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770 PLAZA - ROOF CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 r iI ROOF PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-ROOF-756 Job Type: ROOF PERMIT Description: metal roof Estimated Value: $4,000.00 Issue Date: 4/4/2016 Expiration Date: 10/1/2016 PROPERTY ADDRESS: Address: 770 Plaza RE Number: 171286-0000 PROPERTY OWNER: Name: RAMIREZ, JOSE F Address: 770 PLAZA GENERAL CONTRACTOR INFORMATION: Name: NPS,INC. Address: 7442 SILVERLAKE TER QA JACK RICHARD SCHEKIRA Phone: - - FEES: PLAN CHECK FEES $35.00 BUILDING PERMIT FEE $70.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $109.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. City of Atlantic Beach APPLICATION NUMBER J3 Building Department (To be assigned by the Building Department.) 1 800 Seminole Road // ,0 „ ?�� o.� 4 Atlantic Beach, Florida 32233-5445 ' Phone(904)247-5826 • Fax(904)247-5845 z9 / s). E-mail: building-dept @coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 770 Pia La-- ment review required Ytes _No Buil�ing � v Applicant: /1//-5 Planning &Zoning LL Tree Administrator Project: G 1 -L 2� Public Works Public Utilities Public Safety Fire Services 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 First Review: WApproved. ❑Denied. (Circle one.) Comments: 1)oc___ NG PLANNING &ZONING Reviewed by: r Date: 3131/`6 TREE ADMIN. Second Review: ❑ pp A roved as revised. ❑Denied. 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 BUILDING PERMIT APPLICATION • Js 1.:11.A4,---,-..,;,\ \S 1,, CITY OF ATLANTIC BEACH FILE COPY \ r 800 Seminole Road,Atlantic Beach FL 32233 �rm-ti9r Office: (904)247-5826 • Fax:(904)247-5845 Job Address: 7 7 d 1/4,2--A' Permit Number: /6 '©o 1 -7 S6 Legal Description RE## Valuation of Work(Replacement Cost) $ 92t'O " Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s) (Circle one): Commercial Residential • If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: -----ni i n 9 I /eedi Florida Product Approval# 7 �7 /. (, for multiple products use product approval form Property Owner Information Yq ' . q -10 Name: 13 2 2 0 P14 z�__t _f vtI / � Address: City — 4! n Stat• Zip _ 3 - 'hone E-Mail (re-Owner or Agent (If Agent,Power of Attorney or Agency Letter Required) ` WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTI E OF COM L, ifJ RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YO R PROPER !,' Y U igii T‘ TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A �O'N' Y • - {� 0 q - i 0--RECORDING YOUR NOTICE OF COMMENCEMENT. / q O ,. �D Oti J ....e. - ,e1•1 .Contractor Information: ciserp - Name of C.Ani y: /V T Qualifying ant• JO-Ck. C ii 146 Q-'' Address: / Z /v�r L TA City --j1� V L State ZipPL 3 z z. l/ Office Phone Job Sit Contact Number State Certification/Registration# `/(1 3 E-Mail Architect Name &Phone# Engineer's Name &Phone# Worker's Compensation Exempt / Insurer / Lease Employees / Expiration Date 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. i ignature of Property Owner: ���tort at Signature of Contractor: Bef sx pie L thiso4'(Day of ���ib is i1 I / . Before me this _ i.• Notary Public: wring" Notary Public: / Air t. I hereby certifii hakkkay.e yc ile.sw ai- • a.'lication and know the same to be true and correct. All provisions of laws and ordinances got •rts1&akawill be coma ied with whether specified herein or not. The granting of a permit does not presume to giv: • alt�t�y omnd4FtASMATie p visions of any other federal, state, or local law regulating construction or the performance o o • It 02/14/2018 Rev.3/14/16 ice ,b. isy" BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH FILE COPY 800 Seminole Road,Atlantic Beach, FL 32233 Office (904)247-5826 Fax(904)247-5845 Job Address: f10 ?l 4,2Q. Permit Number: Legal Description Parcel# Floor Area of Sq.Ft. t Valuation of Work$ 'roposed Work heated/cooled If30U non-heated/cooled Class of Work(circle one): New Additio Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial Residential If an existing structure,is a fire sprinkler system insta •d? (Circle one): es No N/A Florida Product Approval# For multiple products use product approva form Describe in detail the type of work to be performed: Property Owner Information: Name: Address: City .to Zip Phone E-Mail or Fax#(Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: 5 7 Qualifying gent: �� K, Sc h Address: , ` G Office Phone �l.. �'� .v� oc, c . City 9 State, L Zip 393,q6 `�• •- Job Site/Contact Number Fax# State Certific. 'on/R•gistration# < < '- 0 ' t p 3 A awry 9 rchitect Name&Phone# f' AIMMIMIMIMIMIIIIIIIIEMMMIMIRAI. 4/ Engineer's Name&Phone# owir= Fee Simple Title Holder Name and Address ' Bonding Company Name and Address ���� + Q Mortgage Lender Name and Address 1 , L' Application is hereby made to obtain a permit to do the work and installations as indicated I t• tify that no work or installation has commenced pri.r 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 ertify 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 !ype of work will be complied with whether specified herein or ,ot. The granting of a permit does not presume to give '■ Iority to violate or cancel the 7rovisions of any other federal,state, or local law regulating : struction or the performance of construction. signature of Owner Signature of Contractor 'rint Name Mr/X Print Name 4'c f �S c/..?/-k_i.,az4 3efore me Be : . e its Day of I __. - ,, _ o 4101/2 E 0/ , 20 /6 N• LO• G �r1�• ii'� Notary Public- • Iota Public ,� Commission ,, * ';'� r, �- 1 '''' -��, A My Comm.Expires ov 1 8 `� -�''''ov ■ss" Bonded through National Notary Assn.■" Revised 01.26.10 1