1086 HIBISCUS ST - ALTERATION N41\\,,s...
in;S f CITY OF ATLANTIC BEACH
• . 800 SEMINOLE ROAD
Yy =" 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-1473
Job Type: RESIDENTIAL ALTERATION
Description: REPLACE 9 PIECES OF T1-11 WITH HARDI T1-11 SIDING
Estimated Value: $800.00
Issue Date: 7/7/2016
Expiration Date: 1/3/2017
PROPERTY ADDRESS:
Address: 1086 HIBISCUS ST
RE Number: 171002-0020
PROPERTY OWNER:
Name: FLORAN, HENRY & ELENITA, *
Address: 1086 HIBISCUS ST
GENERAL CONTRACTOR INFORMATION:
Name: SUPER SIDERS AND TRIM, INC
Address:
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $27.50
BUILDING PERMIT FEE $55.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $86.50
PERMIT' IS APPROVED ONLY IN ACCORDANCE WII'll ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
rr�'�r City of Atlantic Beach APPLICATION NUMBER
,� Building Department (To be assi ned the De artment.�:1.- - `� 800 Seminole Road g by Building Department.)
)1*- , Atlantic Beach, Florida 32233-5445 ) V� — R��� — 1 `t ��
Phone(904)247-5826 • Fax(904)247-5845
'''. .;...1.01/19'r- E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us ,
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 Darn k i (3r5aos s-r Department review required Ye No
uildin�
Applicant: S U Pe-_ S \ �-{-e_ `t- 1 t2 /y-1 Planning &Zoning
Tree Administrator
Project: 1 \ C P LA CE S ( 0 l N G 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 First Review: IT{pproved. ❑Denied.
(Circle one.) Comments:
( ILD )
PLANNING &ZONING ,--^ 9, . f
Reviewed by: � Date:
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
•
rO ..vE
i� '' BUILDING_PERMIT_APP_LICATIQN__
CITY OF ATLANTIC BEACH OFFICE-COPY-
---
800 Seminole Road,Atlantic Beach FL 32233
�`°'tIt) Office: (904)247-5826 • Fax: (904)247-5845 i l0-
RP Pk 2- 1473
Job Address: /0pE-/, ht 'u S S--)-. Permit Number:
Legal Description RE#
Valuation of Work(Replacement Cost) $ 4x--Y3 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 Residentia_
• 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 perfo ed::
i /// < . CST I ' 7-.7- 1/- LJ/T`` IICJ•(d 7Y-7i2
Florida
Product Approval# for multiple products use product approval form
Property Owner Information
iii
/
Name: I p i-Zt v� Address: it) 4' !�'(�' SCLI S Si
�T
City 1 .HP/
6 State{t_Zip 3f?3 Phone goy -
E-Mail G �
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required) t Le)ne!I
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.
Contractor Information:
Name of Corn..
/ ..�Ill�lt«s � iI /;/�'1� .erealif i _ A.ent .ere , ivies-
Address:
,rJ` City i/ .,&4 / I State p _ • t
Office P one '#j t/-4/7 '- 5g'_ , i Ob Site/Contact Number eye,/-ear- 3''
State Ce • • eati a istration# LXIII" E-Mail l e .
Architect Name : ° i - . r"1ti
Engineer's Name & Phone#,--------
Worker's Compensation 1j/'- L{a�-� ,1<t fraap (tom it Y2Vo i7
, E7xempt Insurer Lease Lamp yees / Vxpiration 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 regulati _ instruct on in this jurisdiction.
This permit becomes null and void if work is not commenced within six(6)months, or if construction o ,.r i suss• ed or abandoned for a
period o fsix(6)rnonths at any time after work is commenced. I understand that separate permits mus se secur : lectrica ' irk,Plumbing,
Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc.
Signature of Property Owner: _ '� Signature of Co .
Before me
this 07,2 Day of 3t.4i1- /c)(..)/ Before me t is 01 Da" • A i fr Zo(
,e i i;'••., Beth Ann Dowling
Nota Public: — " - ) Ct)MI.asS10N •#FF 137922 .,
Notary = Notary Public:
2 A-EXP1RES: JUL 01,2018
BONDED THRU •tit. TONI GIS• RGER
1
I hereby certify that I have read and exantttre stMAT NT c kbw the same to be true a, ci4 •'� CAM .; FF•+.s5's a
ordinances governing this type of work will be complied with whether specified herein or n :.'.;:;"` •..t„ Awe ,. t
presume to give authority to violate or cancel the provisions of any other federal, state, or lo a:•_,:-.__� - ___::_.._..-.....
performance of construction. -"'-
Rev. 3/14/16