2307 FLEET LANDING BLDG 2000 - SHOWER TO SHOWER \s, CITY OF ATLANTIC BEACH
+ ti r 800 SEMINOLE ROAD
, '"�: ATLANTIC BEACH, FL 32233
lirl\ INSPECTION PHONE LINE 247-5814
\_J3;1`>r
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RAAR-455
Job Type: RESIDENTIAL ALTERATION
Description: SHOWER TO SHOWER
Estimated Value: $6,000.00
Issue Date: 2/25/2016
Expiration Date: 8/23/2016
PROPERTY ADDRESS:
Address: 2307 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 $80.00
Total Payments: $84.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORID.k
BUILDING CODES.
BUILDING PERMIT APPLICATION
OF ATLANTIC BEACH fQ
800 Seminole Road, Atlantic Beach, FL 32233 455
Office(904) 247-5826 Fax(904) 247-5845 1 4 w 24te-elei
Job Address: )30g /-[e_e-f Lo,d,nry g/v d. i3/ (94r0 Permit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. q, t
Valuation of Work $ 4 000 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition ., 1Qlteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial R- '4. 1 '
If an existing structure, is a fire sprinkler system installed? (Circle one : .4.371, No N/A
Florida Product Approval#
For multiple products use product approve form
Describe in detail the type of work to be performed: ill l,/za¢P/i,Pr f_siower / 5 awp(
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:! 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. /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 comp lied with whether specified 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 regulating construction or the performance of construction.
Signature of Owner .c.:::747 Signature of Contractor
Print Name Jason Holder Print Name Jason Holder
Sworn to and subscr jeci before me Sworn W and subscril before me
this I' Day of Q (•U A.r V1 , 20 )6/ this )`1 Day of f �YLt aft./ 20 It,
,a.1/1.(4 g 1
Notary Pu•lic .............•.,, Notary e,, ,t SHARI R QUEST
�'"• u�`. SHARI R QUEST
'•i � �� MY COMMISSION#FF(168247 •- Ail. r• MY COMMISSION Alt E iMY( 1.26.10
s;��o,;;pr; EXPIRES November 4.2017 "■! oF,c.i EXPIRES November 4.2017
(407)398-0163 FloridaNOtaryService.com (407)398-0163 FloridallotaryService.com