800 STOCKS - PAVERS �SJ
, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
s",:“ ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2459
Job Type: RESIDENTIAL ALTERATION
Description: PAVERS
Estimated Value: $1,200.00
Issue Date: 10/22/2015
Expiration Date: 4/19/2016
PROPERTY ADDRESS:
Address: 800 STOCKS ST
RE Number: 170945-0010
PROPERTY OWNER:
Name: Hernandez, Rufino
Address:
PERMIT INFORMATION: PUBLIC WORKS:
Full erosion control measures must be installed and approved prior to beginning any earth
disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control
Inspection prior to start of construction.
All silt must remain on-site during construction.
Roll off Container Company must be on City approved list and container cannot be placed on
City Right-of-Way. (Approved: Advanced Disposal, Realco, Republic Services, Shappel's and
Waste Pro.)
Full right-of-way restoration, including sod, is required.
FEES:
PLAN CHECK FEES $28.00
BUILDING PERMIT FEE $56.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Y��r\J I-/_
'" / CITY OF ATLANTIC BEACH
ti s 1-- 800 SEMINOLE ROAD
u ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
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Total Payments: $84.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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PAVING AND DRAWACE PLAN
I
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845
Job Address: 60
'i--, Permit Number:
Legal Description Parcel#
Valuation of Work$
A .'_0 3 drop ed Work he ted/cooled t
non-heated/cooled
Class of Work(circle one): New Additi Alteratio Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)(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 approva orm
r'�Describe in detail the type of work to be performed: ow c' �S '__E)2____xl a
Property Owner Information:
Name: & • si f • , & & ' Address: a 0 r S
City ita ,a '=�aMi.4� k State Zip nom,, • '� •
E-Mail or ax#(Optional) p = hone L1 r.� .i'j`:l�
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Qualifying Agent:
Address: City State
Office Phone Job Site/Contact Number Zip
State Certification/Registration# Fax#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
issuances f a is and that allbwork will be permit med to meet and installations of alindicated.law gulating that no in this jurisdiction.This permit be omes 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 'York,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
f
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.
thereby cert&that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
,
ype o 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
7rovisions of any other federal,state, or local law regulating construction or the performance of construction.
i
gnature of Owner Signature of Contractor u.11/'rint Name [ 1 ( --1-A t( yi CA a Z Print Name
6efo e me Before me
its ;t Day of e , & ( V-
r ,+�'"" this Day of
411 IN
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■, TONI GINDLESPERGER 20
ot, ,_ "4,` ,,'':.,- COMMISSION 4 FF 924951
ub is �� SS � ,, fXpIRES:�Tc obOr s,2m9
Notary Public
ai"...: Aided Tin NotNy Pubic UndenwiteR ry
Revised 01.26.10
rsyu‘) City of Atlantic Beach APPLICATION NUMBER
jt # n Building Department FECJI (To be assigned by the Building Department.)
800 Seminole Road L° 1V E+ \ [�
'��� Atlantic Beach, Florida 32233-5445 OCT �, 1 J -R NRR - 7 S-/
Phone(904)247-5826 • Fax(904) '47-5845 9 X 015 1
\..P 1,01t 0. E-mail: building-dept @coab.us BY, i Date routed: 1 O i Co/(
City web-site: http://www.coab.us / 5
APPLICATION REVIEW AND TRACKING FORM
Property Address: 8OO 7pCl J( • Department review required Yes No
RUE-110o I GwP)E2 Building
Applicant: l-4 EfZiVA/vQEz — Planning &Zoning
(�
Tree Administrator
Project: PR VETS -- P f c 1 O __
�auirrc,�vLnr�
Public Safety
Fire Services
Review fee $ Dept Signature fi. ..•�...,_
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: pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING /
Reviewed by: pate: la/ ��
TREE ADMIN. Second Review: A roved as revised. ((((
❑ pp ❑Denied.
''✓'C WORKS Comments:
ar fr at*
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
r,,, City of Atlantic Beach
.`.\ Building Department APPLICATION NUMBER
'� 800 Seminole Road 117-L.,,,
(To be assigned by the Building Department.)
Atlantic Beach, Florida 32233-5445 Oct i 1 c� -R I�t4l� - 7456)
Phone(904)247-5826 • Fax(904)L. 845 1 g 1 I
`dos g�• E-mail: building-dept @coab.us �' _ ��� /
Date routed: I d/I Co( I S
City web-site: http://www.coab.us �- t
APPLICATION REVIEW AND . ACKING FORM
Property Address: BOO S f oav, Department review required Yes No
� Gc.0iivGZ Building
Applicant: 1\UE/Np I-It E2N3Rn�pEz ` Planning & Zoning
Tree Administrator
Project: PrA V ep_.5 .r_ p p, cr c) ,,. .
• Urniire __ ,
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: rXpproved. ❑Denied.
(Circle one.) Comments: fee 1,&41,d (Off/Ha
BUILDING
PLANNING &ZONING defy�Reviewed by:
Date: 16&4\—IS-
TREE ADMIN. 410 ,
Second Review: ❑Approved as revised. Denied.
BLIC 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
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