1879 BEACH AVE RESIDENTIAL ALT PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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-1360
Job Type: RESIDENTIAL ALTERATION
Description: VINYL SOFFIT
Estimated Value: $2,400.00
Issue Date: 6/15/2016
Expiration Date: 12/12/2016
PROPERTY ADDRESS:
Address: 1879 BEACH AVE
RE Number: 169683-0000
PROPERTY OWNER:
Name: PETRONI TST,GERARD P & REIDUNN, "
Address: 1879 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: SANTA FE CONSTRUCTION
Address: 123 BOWLES ST OA CHARLES W DUREN, JR
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $31.00
BUILDING PERMIT FEE $62.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $97.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ylavr� City of Atlantic Beach APPLICATION NUMBER
Budding-0epartmis - - (T-be assigned by tie Building Department.)
"i•a SOU Seminole Road
Atlantic Beach, Florida 32233-5445 tt
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: hap:1lwww.coab.us
APPLICATION REVIE /W� AND TRACKING FORM
(`r�-
Property Address: �79 1`)F g 7'11/£ D ment review required Ye No
Building
Applicant: ���Y,g_-f=C— cS, T. a &Zoning
Tree Administrator
Project: Vt AiL9i 0P [ 7 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 B
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: QApproved. ❑Denied.
(Circle one.) Comments:
BUILDIN [[��
PLANNING&ZONING Reviewed by: Date: �a'�V&
TREE ADMIN.
Second Review: []Approved as revised. ❑Dented.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 0511V09
I
BUILDING PERMIT APPLICATION FILE COPY
CITY OF ATLANTIC BEACH
P 800 Seminole Road,Atlantic Beach FL 32233 /
p Office:(904)247-5826 • Fax:(904)247-5845 ' (:J—RAAR—1 5,,1 C)
Job Address: I8 79 Fe�c t, P,) Permit Number:
Legal Description /3�_ q –2 S – Z9 L RE#
Nla ement Cost) �k4o'—'ox'l'��
Valuation of Work -
(Rep Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition I er ' Repair Move Demo Pool Window/Door
• Use ofexisting/proposed structure(s)(Circle one): Commercial est
• 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 areto be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
ILLp lar. t bud co�4:Fr :it, l ve �C to / J F� t A/ rfl �Sav iFi�r
Florida Product Approval# _ /� SI�9 for multiple products use product approval form
Property Owner Information
Name: ti Address:J$7911 4 cj� Ax r blf(n i�dZ27T1
City wr.rty StateMZip 1L2J3 Phone Oo4� 2kF 6Sl'i
E-Mail'
Owner or Agent (IfAgmi,PomnofAaomey w Agency letter Requiredl
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 NOTRdE OF COMMENCEMENT.
Contractor Information:
Name of Company: Sa •ht Frl dr fi J cfN E P/ x, Qualifying Agent: Nxe e 1zJ %rpt.
Address: 50t,7,jgj dn. 1,0 City JA, , State Zip Ft_. Tz- 07
Office Phone��� tI 0 — 36 57 Job Site/Contact Number � t I — 716 3 7
State Certification/ICegstration# C�(z.-trg E-Mail Ck... IrraL�rc.92_
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation
xempt mare! a mp eye. P. to
Application is hereby made to obtain a permit to do the work and insmllahona os indicated. I cert fy that no n�irs ti enc
pnor 0 the issuance ofapermit and that al(work will hope m meet IM1e smMartG of a!!laws regal g nsnCekibh irl thtr/W15tM'cti
Tkis permit becomes nalt and void if war* u not commenced within six(6 morals, or if construction or x F ended or abandoned((o
pend o((six(6 months at any time after work is commenced. I undemta�that separate permlls must be sea /arab'
Signs,Welly Pools,Purnacu,Boilers,Heaters,Tanks and Ai ndaianers,etc.
Signature of Property Owner � 'f' ignature of Confggjaaaeeetttppp
Before me
this Day of / Before me this a of
Notary Public: Notary Public.
Noun PdZ sur Of flaw yfe�
oherebycertify rntg thisreang4 0Mi"� owthe samordinances governing this ry o k i er sped redhpresume to give puthoriry la ^lire-provisionsther fe eral, M lion or the
performance ofconstruclion.
Rev. 3/14/16