1021 ATLANTIC BLVD # 975 COMM BUILD OUT 2016 \ : 'S, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J - 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-CINT-2811
Job Type: COMMERCIAL INTERIOR BUILD-OUT
Description: BUILD OUT FOR HAIR SALON
Estimated Value: $33,675.00 A' I
Issue Date: 1/20/2016 +�► `v
Expiration Date: 7/18/2016 `
PROPERTY ADDRESS:
Address: 1021 ATLANTIC BLVD
RE Number: 177602-0040
PROPERTY OWNER:
Name: EQUITY ONE ATLANTIC VILLAGE,
Address: 16 NE MIAMI GARDENS DR ATTN: TREASURY DEPT
GENERAL CONTRACTOR INFORMATION:
Name: DIMENSION CONSTRUCTION (GC)
Address: 1045 N LIBERTY ST QA RAMIN PARTOW
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $109.19
BUILDING PERMIT FEE $218.38
STATE DCA SURCHARGE $3.28
STATE DBPR SURCHARGE $3.28
Total Payments: $334.13
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION c /� COPY
��
CITY OF ATLANTIC BEACH OFFICE COP I
�/
O 2A800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 975 Atlantic Blvd.,Atlantic Beach,FL 32233 Permit Number:/Y%f I T—c2ool/
Legal Description 38-2S-29E 14.040 CASTRO Y FERRER GRAND Parcel# 177602-0040
Floor Area o q.P t. Sq.Pt
Valuation of Work$ $33,675 Proposed Work heated/cooled 952 non-heated/cooled 0
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 sprin r system costa a rrc a one): Yes No N/A
Florida Product Approval# N/A Interior Work Only
For multiple products use product approval form
Describe in detail the type of work to be performed:Interior build out for new tenant.The tenant will be a salon for hair
removal.
Property Owner Information:
Name: Sleek Salon Inc./Rani Usman Address:975 Atlantic Blvd.
City Atlantic Beach State FL Zip 32233 Phone(904)294-4484
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Dimension Construction Qualifying Agent:Ramin Partow
Address: 1045 N.Liberty Street City Jacksonville State FL Zip _32206_
Office Phone(904)249-6094 Job Site/Contact Number_(904)294-6094 Fax#_(904)406-8737
State Certification/Registration# CGC 1508799
Architect Name&Phone# AE Studio Architecture (321)615-6171
Engineer's Name&Phone# Same as above
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 in tallations as indicated /cert that no work or installation has commenced prior to the
Issuance of ape rmit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. 7Ris permit becomes null
and void rf work is not commenced within six(6)months,0"7
r if construction or work is suspenckd or abandoned for a period of sap)months at any time offer
work is commenced. 1 understand that separate permits must be secured jar Elecdica!Bark Plumbing,Signs, Wells,PooLx Furnaces Boilers,Healers
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.
/hereby certify that/have trod and examined this a icatton and know the same to be true and correct. All provisions of laws and ordinances go eming is
type o7 work will be complied with whether speci ted herein or not. The granting of a permit does not presume to give au hority to violate can the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner f Signature of Contractor 1
Print Name t t _✓ O tn�
CCf7.........._�Sn'`2i► Prmt N e
Sworn d subscribed before ane orn and su scribe befo m
this ay of �J e h t f3 20 I ✓ Da 20
No is is
AJT t F t E(� W 1 TE-t F LO
s
Q_ V �S 1.l -�U S E.- �Kp 1 E S r� Y P4W<, Not ubiic State of Florida
Shirley L Graham
CJ . av OZ O 4o My Commission FF 086990
�JOTAQ Foe Fl►.-�t 1A S!_t^J O►.:Ly OF Expires 02/14/2018
,.:: � JANICE QUARTERMAN
=.; .= Commission#EE 218948
> -a Expires September 8,2016
' p�F;o Bonded Thru Troy Fain Insurance&-i;'e,iii?P:?
c.a.,
City of Atlantic Beach
Building Department APPLICATION NUMBER
i 800 Seminole Road [Date
e assigned by the Building Department.)
Atlantic Beach, Florida 32233-5445 ,/T /
Phone(904)247-5826 - Fax(904) 247-5845 / 'v " �1
.�'t 9% E-mail: building-dept@coab.us routed: L
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: hoz / d D ent review required Yes No
uilding
Applicant: ning &Zoning
Tree Administrator
Project: Q/�'y� /n / CG' 6 Public Works
Public Utilities
Public Safet
F e 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 Managerr -F
Army Corps of Engineers
Division of Hotels and Restaur
Division of Alcoholic Beverage
Other:
1S
Reviewing Department First Review:
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING
_ Date:--/ —�"7"lG
TREE ADMIN. Second RF
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10