672 AQUATIC DR - FLOOD REPAIR r,- 1SS1`� CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
J-'f ,,)
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RAAR-171
Job Type: RESIDENTIAL ALTERATION
Description: REPAIR - FIRE WALL DUE TO FLOOD
Estimated Value:
Issue Date: 1/22/2016
Expiration Date: 7/20/2016
PROPERTY ADDRESS:
Address: 672 AQUATIC DR
RE Number: 171818-5224
PROPERTY OWNER:
Name: WYATT, CAMERON J
Address: 672 AQUATIC DR
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Iry • ( LL //ft(,
BUILDING PERMIT P /
AP LIGATION
CITY OF ATLANTIC BEACH
/
17- �g J
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1#7Z A Permit Number: / - 17/
Legal Description Parcel #
FIoor Area of Sq.r`t. Sq.Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
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 pro uct approva orm
Describe in detail the type of work to be performed:_ //,e£ /Q/l set/94"7£s
2 1 ' 1/0016
Proper Owner Information:
Name: Q u L A. 04f • Address: 67Z. 444 L Dr City ' . 4 c.. State L Zip 372 33 Phone log- ZZL -l s'r(a
F p Y
E-Mai or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: ifying Agent:
Address: rty State Zip
Office Phone Job Site/Contact N er Fax#
State Certification/Registration#
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 t•
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
and•void f work is not commenced within six(6)months, or if construction or work is suspended or abandoned fora period of six(6)months at any time.
work is commenced. I understand that separate permits must be secured for ElectricalWork,Plumbing,Signs, Wells,Pools,Furnaces,Boilers, Hea
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENT
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certf that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing
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 cancel
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner (� ) Signature of Contractor
Print Name efiviveco, y"(/I'- . Print Name
Befor me i Before me '�`�
his cd Day of �q,wcry ,20 Jw this Day 1\---4...tevergsAzo
\rotary Public Notary Public