345 4th St - Bathroom Remodel ' ',s\ CITY OF ATLANTIC BEACH
r� _ s i 800 SEMINOLE ROAD
4 , . ' /
` �` :" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
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RESIDENTIAL ALT /OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -RAAR -358
Job Type: RESIDENTIAL ALTERATION
Description: bathroom remodel
Estimated Value: $6,000.00
Issue Date: 2/12/2016
Expiration Date: 8/10/2016
PROPERTY ADDRESS:
Address: 345 4TH ST
RE Number: 169837 -0000
PROPERTY OWNER:
Name: MCCAWLEY, PETER V & INGRID D, *
Address: 320 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: FLINT CONSTRUCTION SVCS (GC)
Address: 1419 LINKSIDE DR QA RUSSELL MARK FLINT
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $80.00
Total Payments: $84.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
e r
. BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 3 tt4 S' Ct A /u i&t
Permit Number:
Legal Description Parcel #
Valuation of Work $ 6 Oaf) Posed ed Work h ted /cooled t Area of S.Ft. n on- heated /co oled
Class of Work (circle one): New Addition At3ici Repair Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial Resial'
Han existing structure, is a fire sprinkler system installed? (Circle one): Yes C1T0 N /A
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed: /� S TK /
UV� Plilovr �d'1
Property S
Owner Information:
Name: w / r
City 4/4A- c� . N �.t..r n Gw I 'r Address: f 4S 4 ' fict�
%�ruc 4 / State f--Zip s'o?2 ?j' Phone
E -Mail or Fax # (Optional)
Contractor Information: / CONTRACTOR EMAIL ADDRESS:
Company Name: t i i 1 ( 0// , . '4 . 67 , , a ut Sec i ' .eS 45,1 e l/ 7
� Qualifying Agent: � /
Address: (f(7 ,i',f .0-, 'V City MAX 6-e, 4, S tate F L
Zip VA sci9
Office Phone
( 4 - .17 4,2 Cu Job Site/ Contact Number fy r 4,2 6 Fax # .T 7,2. - Qn / 1
State Certification/Registration # (°CC 11O gcx, 3
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 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 - Work, Plumbing, Signs, Wells, Pools, urnaces, 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 certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
!ype 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 the
7rovisions of any other federal, state, or local law regulating construction or the performance of construction.
nature of Owner � ' �
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g t/IL. /.O _,!11 ,, Signature of Contractor `
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