146 W 14TH ST - RESIDENTIAL ALTERATION . yv
/
' �s
�l CITY OF ATLANTIC BEACH
EACH
J — 800 SEMINO LE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
_J;3)9r
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2666
Job Type: RESIDENTIAL ALTERATION
Description: drywall/siding
Estimated Value: $2,000.00
Issue Date: 11/19/2015
0 Expiration Date: 5/17/2016
PROPERTY ADDRESS:
I Address: 146 W 14TH ST
RE Number: 171064-0050
PROPERTY OWNER:
Name: BENNETT, THOMAS JR
Address: 385 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: JWB CONSTRUCTION GROUP LLC
Address: 7563 Phillips HWY # 109
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $30.00
BUILDING PERMIT FEE $60.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
• 1.An;.•, City of Atlantic Beach
r .�.. APPLICATION NUMBER Building Department (To be assigned by the Building Department.)
800 Seminole Road
�► s� Atlantic Beach, Florida 32233-5445 h5 .-•,-//.9,- 2664,
Phone (904)247-5826 • Fax(904)247-5845
'.011 p E-mail: building-dept @coab.us Date routed: // • /2 -/5
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /`Y 4 W /977i' .'7- Department review required Yes o
uildin
Applicant: J td / �Q Planning &Zoning
Tree Administrator
Project: r Iv /9 1� — / //✓9 Public Works
/ / Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt
Other Agency Review or Permit Required p
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:
UILDIN
PLANNING &ZONING Reviewed b : yy�
y / / Date://v3./ S
TREE ADMIN. Second Review: ❑Approved as revised. L. !led.
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
BUILDING PERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach,FL 32233
Office(904) 247-5826 Fax(904) 247-5845 /S -, Me-26C6
th Permi Number:
Job Address: /H�' l,(1 I� �� 0 1st
C f� A+lay ►C act- LU� ( A Ll) Parcel# l- &Lt -t-osc%
Legal Description a t Sq.Ft
Floor�rea of Sq.Ft. � non-heated/cooled �
Valuation of Work$ Proposed Work heated/cooled
�O00 . d0
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
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 nn
Describe in detail the type of work to be performed:I� (6%i /(' (tLt dt/t(W OLA Cr 31a;hQ
Property Owner Information:,
Name:, ?; L l-Cd Address: S(93 Tt NM &,u . 4f 01
City 3: O f
State L Zip 5a]� Phone CIO tl- (, 4-T— 1-
E-Mail or Fax#(Optional) $55t u1 N1.p(.uA∎Q.S .C.Orn
Contractor Information:
Company Name: YLC ('I4nS U..L o(t (M)U Qualifying Agent: -. A
Address: '7'56A Q1,OU ' 4}j) ' &&..x f 0 q City J SMAu it Q State (^-L Zip 2:: cca
Office Phone 4;4'4'1' Job Site/Contact NumberB (IN-PM-OD-TO Fax#
State Certification/Registration# C&1. I' fl d
Architect Name&Phone# N l
Engineer's Name&Phone# A//Pt
Fee Simple Title Holder Name and Address A) ON
Bonding Company Name and Address AI%P
Mortgage Lender Name and Address Al/A
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be ormed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six 6)�months,or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, Furnaces, Boilers,Heaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU nDNL'VRF.InRFTR CORDING YOUR NOTICE F WITH
BUILDING PERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax (904) 247-5845 /5' -giMP-2J/
th Permit,Number:
Job Address: Mb- (.() 1u S� 0 2 1I-
e- fl A+Icwi ,e R ct� 1-0-1- 1-,A Uk., Parcel# i 3-l- C2 4 -cow,
Legal Description t door Area of Sq.Ft. 1�, Sq Ft
Valuation of Work$ Proposed Work heated/cooled by non-heated/cooled 0
x000 . d0
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
installed?an existing structure,is a fire sprinkler system nstalled? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form I
Describe in detail the type of work to be performed:TO V /00(1U £A,V 4 UJ C cr 3‘,cciv,5
Property Owner Information: c ff
Name:,,'�(U LLC Address: S(a3 Q1)..at.i_Oi 04.3 `lt.�i-t-,e it loci
City 3;uJ�Asor u, State Zip 5a) (,Phone 4f01i- (y T- Co }q'4
E-Mail or Fax#(Optional) $Ste& 1 u '?-S Qorn
Contractor Information:
Company Name: Yh.1Q 01)&5 b L-lC Q( (1\(O ) Qualifying Agent: . ' 1L __ A
Address: CA P i(•O ' tits Su— ( MCI City J Sn 4'i A t State e-L Zip - D?S'1,0
Office Phone Lfl$ -(.. -1.1-'4"1- Job Site/Contact Number e xd✓ qUN-D341--0D73 Fax#
State Certification/Registration# (&1. lc-n S-S
Architect Name&Phone# A)OA
Engineer's Name&Phone# A//Pc
Fee Simple Title Holder Name and Address /U I
Bonding Company Name and Address Al%l\
Mortgage Lender Name and Address NIA
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
ork is commenced.ot I commenced
nderstand that separate permits or must construction
e secured for Electrical- Plumbing Signs,a Wells, Pools, Furnaces, Boilers,Heaters,
any
time
Hea ers,
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
I hereby certify that I have rea' rid 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 comp ' d whether speci red herein or not. Ti e granting of a permit does not pres o give a h,ri to violate or cancel the
provisions of any other fe era!, ,t: , a atla regulating construction or the performance of construction. /ature of Contractor fd!1!!I `�_
Signature of Owner _./ ) i . / Sign r ► /
pr,,,/ / 1 /*' S/t4,, VP Print Name !'S 'x._ al.S...h i
Print Name !1'x'1 '� /L..................
Sworn to and subscribed before me Sworn to and subsc, ed before me '2d,�
this i •"ti- Day of NV '(V�-''( ,201`17 this ) Day of 1OJ V
Nota blic j-'r otary Pu• is -
Revised 01.26.10
rto es ♦ -I♦ *'
.*,,, ICASANDRAJOYNER +:."' KASANDRAJOYNER
l.. ,., .% MY COMMISSION t FF 22900.5 '!:F I ;: MY COMMISSION i FF 229035
vl _ EXPIRES:July 4,2019 ' . = EXPIRES:July 4,2019
+� Bonded iTiN tbiMY P1�6tC Unduwitr�s f s4 BaMed T RES: my 4,2019