201 MAYPORT RD - MAIL KIOSK PERMIT -SrL� .
�" � CITY OF ATLANTIC BEACH
,1 f 800 SEMINOLE ROAD
J - =r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
COMMERICAL ALTERATION/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-COTH-2632
Job Type: COMMERCIAL OTHER
Description: MAIL KIOSK
Estimated Value: $10,000.00
Issue Date: 11/24/2015
Expiration Date: 5/22/2016
PROPERTY ADDRESS:
Address: 201 MAYPORT RD MAIN
RE Number: 177649-0000
PROPERTY OWNER:
Name: BEACHES HABITAT FOR HUMANITY
Address: 797 MAYPORT RD
GENERAL CONTRACTOR INFORMATION:
Name: 201 MAYPORT CONSTRUCTION MANAGEMENT
Address: 2768 STATE RD A1A #701
Phone: 904-334-1202
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $50.00
BUILDING PERMIT FEE $100.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $154.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
13P11.DING CODES.
BUILDING PERMIT APPLICATION
• r.-.• r • • ; CITY OF ATLANTIC BEACH .0 '� C�
..r. ,w — . 800 Seminole Road, Atlantic Beach, FL �Q
•
Office (904) 247-5826 Fax (904) 24 `: by
Job Address: 201 Ma port Rd OceanGate-Communit Mail Kiosk CO • FL 32 rmit Niimb i1
Legal Description 38-2S-29E-7.42 B De Castro Y Ferrer Grant PT RECD O/R 16 48
Valuation of Work $10,000 Proposed Work heated/cooled X non-heated/coo . X
Class of Work(circle one): New (X) 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 pi my
Florida Product Approval #see attached
For multiple products use product approval form
�.r.. vy
Describe in detail the type of work to be performed: Construct Community Mail Kiosk per attached drawings.
Property Owner Information:
Name: Beaches Habitat for Humanity Address:797Mayport Rd.
City Atlantic Beach State FL Zip 32233 Phone 904-241-1222
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:201 Mayport Construction Management,LLC Qualifying Agent: Robert Peterson
Address: 2768 State Rd. AlA#701 City Atlantic Beach State FL. Zip: 32233
Office Phone Job Site/Contact Number 904-334-1202 Fax#
State Certification/Registration#CGC-1506666
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 cert5 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 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 certi&that I ave 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 .•nrplied 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 ederal,state,or loop!law regulating construction or the performance of construction.
Signature of Owner (� ! 4'.:, Signature of Contract or - -
Print Name t <yO•-vc_5 Print Name
Sworn to and subscribed before me Sworn to and subscribed before me
this YI"- Day of /d v,e ar ,20(c--- this ytk Day of IA- j ,20/,"
// t--, -
Notary Public t: MURRAY �' -
•': MY COMMISSION#EE185723 :•:
iVIL.E M
?�, -:%,7'-di: •+` MY COMMISSION 0 EE1857
EXPIRES ApdI 02,2016 '• - vised 01.26.10
• 74'.. ,,,m;,., EXPIRES Apc#02,21316
1407)396. 133 Florida610610ervice corn 1407)996.0133 gr.ir w.....,.e—.-.
no"" r" ry '� r"`, f
k
Nov.4, 2015
To: Dan Arlington, Building Official
COAB
800 Seminole Rd.
Atlantic Beach, FL. 32233
From Rob Peterson, Construction Director
Beaches Habitat for Humanity
Re: Mail Kiosk-OceanGate(201 Mayport Rd.)
Dan,
Attached are the following materials in support of Beaches Habitat application for the Community Mail
Kiosk permit to be located in the park at our OceanGate project.You should have a copy of the original
NOC in your files.
1) One (1) copy Building Permit
2) Two Signed and Seal copies of plans
3) Two(2)copies of the Florida Product approval codes
4) Five (5)copies of the Construction Site plans
Please let me know if you need anything else,Thankyou
Sincerely,
Robert •e - • , • ction Director
#904-334-1202
� City ofi Beach� Building Depament APPLICATION NUMBER
e '`i 800 Seminole Atlantic Road rt (To be assigned by the Building Department.)
s Atlantic Beach, Florida 32233 5445
Phone(904)247 5826 Fax(904) 247-5845
�0;; �% Email: building-dept @coab.us Date routed:
City web-site: http://www.coabus
APPLICATION REVIEW AND TRACKING FORM
Property Address: O7 Q )7) Ay 'der led Department review re.uired war o
/ /:uildi
Applicant: 2O ` ' ' ���
//. _L�`(,C�+j ning &Zorn
• �'""' "'•ministrator
Project: _/ f Q44 rblic Wor.
Pu• ic a - y
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: 1"4 I roved.
❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date: //17'/S
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:
vised 07/27/10
1
rte+j; City of Atlantic Beach
Building Department APPLICATION NUMBER
+�I 800 Seminole Road (To be assigned by the Building Department.)
r Atlantic Beach, Florida 32233-5445
/ ?2.
Phone(904)247-5826 • Fax(904)247-5845 (%e7
9 E-mail: building-dept @coab.us
City web-site: http://www.coab.us Date routed:
Y
APPLICATION REVIEW AND TRACKING FORM
Property Address: cQQ I )1) 7 ,41 7" /�G� Department review required Yes No
Applicant: / , • ildin.
L , // _ kC / j- - ning &Zoni �-
• •mmistrator
Project: %—.7h� 444 public Wor,
Pu. ic a - _-
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
MinFlorida 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.
(Circle one.) Comments:
❑Denied.
BUILDING
PLANNING &ZONING
Reviewed Date: ! /0
TREE ADMIN.
Second Review: QApproved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: []Approved as revised. I jDenied.
Comments:
Reviewed by: Date:
vised 07/27/10
•
City of Atlantic Beach
APPLICATION NUMBER
(4 .
, ' �, Building Department �4
~. I �' 800 Seminole Road Na� 1✓ i (To be assigned by the Building Department.)
�� Atlantic Beach, Florida 32233-54 ml #'?,0/5:17..
� /c' (oZ "• 2 6/3Z
Phone(904)247-5826 • Fax(9 _�'7-5845 r�
moo;; 9Y- E-mail: building-dept @coab.us `"-�; Date routed: // 6 /5
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Q I � 7 A '6,fr' ,ed Department review required Yes No
Applicant: 240 4 " 1 '�e. _ it _['1(,C - � ildfling &Zon7'1IIIIII��
`--72i g • / 4 •ministrator =�
Project: J Oct public Wor.
,.�.n.viwwww —
Pu• ic a - y
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. Denied.
(Circle one.) Comments: _,
BUILDING f
?z,Es�� 704v ID �.ftc_ o>F 1as�
PLANNING &ZONING
,,p
Reviewed by: A/ C— /t- Date: // /
'43
TREE TREE ADMIN. Second Review: roved as revised.
p
AD
P la:enied.
PUBLIC WOR Comments:
PUBLIC UTILITIES
If / d-.—
PUBLIC SAFETY Reviewed by ■ � �� Date: ll d
FIRE SERVICES Third Review: ❑Approved as revised. Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
y
•
tAii;% City of Atlantic Beach APPLICATION NUMBER
i i •A�` Building Department N ��V (To be assigned by the Building Department.)
O r 800 Seminole Road 01/0
„Off, ��
•i }-• Atlantic Beach, Florida 3223 y ��Q �� y �/� Z ���Phone (904)247 5826 Fax(9. 7 5845 ��\ pit E-mail: building-dept @coab.us Date routed:
City web-site: http://www.coab.us IV I
APPLICATION REVIEW AND TRACKING FORM
Property Address: p7 Q I )1) Ay /OA 'T / d Department review required Yes No
/ e:uildi
Applicant: 20 ` ' , ,e _ ,i j _L'& ! j ning &Zoni
- 'cUministrator
Project: %--22)Al 4444 ublic Wor
c ii
Pu is a y
Fire Services
I /Review fee $ Dept Signature s‘.......__
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:
APPLI TION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING L.------
Reviewed by: Date: h 71111A—
TREE ADMIN. Second Review: QApproved as revised.
❑Denied.
WrfirC WOR Comments:
®
( BLI U ILITIES
-/_
PUBLIC SAFET Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
vised 07/27/10
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