4000 FLEET LANDING UNIT 4211 - RES. ALTER / SHOWER r i ,,
. ?_,,?S, CITY OF ATLANTIC BEACH
t 800 SEMINOLE ROAD
_, ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
. J,,19`"
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2489
Job Type: RESIDENTIAL ALTERATION
Description: SHOWER/SHOWER UNIT 4211
Estimated Value: $5,500.00
Issue Date: 10/29/2015
Expiration Date: 4/26/2016
PROPERTY ADDRESS:
Address: 4000 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name: NCCRF
Address: JASON PAUL HOLDER JASON PAUL HOLDER
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $38.75
BUILDING PERMIT FEE $77.50
Total Payments: $116.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OFFICE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office(904) 247-5826 Fax(904) 247-5845
Job Address: i 0 1 I H pnr�in ,BIvL Permit Number: /5 -,?194e-. 79S`i
Legal Description Parcel #
,. Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 3, � Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteratio Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial
is If an existing strucure,s a fire sprinkler system installed? (Circle one): . 411 No N/A
Florida Product Approval#
For multiple products use product approva orni
Describe in detail the type of work to be performed: 2 `. ', • a '1'' I. + ' r OA
Property Owner Information:
Name:NCCRF dba Fleet Landing Address: 1 Fleet Landing Blvd
City Atlantic Beach State FL_Zip 32233 Phone 904-246-9900 xt 431
E-Mail or Fax#(Optional)jholder @fleetlanding.com
Contractor Information:
Company Name:NCCRF dba Fleet Landing Qualifying Agent: Jason Holder
Address:1 Fleet Landing Blvd City Atlantic Beach State FL Zip 32233
Office Phone 904-246-9900 xt 431 Job Site/Contact Number 904-219-4002 Fax#
State Certification/Registration#CBC 1254586
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 if work is not commenced within six(61 months,or if construction or work is suspended or abandoned for a_period of six L6)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.
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 certify that I have read and examined this a plication and know the sane 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 federal,state,or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Jason Holder Print Name Jason Holder
Sworn,to and subscr' ed efore me �✓ Sworn to and subset' ed before me
this )41 Day of , 201,? this 1% Day of 20
____kAlSO4 -
Notary Public Notuv Public
;ao SHARI R QUEST ?� •ct, SHARI R QUWiTisec.01.26.10
MY COMMISSION#FF068247 ).) MY COMMISSION #FF068247
?..„.... EXPIRES November 4.2017 '•.?o,�r; EXPIRES November 4.2017
(407)398.0153 FloridaNetaryService.corn (407)398.0153 FloridallotaryService.com
rs,:1,�j City of Atlantic Beach APPLICATION NUMBER
Js.,W6., Building Department (To be assigned by the Building Department.)
-. - sI 800 Seminole Road /� _ /�/i9€- 2,/p.—
�' Atlantic Beach, Florida 32233 5445 `y 0 g
Phone(904)247-5826 - Fax(904) 247-5845 %n
-0J 9P. E-mail: building-dept @coab.us Date routed: 1 to �.
City web-site: http://www.coab.us
APPLICATION REVIEW A 1 e A KING FORM
211
r - • - + ent review required Yes No
Property Address: / / I. I/I/ :■ At 0 �.•.— q
4/8 (// Building
Applicant: • a ning &Zoning
( LI Tree Administrator
Project: .SLIWiL J'JT-OG 4,4 Public Works ___
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature •
Other Agency Review or Permit Required Review or Receipt Date
of P ermit Verified By
Florida Dept. of Environmental Protection_ r
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: V
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments: it)
1111. 7D )
PLANNING &ZONING
Reviewed by: !2 ' Date: /0'r ''/S
TREE ADMIN. Second Review: ❑Approved as revised. ❑De 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