345 4TH ST - KITCHEN ALTER PERMIT :-5' . -- �S\ CITY OF ATLANTIC BEACH
-,"` j 800 SEMINOLE ROAD
U� .,,,,,,"9.5-)
;�' 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-541
Job Type: RESIDENTIAL ALTERATION
Description: kitchen remodel
Estimated Value: $17,000.00
Issue Date: 3/21/2016
Expiration Date: 9/17/2016
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:
PLAN CHECK FEES $67.50
BUILDING PERMIT FEE $135.00
STATE DCA SURCHARGE $2.03
STATE DBPR SURCHARGE $2.03
Total Payments: $206.56
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
r. City of Atlantic Beach APPLICATION NUMBER
',,,\ Building Department (To be assigned by the Building Department.)
800 Seminole Road-, Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845- E-mail: building-dept @coab.us Date routed: Y"1/ 47
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 36' /' —Cr P t review required Yes No
Applicant: 1( / r (isi)v--ek '�i Planning &Zoning
Tree Administrator
Project: , �,/� �� 44.0 di Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
~
Florida Dept. of Transportation
St.Johns River Water Management District _
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department I First Review: roved. ['Denied.
(Circle one.) Comments:
BUILDI V ô
PLANNING &ZONING
Reviewed by: 77 Dater/Y/1 6
TREE ADMIN. Second Review: ['Approved as revised. ❑Denie .
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Iv BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH 1 7 (TT!
.
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: ?C( S- 4(14 SI' - Permit Number: `6.- R 1 z-sq/
Legal Description Parcel #
Floor Area of Sq.Ft. q, t
Valuation of Work$/7/ I.ed. Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition A erat' Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial Res re tial
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 orm
Describe in detail the type of work to be performed: �,/ e.-T /rei+ote/ " (u s'1t X, s'e 4,7' .- l t A
tf ewi4 -t -
Property Owner Information:
Name: f IC"- d ^<ike / % 6u t /
y. Address: ?41 t(14' 5//c-ee f
City 4 t/µ-/.c / c ,
Stater(Zip ?do??? Phone 9 a S( goo -- 9'3(a 3
E-Mail or Fax# (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS: /
Company Name: f ti 4 I ( 5/X9 '4 SP�-r i e S Qualifying Agent: 1 fSe(( f/ f
g �
Address: a2 (4 �^//cA-f .6/ S,,le (( City df/c,b(- • c4 State fc Zip ?a(2.3
Office Phone 1 e c< -1 9 a26 Job Site/Contact Number Fax# ?7d -96/(
State Certification/Registration# CC ( i y to()y
Architect Name&Phone# ' 4.--se r '( foot - 3' 7S c--
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 tf 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 hereb certify that I have read and examined this a plication and know the sane to be true and correct. All provisions of laws 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 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 its %w� �1A►� Signature of Contractor �/L /t
Print Name �i y-i..d /v l CCGt.1�1/....I Print Name /,..S j '-(/ / f
Befo - • - Before ,
thi 4 !' D,y of Ai , JZ 20 / this Day of /J//.i/ 4 20 /
*// _ISPIK.e.0-- - t.riaa ' /• _ ` _.;+.
. .. _ .
.'std'uu re Shirley L Graham +►"� �' w i i- : ""
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