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715 ATLANTIC BLVD - COMMERCIAL CEILING WORK -Sr\i' '` '' S� CITY OF ATLANTIC BEACH rr J 800 SEMINOLE ROAD -' 1•'tisk: �) K r ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 05119"" COMMERICAL ALTERATION/OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-CAAR-1172 Job Type: COMMERCIAL ALTERATION Description: INTERIOR WORK AT MOBILE STATION - CEILING ABOVE STATIONS Estimated Value: $35,000.00 Issue Date: 7/13/2016 Expiration Date: 1/9/2017 PROPERTY ADDRESS: Address: 715 ATLANTIC BLVD RE Number: 177541-0000 PROPERTY OWNER: Name: PREM AND POOJA LLC Address: 7545 CENTURION PKWY SUITE 204 GENERAL CONTRACTOR INFORMATION: Name: SUNCOAST INDUSTRIAL & CONSTRUCTION SERVICES, INC. Address: P 0 BOX 330439 Phone: 904-662-3262 PERMIT INFORMATION: FEES: BUILDING PERMIT FEE $225.00 STATE DCA SURCHARGE $3.38 PLAN CHECK FEES $112.50 STATE DBPR SURCHARGE $3.38 Total Payments: $344.26 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 1(0 -C RAR.- 1 17 Z_ Job Address: 1 15 PA-64C, 3\1 1 . Permit Number: Legal Description Parcel# 1 T-7514 1 - 0000 Floor Area of Sq.Ft. q.Ft Valuation of Work$ - 5\l.--- Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alterati 9 Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): ommercial Residential insta an existing structure,is a fire sprinkler system • e one): Yes No N/A Florida Product Approval # For multiple products use product approval form • 1 Describe in detail the type of work to be performed: CC-- 1/ $0C C's' A�i`OO abt i r ., e )O<_ \VAi e-r,S) ; lua ��k .) 011it� mote l-;C -C r Ioe. e...o_ a.reet/J J Prope�2Owne nformation: v • Name: &LIG - -y.„0--Apos* 1 I(\C • Address: '.A_. _ L :�� ill— .0.....City 1-0.0 SCaiNv',l\�Q State. ...Zip ,2)2 oPhone �o Lk-- �Ra- 9 r X13 IE-Mail or Fax#(Optional) Contractor Information: \C� 1,-,d Lc5-�►-'•a-\ 4 Company Name:,( i,r'S.-k%—u. 'RR el Wit'\/1C�S_ i 1 Qualifying Agent: .t $. A. • / . 1 .Mb4 C Address:1 ). ''J�Jb j`1 City Auh-};� 'c State c.L Zip 3al3 3 Office Phone904-(dont-3 .tc a. Job Site/Contact Number `.O4-COCAa -,3a(oaFax# 90q - ( a -CVO, State Certification/Registration#_C G- 15 t$-11\ Architect Name& Phone# DorlaA,wte 4Ncrc,k,Je c-4-1.0v2 l "'" 5 2--$(p'1- 51 '4-s Engineer's Name& Phone# Fee Simple Title Holder Name and Address i`ki C(1 112 O/'A °y O LQ Bonding Company Name and Address chat ( _C'©,r, 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 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 herebycertify that I have read a • examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of ork will be complied it • ether specified herein or not. The granting of a permit does not presume to give authority to violate or cant•I the provisions of any other federa state, o ocal law regulating construction or the performance of construction. ,4, 1 Owner Signature of Contractor , ilA4 1 Ali vv: I J Signature of g Print Name A (o ,Pprt& Print Name Dayv~ _e 6.4 CI A. rt4 wK.�jpt o Sworn to and subscribed before me S and subs .-d before me this llp Day of (`(1 v1 ,20 \ L thi Day o t Y • i ,20 Ke ' li % tV_ ..1 ...I A— _e. 1j �'�:,.. et A 1 ' PERGER No .ry Public ,�°r; No Publi 1.-.-"I''-:''.1•,..7'84-;,1 . %.;,. '" `W►''i''! DANA 'w' EXPIRES: ••= 8,2019 •, MY COMMISSION/EE 198795 ' 0`: *•-!��.•r EXPIRES:July 18,2018 y'?R !4� Bonded Thru No. g ^d:Why` _ t.10 '•Pi, ° ` Bonded TTru rotary Pubic underwriters S!.ay;y,, City of Atlantic Beach APPLICATION NUMBER rf r Building Department (To be assigned by the Building Department.) 800 Seminole Road ii 6 // C/� s� Atlantic Beach, Florida 32233-5445 lD— A A-1Z - I 1 7 Z \: V � Phone(904)247-5826 • Fax(904)247-5845 �;;�>r E-mail: building-dept@coab.us Date routed: 5 /ZC�/I fc:::, City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM I\&oftrE S T STI oND Property Address: 71 c 3 P`C(\1\Yr( C b Lv LI De artment review required Yes No uilding Applicant:S t?n v• N80 `f-c-I Oj,l 4' g Zoning ' o nS rL c 4-L o n S e r V.ee-S /0 c..., Tree Administrator Project: Public Works i (, Public Utilities M CO 1 n , I n_T el' (O(' "� Re_ C r"l Public Safety /i Fire Services ., o'l Review fee $ Dept Signature Revie" 4 y Other Agency Review or Permit Required of Pr e ` ^�� Florida Dept. of Environmental Protection <-.7- Florida Dept. of Transportation •`/ 4%St.Johns River Water Management District k/(4 ,y Army Corps of Engineers ,' i Or Division of Hotels and Restaurants r Division of Alcoholic Beverages and Tobacco Other: 4n APPLICATION STATUS • il- Reviewing Department First Review: IF! A ••roved. ❑Denied. ��V (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: 6 lo 3 It 4 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑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