor Area of Sc Ft. e'N�ai 4,0 c c re['ctXg't P 1a+locec top )(Da'hh e--
Valuation of Work $25,000 Proposed Work heated/cooled 600 non-heated/cooled� �
Pb 1uMY �L.
in o
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa ww oor
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 form
Describe in detail the type of work to be performed: t�T�;�rD o ''1- , t-1vvAricNi
Property Owner Information:
Name: Terrie S. Parrish Address:_ PO Box 182
City Summerfield State NC Zip 27358 Phone_J336)706-0423
E-Mail or Fax#(Optional) terrie_parrish @vfc.com or terrie.parrish @aol.com
Contractor Information:
Company Name: C 6'a- eDIUSTIZ vG?tea Qualifying Agent:
Address: IO LS' $14-14....1. ?4 r F's,ti-e 0409 City a. N..lie. DG4C if State F( Zip 3'2,2.3)
Office Phone loos-"PO.4 Job Site/Contact Number Me't'R-� Ct kER•Ix#
State Certification/Registration# !�/ ( C� C dG L5 •
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 ofo remit and that all work will he performed to'meet the standards()fall laws resmlat■'i consh7rctiOn i"this jur'sdic!i^n. This permit he"or,ea mill
and void if work is not commenced within six(6j months, or if construction or work is sus ended 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 ElectricalpWork, Plumbing,Signs, Neils, 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 hereby certify that I have read and examined this.application 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
provisions of any other fe al,state, or local law regulating construct'on or the peufornatce of construction.
Signature of Owner_ £�,(E CS: az. Signature of Contractor
•
Print Name Print Nam• A' R'K C N . �-
Sworn to and subscribed before me Swo •. and sub ribed • • - e
this '7 Day of OCbbe r ,20 15 ti:e Da /i�tt - ." 20/15".
ir
Notary Public Notary Pu• is
'tie, Notary Public State of Florida
Shirley L Graham
g� My Commission FF 086990