320 1ST ST SIDING 2016 r ' �" \s CITY OF ATLANTIC BEACH
:' ) 800 SEMINOLE ROAD
7311F * ` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
SIDING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- SIDE -632
Job Type: SIDING PERMIT
Description: SIDING HARDI BOARD
Estimated Value: $4,500.00
Issue Date: 3/15/2016
Expiration Date: 9/11/2016
PROPERTY ADDRESS:
Address: 320 1ST ST
RE Number: 169738 -0000
PROPERTY OWNER:
Name: PEAKE, LINDSEY CHANTAL
Address: 320 1ST ST
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $72.50
Total Payments: $76.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BE CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: t5 5(- k 0-11C ��
i Permit Number:
Legal Description - ? 7 t -cx -U Parcel # LOT E a is or B/C 2
oor • ea o t. q.
Valuation of Work $ -I-S'O Proposed Work h /cooled t
non- heated /cooled
Class of Work (circle one): New Addition ---- Alteration/ Repair Move Demolition poollspa window /door
Use of existing /proposed structure(s) (circle one): Commercial
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval # /(.,�ie_ ?LK P2
For multiple products use product approval form � 4.
Describe in detail the type of work to be performed: Ze- J(A- Ce___ ' , iCie
I / t� (/' `
Property Owner Information:
Name: G c---12-
Address: 3Ze) Ls* S
City 1 ►. ± t L ay' • StaterLZip. 3 z Phone 70 3 .-
E -Mail or Fax # (Optional) 1 c c•2 _ C K C_c)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Qualifying Agent:
Address: City State Zip
Office Phone Job Site/ Contact Number 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 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 ElectricalWork, 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 cent that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
ye 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.
iignature of Owner Signature of Contractor
'rint Na l-. r� ��, {�� k Print Name
lef' I e ,� " Before me
i . II ay o / /WA =� 20 this Day of , 20
rotary • u I is Notary Public
Revised 01.26.10