3000 Fleeting Landing Blvd. #3201 - Tub to Shower S CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
V J; 31 J
RESIDENTIAL ALT /OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- RAAR -32
Job Type: RESIDENTIAL ALTERATION
Description: UNIT 3201 - TUB TO SHOWER
Estimated Value: $2,750.00
Issue Date: 1/6/2016
Expiration Date: 7/4/2016
PROPERTY ADDRESS:
Address: 3000 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:
BUILDING PERMIT FEE $63.75
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $67.75
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 I _ Aa
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845 _ 1
Job Address: 30 #19 iiii , 3 000 f/p y �{ W Number:
` d
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ o ?, 750 Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition (..:Alterati). Repair Move Demolition pool/spa window /door
Use of existing /proposed structure(s) (circle one): Commercial
If an existing structure, is a fire spr system installed? (Circle one): No N /A
Florida Product Approval #
For multiple products use product approval form //
Describe in detail the type of work to be performed: - 147:i 14 ,.5�t3tver
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 per formed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not conunenced 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. 1 understand that separate permits must be secured for Electrical Work, Plumb Signs, Wells, Pools, F urnaces, Bo 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.
1 hereby certify that 1 have read and examined thisplication 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 speci zed 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 regz ting construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Jason o er Print Name Jason H r
Sworn o and subscribed • -fore me Sworn to and subscribed bd e me
thisp Day of / QAA � - , 20 , this A't
ay of II , 201
Notary Public „. . ? ..... Notary a lic
le - ' : SHARI R QUEST ' i.e ""
,.l : { .... _. . SHARI R QU Tise 01.26.10
• a M Y COMMISSION #FF '
_, �! ; 46824 - ` ; f l - MY COMMISSION #FF068247
•• EEXPIRES November 4. 2017 aa!: EXPIRES November 4. 2017
(407) 388 -0153 FlorldallotarySerWce.com (407) 398.0153 FloridallotarySet,ice.com