142 SYLVAN DR - ALTERATION fst, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
`, y
*"�'r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
1
1: 01,19'"
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RAAR-1939
Job Type: RESIDENTIAL ALTERATION
Description: install 2 windows and hardi-plank siding on south side of
townhouse
Estimated Value: S2,400.00
Issue Date: 9/6/2016
Expiration Date: 3/5/2017
PROPERTY ADDRESS:
Address: 142 SYLVAN DR
RE Number: 170646-0000
PROPERTY OWNER:
Name: DANSER, ELOISE B
Address: 3536 N UNIVERSITY BLVD STE 174
GENERAL CONTRACTOR INFORMATION:
Name: DANSER CONSTRUCTION LLC
, CBCO24179
Address:
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.
? "A1i:7-. City of Atlantic Beach APPLICATION NUMBER
�s * x , * Building Department (To be assigned by the Building Department.)
-,.4 j.:),1 800
Atlantic Seminole BeachRoFloadrida 32233-5445
1`bp-A_ PCS— —1
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L:r\:', ,
Phone(904)247-5826 • Fax(904)247-5845
011j9S� E-mail: building-dept@coab.us Date routed: Crit- I agI IkO
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 64 a Sy\V o-n •Di ,' L De artment review required Y714o
Building
Applicant: 1661.A j edOnStKLAiDA Planning &Zoning
Tree Administrator
Project: , (1 StC4 t\ a W•nc...,1 S Q /la Public Works
%\o-iA—pkant- S;d i M D In, SO urn Sidi Public Utilities
uf -1-pt,Jl1 h l7lrls 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: LApproved. ['Denied.
(Circle one.) Comments:
BUILDING /�
PLANNING &ZONING Reviewed by: ! Date: 3 v
TREE ADMIN. Second Review: ['Approved 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
OFFICE COPY Danser CO
BUILDING PE chrispanStr ►>1sf�W�vv\ ERMIT/�T
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Job Address: Sg26 • Fax: Cemhed F f
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Legal Descriptio L. , '. ill
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Description 4939
Co ` `.
Valuation ofmAkingg9@Yahoo.co -,
Legal
Work(Replacement Cost pe�111t m
Class o f ) RE#
ls------
Numl,pd �b_ �
• Use°fexisting-/prop
Work(Circle One): Heated/ R �
existin / New Cooled SF
• b proposed Addition
If existingstructures Alter �'°n-Heated
■ structure, is a fire sprinkle ircle one):Alteration Repair a C°oted�
Describe Submit a Tree Removal pe system • CO Mercia Mov Demo
e in detail Permit q installed? 1 Reside pool
the type Application if (Circle ntia] Wdow/Door
rr�-} t a of Work to be performed: any trees are to be removed
o Yes N/q
4-44
Florida craws or of
nda Product Approval # No Tree Removal
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Pro erty Owner Information ���.` fo"r
S�.-.Kame: < <4ryl t / rr s�S multiple products - T oma,, "L„
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use product approval form
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Address:
1, ::;S,,, _ State �iP 3
�wnerorq Agent -a 3 p
g (If Agent,Power of •i� hone �, '' 4;,
SD*TIN YOUR
Attorney or Agency Letter Required
-
1\l� GTO OWNER:
LT IN YOUR PAYING TWICE FO URE TO
0 OBTAIN FINANCING CONSULT
IMPROVEMENTSjECORD
FCORDING YOUR NOTICE OF COMMENCE TO A NOTICE OF
H YOUR LENDER UR pROPERTyEIF yOUNT tri\l-in.
Yntractor Information: MENT.
ORAIV ATTORNEY BEFD
me of Company: 4...s 4., ,.ti L
tress: 0 6 i �6 rZ s fiv :
ice Phone d Qualifying Agent:
�b't-'r3�r-Y s 3 R fob Site/Co City S ' ,/k �-oc
e Ceriification/Registratio # ,�Site/Contact Number o State Zip 1 L
iitect Name&Phone # E-Mail Y.Y �` 9 3q
neer's Name &Phone# �0 `~` ' �' ^ • If
ker's Compensation
Cmpt 'surer -ase mp oyees
ration is hereby made to obtain a permit to do the work nstaltatrons xp,rahon sate
to of a permit and that all work will be er c, as indicated. I certr that no work or instal/atro
nermil becomes null and void if work is not commencerd to meet the standarfy
d of six(6)months at an time a ter work is commenced. six(6 months, ds of all laws re indatrn n haserstand that °Y f constnrction g cd commenced
Wells,the issuance PoolsFurnace ,Boilers,Heaters Tanks an . separate e or work snStIectron in this jurisdiction.
nditioners,etc. permits must be secured or ppendec or abandoned
1 Electrical Work,Ph b°ga
nature of Prope I Signature of Contractor: / /1----
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OFFICE COPY
rs�1,y.J+, .
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
Office: (904)247-5826 • Fax: (904)247-5845
Job Address: ILO S`/LM ) OR. Permit Number: I tO -AA R-- 1°I 35
Legal Description RE# f 70 P16-DOQt'
Valuation of Work(Replacement Cost) $ ,7L(cr,OO 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 65 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:
`,�G/iQ: P`4,.-/Z: S .t�, w-v Oh � S('Lc ('!T 1OaLK l'i-J v'
Florida Product Approval# for multiple products use product approval form
Property Owner Informationor
Name: £LOI1/1
S6 ARD'S Address: /4 SYLVilk 13k
City ATC.ANTe AEAd.I4 State Ftzip 3=3 Phone ?Od- -4/4-y„/XS-
E-Mail EL/enyA,2i2s 6)VAlicko, e1)m
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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 Company: `�ay.-S-, Ca•+-s'r,ck• .a' Qualifying Agent:
Address: t b 6 s l6 t't. St ►u. City Ste,-•41 d'..,1- State Zip 3 1 L ,1
Office Phone 414 ti-Y1if- e f 3 9 Job Site/Contact Number goy-Y 3Y-`t•9 39
State Certification/Registration# C6 c o 9.`1` 1'19 E-Mail C.6 e"p k;,› qq & -4.a• C,,,.,
Architect Name &Phone #
Engineer's Name&Phone#
Worker's Compensation
Exempt / ' surer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work an. 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 U.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. /
` MLI -
Signature of Prope Owner: ���� //! Signature of Contractor: A
Bef me
I ,,
tln Day of i . O 1 CO Before met 's Day of Il�,A
1
-• II )/ Notary Publ • ( L
Notary Public: �
I hereby certifii that I have read a N. fined :m....:,r ,,n and know the same to be true and correct.41; )vi .1. +� PEN
ordinances governing this type o :,• 'il �, : i' , vhether specs ted herein or not. The f ' ��'; . t
gSiFt ,,,.: *c 1
presume to give authority to vio •a•; Iicee .IAEN-.rlsfgr any other federal, state, or local law re•�. 'i a.,Fon.F,XrR'� A.
t Till 19
performance of construction. \omcS Bonded imutet Notary sento ?,,ro,,RR�e BondedThruBudgetNotary nes
� rUbLA 1)� - 11 O-`t'i -04'1. 3/14/16
. 3/14/16