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189, 193, 197, & 201 OCEAN GATE DR - SINGLE FAMILY ATTACHED (SFAT) PERMIT �' ; ''-,- °S, CITY OF ATLANTIC BEACH s- 800 SEMINOLE ROAD � �mil\ _ _ '.� � J `-v ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 SINGLE FAMILY ATTACHED MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-SFAT-2539 Job Type: SINGLE FAMILY ATTACHED DWELLING Description: SFAT Estimated Value: $130,000.00 Issue Date: 11/18/2015 Expiration Date: 5/16/2016 PROPERTY ADDRESS: Address: 197 OCEAN GATE DR RE Number: None GENERAL CONTRACTOR INFORMATION: Name: 201 MAYPORT CONSTRUCTION MANAGEMENT Address: 2768 STATE RD A1A #701 Phone: 904-334-1202 PERMIT INFORMATION: FEES: ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $285.00 UTIL REV RESIDENTIAL BLDG $50.00 BUILDING PERMIT FEE $570.00 STATE DCA SURCHARGE $8.55 STATE DBPR SURCHARGE $8.55 WATER CONNECT/TAP & METER $185.00 W k 'ii k8:1CONN5t tip,FDANCE I OLL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA 13l 1, t`( Ul`..(. -Sr�Jyj ,_ ,s, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 .,� INSPECTION PHONE LINE 247-5814 Total Payments: $1,257.10 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. -S r��`�. � , CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD f 'r ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 SINGLE FAMILY ATTACHED MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-SFAT-2538 Job Type: SINGLE FAMILY ATTACHED DWELLING Description: SFAT Estimated Value: $130.000.00 Issue Date: 11/18/2015 Expiration Date: 5/16/2016 PROPERTY ADDRESS: Address: 193 OCEAN GATE RE Number: None GENERAL CONTRACTOR INFORMATION: Name: 201 MAYPORT CONSTRUCTION MANAGEMENT Address: 2768 STATE RD Al A #701 Phone: 904-334-1202 PERMIT INFORMATION: FEES: ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $285.00 UTIL REV RESIDENTIAL BLDG $50.00 BUILDING PERMIT FEE $570.00 STATE DCA SURCHARGE $8.55 STATE DBPR SURCHARGE $8.55 WATER CONNECT/TAP & METER $185.00 1 r Ag�ti�(� ,tollly Eci�NitDANCE$50 60.1.I. CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA l 1.1 (. )U4..'. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD • ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 ��S31�r Total Payments: $1,257.10 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. �5, CITY OF ATLANTIC BEACH : H C J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �JJil9f' SINGLE FAMILY ATTACHED MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-SFAT-2540 Job Type: SINGLE FAMILY ATTACHED DWELLING Description: SFAT Estimated Value: $130.000.00 Issue Date: 11/18/2015 Expiration Date: 5/16/2016 PROPERTY ADDRESS: Address: 201 OCEAN GATE DR RE Number: None GENERAL CONTRACTOR INFORMATION: Name: 201 MAYPORT CONSTRUCTION MANAGEMENT Address: 2768 STATE RD A1A#701 Phone: 904-334-1202 PERMIT INFORMATION: FEES: ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $285.00 UTIL REV RESIDENTIAL BLDG $50.00 BUILDING PERMIT FEE $570.00 STATE DCA SURCHARGE $8.55 STATE DBPR SURCHARGE $8.55 WATER CONNECT/TAP & METER $185.00 'MITER MOSSicatiNecTioNDANcE rypooLL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r\J9 f' ; 4' ''�� CITY OF ATLANTIC BEACH " s, .4k'' 800 SEMINOLE ROAD j ji X ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Total Payments: $1,257.10 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r .. ,-' `S, CITY OF ATLANTIC BEACH ' - l E ROAD 800 SEMINOLE _ ATLANTIC BEACH, FL 32233_____yy N INSPECTION PHONE LINE 247-5814 SINGLE FAMILY ATTACHED MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-SFAT-2537 Job Type: SINGLE FAMILY ATTACHED DWELLING Description: SINGLE FAM ATT 3 BED 2 BATH 1370 SQ FT Estimated Value: $130,000.00 Issue Date: 11/18/2015 Expiration Date: 5/16/2016 PROPERTY ADDRESS: Address: 189 OCEAN GATE DR RE Number: None GENERAL CONTRACTOR INFORMATION: Name: 201 MAYPORT CONSTRUCTION MANAGEMENT Address: 2768 STATE RD A1A #701 Phone: 904-334-1202 PERMIT INFORMATION: FEES: ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $285.00 UTIL REV RESIDENTIAL BLDG $50.00 BUILDING PERMIT FEE $570.00 STATE DCA SURCHARGE $8.55 STATE DBPR SURCHARGE $8.55 WATER CONNECT/TAP & METER $185.00 HEATER ORU9SicoNNECcrioNDANCE Tgoto©LL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. J' 1c) CITY OF ATLANTIC BEACH �■ 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 -61-119 Total Payments: $1,257.10 PERI191T IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY' OF ATLANTIC 1(II ORDINANCES AND TIIL FLORIDA BUILDING CODES. erm'r/ 4,5 15..._ SF/a T._ (ate 3'7, )536; , S•3;, J.5-‘/0) NOTICE OF COMMENCEMENT OFFICE COPY State Florida Tax Folio No. County of Duval To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved : 38-2S-29E-7.41 B De Castro Y Ferrer Grant PT Recd OR/16531-2248 ( Block# 5 Lots# 5, 6, 7, 8) Address of property being improved 201, 197, 193, 189 Ocean Gate Drive, Atlantic Beach, FL 32233 General description of improvements: Construct 2 Story Single Family Attached Quad-Plex Owner: Habitat for Humanity of the Jacksonville Beaches Address: Atlantic Beach, FL 32233 Owner's interest in site of the improvement: 100% Fee Simple Titleholder(if other than owner): • Name: Contractor: 201 Mayport Construction Management LLC ( FL State Certified General Contractor#CGC1506666) Address: 2768,Atlantic Beach, FL 32233 iPhone No.: 904-334-1202 Fax No.: 904-241-4310 Surety(if any): Address: Amount of bond $: Phone No.: Fax No.: Name and address of any person making a loan for the construction of the improvements: Name: Address: Phone No.: Fax No.: • Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name: Robert Peterson, c/o 201 Mayport Construction Management, LLC Address: 2768 State Rd A1A,Atlantic Beach, FL 32233 Cd y O p � a. = y b b a < 99N 00 J c!i � - . - Cil p, . •0 • 2 "4 � ba � dc) x oaz1v) � v� .., p , 0 O o o ,, x o ; o o5 0 o ? a: IC N . a Z CD alp co' p ' n • O g ' . � _ Ra5 (D . , O oa p 0 ' o Z O Z CI) 5 •-a - t.. 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Cr II-II r ° vii ° < A� (p O 8 p 0..0 CT' ¢' i-i i 0*,: . , City of Atlantic Beach /O/ ,) ' • ', Building Department APPLICATION NUMBER _, 'y . 800 Seminole Roa (To be assigned by the Building Department.) ., - Atlantic Beach, Florida 32233-5445 IVE a; /Phone(904)247-5826 • Fax(904)2445 J i :,%.�;;��..- OCT Email: Fax(904) - .� __________________] City web-site: http://www.coab.us a 2015 Date routed: Qm/� APPLICATION REVIEW A 1-'-:'=- KING FORM / Property Address: i `fl // ( 1 ' De.artment review required Yes No c ul:ding Applicant: aQ 1 �/q y/ a Q �4 — P-rnng &Zoni . / - '•mmistrator �- ProjeCt: / / . ,mot j I r'ublic Wor _- Pus lo ty Fire Services Review fee $ J Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified B 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 IIIIIIIIIIIIIIIII Division of Alcoholic Beverages and Tobacco Other: — ___ APPLICATION STATUS Reviewing Department First Review: pproved. nDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING �,, Reviewed by: '�/ 1.✓i [.--k-- Date: it 3 1 f TREE ADMIN. Second Review: nApproved as revised. nDenied. j1�IC WO' S omments: 'UBLIC UTILITI —/ PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. ❑Denied. Comments: I Reviewed by: Date: , ised 07/27/10 :u,� City of Atlantic Beach Z 4 APPLICATION NUMBER - y = ' '•r. Building Department �j `i 800 Seminole Road V (To be assigned by the Building Department.) partment.) r ^'"'", ' Atlantic Beach, Florida 32233-5445 ..(�'CA - 07438•t f ` Phone(904)247-5826 Fax(904)247 5845 �f' ;_;j��% E-mail: building-dept @coab.us -� City web-site: http://www.coab.us Date routed; Q APPLICATION REVIEW AND TRACKING, FORM Property Address: /93 4&et-r) Dear �� .artment review re.uired Yes No uildin. Applicant: ao 1 /y1,9 12e 1� 6 nsri - _ P nmg &Zoni sib, S,nt/L - •ministrator Project: y» I ] �h�� •ublic Wor •i:iirattilni[ Pu•liir safety == Fire Services Review fee $ Co 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 an Division of Alcoholic Beverages and Tobacco -— Other: -- APPLICATION STATUS Reviewing Department First Review: ' A proved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING il >_ Reviewed by: =77�` ' j1�3 !� TREE ADMIN. - Date: Second Review: nApproved as revised. [Denied. a�j!' WORK$, Co ments: • BLIC UTILITIES /0- z9-!S PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. ❑Denied. Comments: '-_ Reviewed by: Date: ised 07/27/10 i`i/, City of Atlantic Beach ��' APPLICATION NUMBER '.f•� Building Department 2014 �- � 800 Seminole Road (To be assigned by the Building Department. �' "'4 t � Atlantic Beach, Florida 32233-5445 �fAr— sill 'J Phone(904)247-5826 • Fax(904) 247-5845 /� . 9%-- E-mail: building-dept@coab.us /O-�' City web-site: http://www.coab.us Date routed: Q J APPLICATION REVIEW AND TRACKING FORM Property Address: /91 i&a,-r, a De•artment review i required Yes No uildin• Applicant: p2Q 1 Alpe/ /' 4 ,» P - Wing &Zoni •y-- A•mmistrator - Project: a _ ratt i • rublic Work i == / i- PusiTaety 111 Fire Services Review fee $ J-b Dept Signature ;-ivy 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: roved. ODenied. (Circle one.)) Comments: BUILDING PLANNING & ZONING Reviewed by: ' y"--, Date: ( ) I J— TREE ADMIN. Second Review: 0Approved as revised. ❑Denied. PUJ5 WORKS Comments: 41.i •U:LIC UTILITIES /0 - 29–ice PUBLIC SAFETY Reviewed by: Date: , FIRE SERVICES Third Review: ❑Approved as revised. (Denied. Comments: Reviewed by: Date: ised 07/27/10 :0•ArT;,, City of Atlantic Beach �s' , �� Building Department APPLICATION NUMBER " ' 800 Seminole Road (To be assigned by the Building Department !� s Atlantic Beach, Florida 32233-5445 /5 ..c6 or T area Phone(904)247-5826 Fax Fax(904)247-5845 •! .7 `7 V '��,i a%- E-mail: building-dept @coab.us .� City web-site: http://www.coab.us Date routed: �m/� APPLICATION REVIEW AND TRACKING FORM Property Address: !4 1 as 2), '" De•artment review required Yes p� uildin• No Applicant: ao 1 I4l d il` / Q nrle - P : ning &Zornn•� Si /L� �� '•mmistrator Project: l ,n > ublic Work y l�ti�J Pu• i a ety Fire Services Review fee $ 540 Dept Signature . ---flit--, Other Agency Review or Permit Required Review or Receipt of Permit Verified B Date Florida Dept. of Environmental Protection Florida Dept. of Transportation MININIMMIIIMMI St.Johns River Water Management District Army Corps of Engineers IIIIIIIIIIIIIIIIIII Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: IIIIIIIIIIIIIIIIIII APPLICATION STATUS Reviewing Department First Review: l Approved. (Circle one.) Comments: ❑Denied. BUILDING PLANNING &ZONING Reviewed by: 1 2 Date: ( 3 Is TREE ADMIN. Second Review: []Approved as revised. ODenied. ' %'f C:40>KAR C omments: 'UBLIC UTILITIES !e— 24s-/5 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: pApproved as revised. ❑Denied. Comments: Reviewed by: Date: 'ised 07/27/10 I (4.. 1-;. ,, ff S J CITY OF ATLANTIC BEACH I4'� `--~` = �� PUBLIC UTILITIES v 1200 Sandpiper Lane t J j;j ATLANTIC BEACH,FL 32233 (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: /0-29 -/S' Project Address: /19 O� ,..art r No. of Units: / Commercial Residential V Multi-Family New Water Tap(s)&Meter(s) Meter Size(s) 3/,/ ., New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaimed Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# IS- 5F4r- 2 537 Water System Development Charge $ N,, S dC (s A-60'4 Sewer System Development Charge $ Water Meter Only $ /85' vv - -O ,ilrz- e4-frtf- 4 Reclaimed Meter Only $ Water Meter Tap $ Sewer Tap $ (notes) Cross Connection $ LSD,DO Other $ TOTAL $ 235',o APPROVED: Kayle Moore,PEA (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED r,. '..4:„. -t . s\ CITY OF ATLANTIC BEACH 4 .,.`.: c PUBLIC UTILITIES 1200 Sandpiper Lane e fir; � : ATLANTIC BEACH,FL 32233 (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: /Q- 29—, f Project Address: /93 ed 7-7 ) SA0-7E Or- No. of Units: I Commercial Residential t/ Multi-Family New Water Tap(s)&Meter(s) Meter Size(s) 4y sr New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaimed Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# 45- SF4 - 23-38 Water System Development Charge $ .yeui-t.--o0 4-- Sewer System Development Charge $ Water Meter Only $ /9c co ,vo S e C S , .D. Reclaimed Meter Only $ Water Meter Tap $ Sewer Tap $ (notes) Cross Connection $ A . 00 Other $ TOTAL $ 23SoO APPROVED: Kavle Moore,PE ""L (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED CITY OF ATLANTIC BEACH PUBLIC UTILITIES 1200 Sandpiper Lane JF31Ef' ATLANTIC BEACH,FL 32233 (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: /O-29-/ .� Project Address: /97 OLD No. of Units: ✓ Commercial Residential V Multi-Family New Water Tap(s)&Meter(s) Meter Size(s) New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaimed Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# (5-3 FA T- 2539 Water System Development Charge $ l.1/6 C-62/ 41v`c—i- Sewer System Development Charge $ Water Meter Only $ /f 5 61.7 Ale SIC s ter-4M . Reclaimed Meter Only $ Water Meter Tap $ Sewer Tap $ (notes) Cross Connection $ 5'11. 06 Other $ TOTAL $ 235 06 APPROVED: Kavle Moore,PE (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED -Si „,, , ,„ CITY OF ATLANTIC BEACH -:` '° PUBLIC UTILITIES 1200 Sandpiper Lane r� ATLANTIC BEACH, FL 32233 0;319`" (904)270-2535 or (904) 247-5874 NEW WATER/SEWER TAPAM20-7 REQUEST Date: /D-Z9-/ S" Project Address: 2 0/ (r ,r N o. of Units: I Commercial Residential Multi-Family New Water Tap(s) & Meter(s) Meter Size(s) 3/7 ,' New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaimed Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# Water System Development Charge $ , 0&( & ',, ✓j-- Sewer System Development Charge $ Water Meter Only $ fVo 51C +s (A . Reclaimed Meter Only $ Water Meter Tap $ (notes) Sewer Tap $ Cross Connection $ 50. 67) Other $ TOTAL $ Z-31-141-2 APPROVED: Kayle Moore, PE (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED OFFICE COPY Oct. 27, 2015 Mr. Kayle Moore Public Utilities Director City of Atlantic Beach 1200 Sandpiper Lane Atlantic Beach, FL 32233 Dear Mr. Moore, I have submitted a building permit application for a house at: BLK 5: Lots 5, 6, 7, 8. #201, 197, 193 and 189 OceanGate Dr., COAB. Beaches Habitat will not be installing a fire sprinkler in this structure. In addition, pursuant to our HOA docs, we will be installing an irrigation system. Please give me a call 904-241-1222, or 904-334-1202 if you require any additional information. Sincerely, ,• _,. 1lb Peterson, Construction Director Beaches Habitat for Humanity #904-334-1202 OFFICE COPY Oct. 27, 2015 Mr. Dan Arlington Building Official City of Atlantic Beach 800 Seminole Rd. Atlantic Beach, FL 32233 Dan Attached are the following materials in support of Beaches Habitat application for the building permit : Quad S, Block#5 Lots # 5, 6, 7, 8 #201, 197, 193, 189 Ocean Gate Drive, COAB 1) One (1) copy of the Building Permit Application each unit 2) Two (2) copies of roof truss plans 3) Two (2) copies of HVAC Energy Sheets 4) Two (2) copies of the Florida Product Approval form 5) One (1) copy of recorded Notice of Commencement 6) One (1) copy of letter to Kayle Moore regarding fire sprinkler/irrigation systems. 7) Five (5) copies of the Construction Management Plan 8) Two (2) copies of architectural plans 9) Two (2) copies of structural engineering plans 10)Five (5) copies of civil engineering plans 11)Two (2) copies R.O.W. Permit Please let me know if any additional information is required. Thank you, Sincerely, Robert Peterson, Construction Director Beaches Habitat for Humanity 904.334.1202 attachments OFFICE COPY 1121 Turner MAIN Orslae:480 EocEw000 AVENUE,SWIM,JACKSONVILLE,FLORIDA 32205 Peet tutu 994.365:5.340•FAX 904-353.1408 1DAL F tLJ8Qp 3•.33pb•WWW.7VRMRRWSt,C_N A '^ Control T.MOM GA.-912-576.1300 Ouu,Fu.-362-361-4386 Csnaa BEECH,F .-334.7U-8303 Posi ST.Luca,Fu.-772492-0(178 What's Bugging You? Malour,s,FLA.-321-861.3325 TANTA,Fu.-1134114311 NOTICE OF INTENT FOR PREVENTATIVE TREATMENTS AGAINST TERMITES ac re.sired by Florida Building Code.FRC 104.2.6) Address: 9 6 I 411.G,-Oi�.. Lot: Block: Date: /01L7/().-- IiUI(AAItL"I nniti icicle(Wuod'frtatn:cE�t) ALL STRUCTURAL CHANGES Product Used • ARE TO BE REPORTED FOR RETREATMENT ni,tntium OctablIratc Tvtrb yilr:,tc 23%Active Ingredient Chemical used(active ingredient) Percent Concentration Application will be.p. lurmt:J onto strutturtj vooil:It drit111_in.stage o CO11J1t1ICIJ;In Stage of treatment(Horizontal,Vertical,Adjoining Slab,retreat of disturbed area) BORA-(;ARE:7criniticide applica(jpit shad be applied according;o EPA registrated label di}rctiut>!s as stated in the FloridaPuilding Code Section 1816.1.8 (INFORMATION TO BE PROVIDED TO LOCAL BUILDING CODE OFFICES PRIOR TO CONCRETE FOUNDATION INSTALLATION) =Turner IMMA1M Orrlaa:480 E%%Lwoce AVENUE,SOUTH, JACKSONwllI,FLORIDA 32205 MI Pest °--BA4.355,5.3J9•FAr 904.353.1488! FT-- — Eli Turner MAIN Orrloel 480 Eoscw000 AVENUE.Sours, JACKSONVILLE,FLORIDA 32205 Peet £ii ici 804-3551310•fo.804-359.1418.1su FRt�;B,Q1.2Z5.5395•www,TVRl�cawsr, li Control YS,SA.-112476.1380 Oulu,Fu.-862-3614386 DST.An MARa./sal,Fu.—318.7884909 Pan Si.luau,Fu.-772-692.0078 What's Bugging You? ,Fu.-921-861 8325 TAMPA,Fu.-1134814381 NOTICE OF INTENT FOR PREVENTATIVE TREATMENTS AGAINST TERMITES as re.aired by/Flo,ida Building Code.FRC 704.2.6) q Address: ' l 3 ocga C? .k . ,/ _ _ _ . Lot: . Bloch: Date: , U/2-7/0 ) ALL STRUCTURAL CHANGES BBOltA-CARE lcrmitiride(Wood Trcatulsnt) ARE TO BE REPORTED Product Used • FOR RETREATMENT Disodium()elaborate Tetrallysiratt. 23%Active Ingredient Chemical used(active ingredient) , Percent Concentration Application will bc.>'gTlut'nUe&l onto stfiJcltlydl.N_tnl at dried-in stage ofconsit a jistn Stage of treatment(Horizontal,Vertical,Adjoining Slab,retreat of disturbed area) BO RA-( A RE"limn iticide ap_p_11.cation shall be applied according to EPA registrated label dliccctions as stated in the Florida Building Code Section 18 16.1 8 (INFORMATION TO BE PROVIDED TO LOCAL BUILDING CODE OFFICES PRIOR TO CONCRETE FOUNDATION INSTALLATION) BSI Turner MAIM Oman 480 Eosiw000 Ate,So" JACKSOHVKit,FwswA 32205 ME Peet emu 904-355-53.10•Fa'804.3531488•Iou Fsu:021-7151306•www.iunstarast.um El/r.�Control Sr.MAW,GA.-812-576.1300 DCAU,Fu.-852-3514386 Darrow Buell,Fu.-338.788.8303 Pan ST.LURE,fu.-772482-0078 What's Bugging You? Matousre,Fu:821-861-3325 Tmn,fu.-8184814381 NOTICE OF INTENT FOR PREVENTATIVE TREATMENTS AGAINST TERMITES as re.uired by Florida Building Code.FBC 104.2.6) Address: 1 Lot Block: Date: 6 12-7/‘ 13URA CARL'lnnitiridc(Wood Treatment) ALL STRUCTURAL CHANGES Product Used • ARE TO BE REPORTED FOR RETREATMENT • j)ixtnlium Oct:Ibnratc TctgI y'cjt.tt 23%Active Ingredient Chemical used(active ingredient) Percent Concentration Application will In:performed uitto stiicturtL+_sTtlll drictl—in stage of constt a llii►_n Stage of treatment(Horizontal,Vertical,Adjoining Slab,retreat of disturbed area) !3C)RA-( ARE'Icrmiticideapplitati-c00 4tall be applied according is EPA registrated label itirections as stated in the Florida guilding Code Section 18!(44+ (INFORMATION TO BE PROVIDED TO LOCAL BUILDING CODE OFFICES PRIOR TO CONCRETE FOUNDATION INSTALLATION) ;_s j)T;y.. City of Atlantic Beach APPLICATION NUMBER �• 1 Building Department lq4 (To be assi ned by the Building Department. 't1 800 Seminole Road ✓�r Atlantic Beach, Florida 32233-5445 I� i Phone(904)247-5826 Fax(904)247-5845 �;� gr E-mail: building-dept @coab.us Date routed: MAC City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z-01 De artment review required Yes o uildin� Applicant: ao � Ahliwier Q I)sre. - P ring &Zonin ministrator Project: / / . �.� / ublic Work 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 STATUS Reviewing Department First Review: roved. ❑Denied. (Circle one.) Comments: ILDIN PLANNING &ZONING / r Reviewed by: / Date: j' i TREE ADMIN. Second Review: ❑Approved as revised. ❑D - d. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. ['Denied. Comments: Reviewed by: Date: Revised 07/27/10 ;c,�ri,•,. City of Atlantic Beach APPLICATION NUMBER ,- i • �r Building Department� � �,.1 g p 30 4 (To be a si d by the Building Department.) �� ,� { 800 Seminole Road � `��% Atlantic Beach, Florida 32233-5445 J Phone(904)247 5826 • Fax(904)247 5845 �� 5-S., ;! � �r E-mail: building-dept @coab.us Date routed: G m . j City web-site: http://www.coab.us _J APPLICATION REVIEW AND TRACKING FORM Property Address: (91 ót 6,7, dri bv-- Department review required Yes o- 1uildin• Applicant: ao 1 AA)y pQ er 6 I)We.. - P P . nmg &Zoni .y--- / -- £ •ministrator j i. ern public Work Project: I t 1is y 1" Lt 1,a ,/ Er.• IC 1 I I I- Pu•lic saYety 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 STATUS Reviewing Department First Review: t, pproved. (Denied. (Circle one.) Comments: ILDINC PLANNING & ZONING Reviewed by: 12/y Date://''(0011415- -- TREE ADMIN. Second Review: ❑Approved as revised. nD ied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: • FIRE SERVICES Third Review: (Approved as revised. UDenied. Comments: Reviewed by: Date: 'evised 07/27/10 r{P?),);, City of Atlantic Beach a APPLICATION NUMBER �,.. Building Department (To be assigned by the Building Department.) r : ' 800 Seminole Road /c46/1 w �5 Atlantic Beach, Florida 32233-5445 3� V Phone(904)247-5826 • Fax(904)247-5845 1 , fir E-mail: building-dept @coab.us Date routed: /Q/oi 7//� City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 193 ól!/ Ai') ari DeQartment review required Yes o uildin Applicant: Q70 1 A1y pee 6 nsre- - .P nmg &Zorn / / ministrator Project: / ,,� 'j ' 'ublic Wor. / • is Utilifr!sj Pu• IC 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 STATUS Reviewing Department First Review: Eproved. nDenied. (Circle one.) Comments: UILDIN PLANNING &ZONING Reviewed by: krt. Date: /<<NZ./ S''-- TREE ADMIN. Second Review: nApproved as revised. n enied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [Approved as revised. ❑Denied. Comments: Reviewed by: Date: 'evised 07/27/10 ;S-----,-,.',/,.- r• City of Atlantic Beach /ôì APPLICATION NUMBER ,j 1 • Building Department (To be assig d b the Building Department.) f !'r 800 Seminole Road /o5. 56/1- " 2,5'3 7 - Atlantic Beach, Florida 32233-5445 \ Phone(904)247-5826 • Fax(904)247-5845 % -Oit 9'1- E-mail: building-dept @coab.us Date routed: /Q/c)7//� City web-site: http://www.coab.us — ___I APPLICATION REVIEW AND TRACKING FORM Property Address: III 6& et7) ari Zr De•artment review re•uired (M No ruildin• al Applicant: ao I 4'i / C'o l��je P : Wing &Zoni .1,-- -- ■•ministrator Project: / / tn. / I a' J • 'r-ublic Wor / .• icIiii- Pu• i-a ety _ 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 STATUS Reviewing Department First Review: roved. ❑Denied. (Circle one.) Comments: CUILDING ) PLANNING &ZONING Reviewed by: rn 1 Date: //12 '/ S"_ TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. [Denied. Comments: Reviewed by: Date: 'evised 07/27/10 .,-.0-5-ii k, City of Atlantic Beach i Building Department APPLICATION NUMBER ;;,,� �--` �� 800 Seminole Road (To be assigned by the Building Department.) �� Atlantic Beach, Florida 32233-5445 ) J/jq�� zs�� Phone(904)247-5826 • Fax(904) 247-5845 1 I (/ `i ixt 9:- E-mail: building-dept @coab.us Date routed: 1%7//./ City web-site: http:/lwww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: U1 oei 47j as Zr Department review required Yes No =uildin. Applicant: ao 1 i4l19 y pd 6 I).le — P : Wing &Zonin.� / - A .ministrator Project: , / / ,,agt I / r I • rublic Wor kriimiritillliir Pu p lc ety 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: EIp�•proved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: A^• .� ✓ /'L-V Date: G 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: 'ised 07/27/10 City of Atlantic Beach APPLICATION NUMBER (/ t"t )yam= ' Building Department Q sn (To be assigned by the Building Department. Q .-;, j tla tic Beale Road 1-5-- �� ) ^~ °r Atlantic Beach, Florida 32233-5445 24-3 q Phone(904)247-5826 • Fax(904) 247-5845 J/ •'9%.- E-mail: building-dept @coab.us Date routed: d Agar I City web-site: http://www.coab.us — J APPLICATION REVIEW AND TRACKING FORM Property Address: /91 0 a Department review re.u' fired Yes No _:uildin. Applicant: Q2Q 1 "iipe l ���Z P: ning &Zorn oil, --- A.ministrator Project: , a _ rill d /• ublic Work _- -- / .i�.. �11 Pus i a ety �- Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified B 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: Approved. ]Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: ..." --1 Date: I TREE ADMIN. Second Review: DApp roved as revised. Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ❑Denied. Comments: Reviewed by: Date: ised 07/27/10 - ,; �>>,> City of Atlantic Beach 2 APPLICATION NUMBER y ,,. Building Department �� t� (To be assigned by the Building Department.) i� 800 Seminole Road 4410=•; Atlantic Beach, Florida 32233-5445 3 Phone(904)247-5826 - Fax(904)247--5845 . `�_;ii E-mail: building-dept @coab.us Date routed: Q - J j City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 193 o& t7) a review Department 69 pa view required Yes No luildin• Applicant: p?Q 1 41 47 194 lr 6 4srt P . nmg &Zornn•y £fltJL -- •mrnistrator Project: -y711 � 7 I Aj rublic Wor _______________ '+. icliiI- Pub icsaety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt _ of Permit Verified B 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: Approved. ]Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING 4""'.---/-----/-Reviewed by: iv► —, Date: 1/ 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. LiDenied. Comments: _` Reviewed by: Date: ised 07/27/10 !-0; City of Atlantic Beach /4// ii APPLICATION NUMBER 1,4* ' Building Department ;n (To be assigned by the Building Department.) r,��.r._ I' � 800 Seminole Road ^ Atlantic Beach, Florida 32233 5445 - L'�?7 Phone (904)247-5826 • Fax(904) 247-5845 J ?;`,j9 E-mail: building-dept @coab.us Date routed: 4m/4 City web-site: http://www.coab.us J APPLICATION REVIEW AND TRACKING FORM Property Address: fCJ L1& 4,11 Ms Department review re•uired Yes No �uildin. Applicant: c,? l �/11 d ter Co 4512 P _ Wing &Zoni • C� / •mrnistrator Project: /�4 _ €a♦ If f r rublic Work / .11-,e is 1 i Pu. iic as ety 1111 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: / Approved. nDenied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: Date: TREE ADMIN. imw Second Review: nApproved as revised. nDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. ]Denied. Comments: Reviewed by: Date: ised 07/27/10 Jlry. City of Atlantic Beach APPLICATION NUMBER ; ryM, Building Department Q �' 800 Seminole Road (To be assigned by the Building Department.) 1,,p, IVY `Q Atlantic Beach, Florida 32233-5445 i —Sr 2 5 (/a Phone(904)247-5826 • Fax(904)247-5845 h A4,3 1 9r E-mail: building-dept @coab.us Date routed: /a �7/4 City web-site: http:/lwww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: !• I 4 n a Z,`' De•artment review re•uired Yes No �A uildin• Applicant: c,70 f Ali pe 1r Q ns� P : ning &Zonin•� / -- '•ministrator Project: . I i r,t • I tha rublic Wor lr.1111JM11r Pu• is a ety 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: krApproved. ❑Denied. (Circle one.) Comments: BUILDING EF ,47 ?.P > C.0440te " ' PLANNING &ZONING Reviewed by: < Date: /q�l�� TREE ADMIN. � / Second Review: Approved as revised. Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: QApproved as revised. ❑Denied. Comments: Reviewed by: Date: 'ised 07/27/10 r�s+ii;i City of Atlantic Beach ^ Building Department APPLICATION NUMBER � 9 34 (To be assigned by the Building Department.) 1 tla Atlantic Seminole Road �� JQ 7 �� nr- :' Atlantic Beach, Florida 32233-5445 F,�7 '� Phone(904)247-5826 • Fax(904) 247-5845 ._ %�`j;tpj� E-mail: building-dept@coab.us Date routed: e� I City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /91 öL ?t7? an. bi-- De.artment review required Yes q No [:uildin• Applicant: p2Q 1 Aii p er Q nsr-je - P : Wing &Zoni .�— / 1 -- _••ministrator f a _ �ublic Work Project: �,�! r ' Pu• lc a ety 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: R pproved. ❑Denied. (Circle one.) Comments: BUILDING ,5 f " K.4D 0m.4... E i. r5 PLANNING & ZONING IReviewed by: `- ` L Date: /m I- ,f TREE ADMIN. Ili/ 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: ised 07/27/10 4c >. City of Atlantic Beach 24tri APPLICATION NUMBER r "i' ' , .l Building Department (To be assigned by the Building D 800 Seminole Road y 9 e};a�ent.}� ;.;4--.-- h417'b. . Atlantic Beach, Florida 32233-5445 / r Phone(904)247-5826 • Fax(904)247-5845 .� �'1=i;.i�,r E-mail: building-dept @coab.us Date routed: 4 Aar City web-site: http://www.coab.us _ - APPLICATION REVIEW AND TRACKING FORM Property Address: 193 ��� 1,-71 dT bi Department review re uired q Yes No t 19 uildin. Applicant: p?Q 1 Alp)ter d� le - P : Wing &Zorn •� —S -- '•ministrator Project: / % . ratt ,J 1 Fublic Wor -- l• 1 Pu• is a ety Fire Services Review fee $ Dept Signature • Other Agency Review or Permit Required Review or Receipt of Permit Verified B 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: APPL CATION STATUS Reviewing Department First Review: CApproved. nDenied. (Circle one.) Comments: A BUILDING c:1-E£ f17Tk�fEa Cm^" -6ev-SJ PLANNING &ZONING — �'=/`'_ Reviewed by: Date: / o/t4 /r TREE ADMIN. Second Review: (Approved as revised. I Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. Denied. Comments: Reviewed by: Date: — ised 07/27/10 I sg—!:y;;. C /� APPLICATION NUMBER ,,' (To be assigned APPLICATION by the N NUMBER Department.) ..:", - 'i 800 Seminole Road C TVFT� n Building p ) ;`r '`k` Y—'' Atlantic Beach, Florida 32233-5445 .., ��T— 1,-i r Phone(904)247-5826 • Fax(904)24 -5845QCT 28 2015 . `_,,c 91- E-mail: building-dept @coab.us Date routed: 4 Afir 6-4 __ICity web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Ill tLL A-ri 7 2 Department review required Yes No IE::uildin• Applicant: ao 1 n/ I2e� d n e. — 'rung &Zoni •_ i_ •mmstrator rublic Wor Project: _S 7 . Ij'rynhivA Ja __- Pu• is a ety Fire Services Review fee $ Dept Signature • Other Agency Review or Permit Required Review or Receipt i 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: I Approved. ❑Denied. (Circle one.) Comments: -lei W _� /�tck%v'� BUILDING PLANNING &ZONING TREE ADMIN. Reviewed by: OX �" Second Review: ['Approved as revised. lenied. Date: L 7 / PUBLIC WORKS Comments: PUBLIC S PUBLIC SAFETY Reviewed by: Date: / //t)FIRE SERVICES Third Review: ['Approved as revised. ['Denied. Comments: Reviewed by: Date: ised 07/27/10 r'+r