168 SYLVAN DR - SIDING _S V1�
,, f -;)
r_. f, . ss , CITY OF ATLANTIC BEACH
'Q ._:, 1) 800 SEMINOLE ROAD
j 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-708
Job Type: SIDING PERMIT
Description: T-11
Estimated Value: $1,250.00
Issue Date: 3/24/2016
Expiration Date: 9/20/2016
PROPERTY ADDRESS:
Address: 168 SYLVAN DR
RE Number: 170645-0010
PROPERTY OWNER:
Name: GASTON, LOIS J
Address: 168 SYLVAN DR
GENERAL CONTRACTOR INFORMATION:
Name: FIRST COAST ENTERPRISES OF
Address: 920 9TH ST SUITE 20 QA FRANCIS THOMAS JOURA
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
PLAN CHECK FEES $28.13
BUILDING PERMIT FEE $56.25
Total Payments: $88.38
PERMIT IS APPROVED ONLY IN ACCORDANCE WI'111 ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: 1. _Og Sy i Liv4N JE Permit Number:
Legal Description io-It, a(-&-aq E. sTA: Se ti FT Lc)5-- 7()a Parcel#
loor
Area of Sq.Ft. Sq.Ft
Valuation of Work$ R-5O' Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)(circle one):. Commercial Re ' ential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: S; 2k=p Pr< An Fri L( Si!e c
Property Owner Information:
Name: Los et S7u N) Address: \10� �y L\ t r-
City r\Tl,,A , State FLZip 3 a-IR Phone 9 nu- 955- I S'o-j
E-Mail or Fax#(Optional) 1(S Derr.:, ta;,.. r.0 ••
Contractor Information:
Company Name: rc.k-r Coe oeNM R Qualifying Agent: FR_Ar.v.:, s p
Address:°lao OvE.AILLE, .3 I tN:I A City Jfv-v cry-3k): l t+ State r Zip 5C
Office Phone qQ4 -a-4a -010D Job Site/Contact Number C10 -aya-bt (Jo Fax#
State Certification/Registration# CRC( - 8 0\
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 aperiod 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,eta
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 a plication and know the same to be true and correct. All provisions of and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to g thority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.provisions
•O e 1
Signature of Owner O( Cam- Signature of Contractor iI 1)
Print Name Lo;_s ��� -j Print Name Atliff./ ,T`\P(J/a
Sworn to and subscri_bAbefore me / Swo o and subscribed before me
this /f Da of G� 20 /i• this Day of e,t/ ,20 le‘
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