4000 FLEET LANDING BLVD #4313 - SHOWER TO SHOWER J 1
CITY OF ATLANTIC BEACH
S� 800 SEMINOLE ROAD
' 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-456
Job Type: RESIDENTIAL ALTERATION
Description: SHOWER TO SHOWER
Estimated Value: $3,500.00
Issue Date: 2/25/2016 -*/ / 43 13
Expiration Date: 8/23/2016
PROPERTY ADDRESS:
Address: 4000 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:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $67.50
Total Payments: $71.50
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
800 Seminole Road, Atlantic Beach, FL 32233 ``9. —
Office(904) 247-5826 Fax(904) 247-5845 I(0—11 P A1.—f 5 b
Job Address: +'3/.3 F/pr�.�a.,�l.., d/col &e , '���D Permit Number: I��"'l"'
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.l�t
Valuation of Work $ 3500 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition teration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial
If an existing structure, is a fire sprinkler 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: 7T1 ,, Saw / S- er z, , k
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 1 nfornlation:
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 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, 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 certify that I 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 red 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 taw regulating construction or the performance of construction.
Signature of Owner Signature of Contractor /-7
Print Name Jason Holder Print Name Jason Holder
Sworn to and subscribed before me Sworn to and subscribed before me
this 1 q Day of J kYUL,et1 , 20 / L' this ) Day of F�i'u p,/'✓I , 20 I�
Notary Pub is /P"° SHARI R QUEST Notary u ,,,Ip,,,,,,
J*) MY COMMISSION#FF068247 ` P� "' SHARI R QUEST-....•°4:t �P�(� ,26.10
1•) MY COMMISSIOr# �Tf8M V
EXPIRES November 4.2017 ,-`
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