312 4th ST - INTERIOR REMODEL PERMIT rJ,
S CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J �" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�
RESIDENTIAL ADDITION
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RADD-2521
Job Type: RESIDENTIAL ADDITION
Description: INTERIOR REMODEL
Estimated Value: $50,000.00
Issue Date: 11/16/2015
Expiration Date: 5/14/2016
PROPERTY ADDRESS:
Address: 312 4TH ST
RE Number: 169812-0000
PROPERTY OWNER:
Name: HOLLOWAY ET AL, MARGARET M
Address: 1200 OCEANFRONT
I GENERAL CONTRACTOR INFORMATION:
Name: TURNKEY CONSTRUCTION RUBEN LAVARIAS
Address: 5991 Chester AVE STE 105
Phone: - -
PERMIT INFORMATION: PUBLIC WORKS:
A Right-of-Way Permit must be obtained for use of(construction parking, if required).
All concrete driveway aprons must be 5" thick, 4000 psi, with fibermesh from the edge of
pavement to the property line. Reinforcing rods or mesh area not allowed in the right-of-way.
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 and silt fence must fully enclose work area.
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.
IEEE&IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
BUILDING PERMIT FEE $300.00
STATE DCA SURCHARGE $4.50
ENG REV RESIDENTIAL BLD $100.00
PLAN CHECK FEES $150.00
UTIL REV RESIDENTIAL BLDG $50.00
STATE DBPR SURCHARGE $4.50
Total Payments: $609.00
PERMIT IS APPROVED ONLY.N ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH •
800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845 1 5_R
OD -zsz
Job Address: 1__ -II.` S-1-{. . oinot 10 It.,
S}rWH Permit Number:
Legal Description 5 6 9 i 1 _ as _a9 E 4 N %c.
Valuation of Work$ oor A ea o q. t
IOC AcHparcel#tor' 5 g(�j
Proposed Wqrk heated/cooled t
S-Q 1700 71L �6 no.n-heated/cooled
Class of Work(circle one): New f _A ddition Alteration Repair Move Demolition ool/s a wi
Use of existing/proposed structure(s)(circle one): Commercial •esidenti. p p ndow/door
If an existing structure,is a fire sprinCder system installed?(Circle one): 'es No
Florida Product Approval# FL 17 4-°t¢. . 4130
For multiple products use product apps f orb r— /?qtr.
It �Q�/1/(� �'7�l
Describe in detail the type of work to be performed: N 0
V+4it0N
Pro a Owner Information:
Name: J LL, 12.6 G-AN T Address: 310 71.
City At I,o.n -cc. �.eq StatelaZip 3'LZ 3 Phone %-f-Y-42..-12.,t
E-Mail or Fax#(Optional) —'
•
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: I ug_ nett s0 Q,o .10, 't i i
Address:S 9 I C4#t+.s-r a Avg , S1K So C City J mg Agent: 12v 3�= nl L�AV to
Office Phone - C)00 ,'0 69 Job Site/Contact Numbers -- cam& ii State C.
State Certification/Registration# 4 0 g -
-�4y- -�- _Fax# �--Zip 22.t 2
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address -���/ 7' a . ..1 _I b
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certj 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(6)months, or if construction or work is suspended or abandoned for a period of six 6)months at any time aver
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 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 certiA,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
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 ca ncel the
7rovisions of any other federal,state, or local law regulating construction or the performance of construction.
_ .24.i.....e_______,
signature of Owne ,.,,c�—
Signature of Contractor
'rint Name ii L/,- /Z,64, 7. Print Name 120 6 G (..•p if A-e_t,q 5
lefore me
zis 93 Day of_O____c �i, i 20 /S- Before me
•
this 21_Day of dvE .Q,,,- ,20 IC
Ark....: __till*.
Iota' Public ZANO - �rry ..'.
MY COMMISSION i FFI09596 t�'" ,.cmpi .-IC
a EXPIRES:April 03,2018 JtJj,l ZANO
MY COMMISSION 8 FFI09S96
EXPIRES:April 03,2018 Revised 01.26.10
,;0....A n; y. City of Atlantic Beach 4 '
Building Department + � APPLICATION NUMBER
�',- -- "" .[.' (To be assigned by the Building Department.)
' r 800 Seminole Road ' 4�
s Atlantic Beach, Florida 32233-5445 1 C
s' Phone(904)247-5826 • Fax(904)'247-5845 2� -vo ,. ` R l�fl� I_ �``,
f'4011)9%.- E-mail: building-dept @coab.us / Date routed: 1 O
City web-site: http://www.coab.us ,13
APPLICATION REVIEW AND TRACKING I
jc± U h %�
/,-K_ _ C_nc( A rove d
Property Address: 1 Z `-A- S ( , /B`e�partt nt revie
�,� Building—) t s RADA - Is (4-
Applicant: 1. UR-I t.l 51 C oNDSIK 001 p Planning &Zoning e�
y Tree Admrnistrafor Qs, r\ COLA.
Project: 1 1\ i Et2J.O R. Cam 0 Q E L Iic worl
Public Utilities)
IC) D ict_g_ E or. 0 CT/ 0 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 Mana _
Army Corps of •
Division of Hotel
Division of Alcoh
Other: _—I
°I _ _ _
Reviewing Department First Re
(Circle one.) Commer, Q
BUILDING ) \ \
PLANNING &ZONING 047/-5--
Date: /TREE ADMIN. Second Revs
7n ienied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ❑Denied.
Comments:
_— — Reviewed by: — !-- Date:
Revised 07/27/10
0!..:1 J, City of Atlantic Beach
�S «; Building Department APPLICATION NUMBER
'r 800 Seminole Road (To be assigned by the Building Department.)
j- : Atlantic Beach, Florida 32233-5445
15- R"�O - 25Z (
Phone(904)247-5826 • Fax(904)247-5845 /15
1 0r E-mail: building-dept coabus Date routed: \O/Z3
City web-site: http://www.coab.us
i
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 1 Z `—tv S(, - • • ' -nt review re
flquired Yep, No
Builditla__)
Applicant: i. ui2NK 0 OSTRQCTto- 4 Planning &Zoning
Tree As u 1 tra or
Project: 1 NY7"CfZl.OR. GM OD L �_ - .. „
�� 4 'Ublir•. 1 I+ir+icon
• • Public Safety _
FirP '• vices
Review fee $ Dept
eS �J QAA,
Other Agency Review or Permit RE �� Q l
p`\ ,1� Date
Florida Dept.of Environmental Protection Q
Florida Dept.of Transportation C)•�
St.Johns River Water Management District ��%_ t"`
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: L`�Approved.
❑Denied.
(Circle one.) Comments: D c
BUILDING
PLANNING &ZONING
Reviewed by: Date: //`/G) 15:—
TREE ADMIN. —.
Second Review: DApproved as revised. DDe led.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: DApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
;i A; ,;, City of Atlantic Beach
6' ;, Building Department APPLICATION NUMBER
" 800 Seminole Road (To be assigned by the Building Department.)
; � 1 11 Atlantic Beach, Florida 32233-5445 1 5— '\A ICD — 252
Phone(904)247 5826 • Fax(904)247-5845
1
\J;tl9%• E-mail: building-dept @coab.us
City web-site: http://www.coab.us Date routed: I
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 Z� 4 — S(.
E. -
--••r�■�::.-nt review re. No
,_ — uired Yes
IN Buil...
Applicant: [ uR.IVK,C-/ C Cj TK00.10 4 Planning &Zonin7IIIIIIIII -
Tree A.0 I raor ==
Project: 1 NYI C2!-0(2 C,rn OD e
L �_ublic Wor =-
pi-g-t}CE' II Q i-Ft 0 Public Safety —
Fire
Fire Services i=
Review fee $ Dept Signature J ObS 0bmj
Other Agency Review or Permit Required Review or l� n� ro�
of Permit V 6 S -R�'�V� - 15
Florida Dept. of Environmental Protection (A.)
Florida Dept.of Transportation w _
St.Johns River Water Management District � f�r0. ,l
•
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
I
Other:
APPLICATION STATUS
Reviewing Department First Review: "pproved.
(Circle one.) Comments:
❑Denied.
BUILDING
PLANNING & ZONING
Reviewed by;4‘_„....,., ��Date: 6/
TREE ADMIN.
Second Review: []Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
-t ,v; . City of Atlantic Beach
"� / '‘-k.... L�� APPLICATION NUMBER
ri' , '' Building Department / C ITh (To be assigned by the Building Department.)
r " • = ^ � 800 Seminole Road
u v Atlantic Beach, Florida 32233-5445/ T 6 ZQ 15- (a0,0 .- 25 2
Phone(904)247-5826 • Fax(904) 45 �S
o;t >-- E-mail: building-dept @coab.us � Date routed: \O/C /1.5 City web-site: http://www.coab.us , �
APPLICATION REVIEW AND TRACKING FORM
Property Address: \2` -t S ( . e - . . -- -nt review required Yes No
ff 0Bil• ,.
Applicant: 6 DR..fuk�� C 0K)STK .ACT O, 11 Planning &Zoning
1 Tree A •••• tra or
Project: 1 N. (:EQI.O R Cam o 0 6 L C=ublic Wor
'uTcU if'--gyp GA-k_ E C(Ti
0 Public Safety
Fire Services
•
Review fee $ 2 ( Dept Signature 5<---...,,--
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:
APPLICA ION STATUS
Reviewing Department First Review: pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: —Date: 1 404 Or//r
TREE ADMIN. Second Review:
❑Approved as revised. ❑Denied.
joy. WOR,S C.mments:
�j/ ice i.
+' B ICS TILITIES
or
PU:L C SAF Y Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
1
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