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2109 FLEET LANDING BLVD - INTERIOR BUILD OUT fS, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ��JJiI>r COMMERICAL ALTERATION/OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-CINT-2032 Job Type: COMMERCIAL INTERIOR BUILD-OUT Description: INTERIOR REMODEL - RELOCATE KITCHEN & BATH Estimated Value: $6,000.00 Issue Date: 9/15/2016 Expiration Date: 3/14/2017 PROPERTY ADDRESS: Address: 2109 FLEET LANDING BLVD RE Number: 169397-0200 PROPERTY OWNER: Name: NAVAL CONTINUING CARE Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BOULEVARD GENERAL CONTRACTOR INFORMATION: Name: NCCRF NCCRF JASON HOLDER, CBC1254586 Address: JASON PAUL HOLDER JASON PAUL HOLDER Phone: - - PERMIT INFORMATION: I FEES: PLAN CHECK FEES $40.00 BUILDING PERMIT FEE $80.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $124.00 PERMIT IS APPROVED ONLY IN ACCORDANCE Wan ALL CITY OF ATLANTIC BEACH ORDINANCES AND TILE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH1 F P' . 800 Seminole Road, Atlantic Beach, FL 32233 FILL: kc a i Office(904) 247-5826 Fax(904) 247-5845 Job Address: P/09 F/6 gle, 629jO Permit Number: / —C /i/ 7-— ,)0 3 2 Legal Description Parcel # Floor Area of Sci.Ft. Sq.Ft Valuation of Work$ C000 Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteratio Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial 'esidenti. 1 If an existing structure,is a fire sprinklerinstalled?system (Circle one): , No N/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: a.,./.., �� ,‹ _ � - , , �� Property Owner Information: / Name:NCCRF dba Fleet Landing Address: 1 Fleet Land. 'd City Atlantic Beach State FL_Zip 32233 Phone 90' 431 E-Mail or Fax#(Optional)jholder@fleetlanding.com Contractor Information: Company Name:NCCRF dba Fleet Landin Address:1 Fleet Landing Blvd City A • eVT Office Phone 904-246-9900 xt 431 # State Certification/Registration# ' • 67 Architect Name&Phone# e" Engineer's Name&Phone# a' e Fee Simple Title Holder Name art •(." • Bonding Company Name and Addi `c.'" Mortgage Lender Name and Addressli Application is hereby made to obtain a permit to 0 ,ork or installation has commenced prior to the issuance of a permit and that all work will be pedb _don in this jurisdiction. This permit becomes null and void if work is not commenced within six(6j mo .toned for a period of six(6)months at any time after work is commenced. I understand that separate per ding,Signs, Wells, Pools, Furnaces, Boilers,Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: 1 O RECORD A NOTICE OF COMMENCEMENT MAY RESUL. .PING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN _ JBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORN. 'ORE RECORDING YOUR NOTICE OF COM. .I NCEMENT. I hereby certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state,or local law regula ' g construction or the performance of construction. Signature of Owner Signature of Contractor ,(/::7!"----1°... Print Name Jason Holder Print Name Jason Holder Sworn to and subscribed before a Sworn to and subscribed before me this 9"• Day of S4 , 20)0 this Cell Day of 4.40-1m n , 20) (o Notary Pub c NntartP,,•)ic ie�� SHARI R QUEST „4� ry��. SHARI R QUESTi�`� �°` P'.`.... i ed 01.26.10 •' " •' rn .,•1 MY COMMISSION#FFO€ 4 t MY COMMISSION#FF068247 gni% °'' ,'••4i �', r EXPIRES November 4.2017 ?or fv,... EXPIRES November 4. 2017 '''•Eosn;./ (407)398-0153 FloridallotaryService.com (407)390-0153 FloridallotaryService.com i./ City Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) f..." `i 800 Seminole Road Atlantic Beach, Florida 32233 5445 0 —al/VT-703Z_, wPhone(904) 247-5826 • Fax(904)247-5845 +l ' '.r;,.1,,,• E-mail: building-dept©coab.us Date routed: 4111' ( City web-site: http:llwww.coab.us APPLICATION REVIEW AND TRACKING FORM + 1 , l.ci & Z.OC)0 Property Address: 2 1 09 I I��`- �n Department review required Yes No \ 1 (�-- <� uildi�> ✓ Applicant: .) CC R 1- 1 Zoning Tree Administrator Project: I N (G- �-- PLpj-` RdAivT:) i -G-_-C__- 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: roved. ['Denied. (Circle one.) Comments: IV o C- BUILDING /V� C� PLANNING&ZONING Reviewed by: /, ! , Date: ` -1 471-/GTREE ADMIN. V 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 07/27/10 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH � 800 Seminole Road, Atlantic Beach, FL 32233 [ 1 col_ t+ Office(904) 247-5826 Fax(904) 247-5845 Job Address: " 19 i , . .AI. Permit Number: l��—C /7/ 7-- 0 3 2 Legal Description Parcel# Floor Area of Sq.Ft. q. t Valuation of Work$ 6 pOO Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteratio Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial 'esidenti. If an existing structure, is a fire sprinkler system installed? (Circle one): No N/A Florida Product Approval# For multiple products use product approvalform Describe in detail the type of work to be performed: ,e0A•f.' L,/ ,fi �. x;7/, / , '#.5.-/471 Property Owner Information: / Name:NCCRF dba Fleet Landing Address: 1 Fleet Landing Blvd City Atlantic Beach State FL_Zip 32233 Phone 904-246-9900 xt 431 E-Mail or Fax#(Optional)jholder@fleetlanding.com Contractor Information: Company Name:NCCRF dba Fleet Landing Qualifying Agent: Jason Holder Address:1 Fleet Landing Blvd City Atlantic Beach State FL Zip 32233 , Office Phone 904-246-9900 xt 431 Job Site/Contact Number 904-219-4002 Fax# State Certification/Registration#CBC 1254586 Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address 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 pe ormed 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 six6)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 YO�JR NOTICE OF COMMENCEMENT. I herebycertify 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 type ofworkwill be complied with whether speci led herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state,or local law regula ' g construction or the performance of construction. Signature of Owner Signature of Contractor 4 :::17/;71°...- Print Name Jason Holder Print Name Jason Holder Sworn to and subscribed before ipe Sworn to and subscribed before me this 911` Day of .'qA1,rl , 2010 this Day of 4,40-1,1 L , 20) (o NotaryPub d� D>11.44Nntar�J P„hl;r...4-7s)1� kJYCX� /....",%\ SHARI R QUEST :g'"�”' `' SHARI R QUEST _+ ...... . ;_ ted 01.26.10 "I '•a MY COMMISSION#FF008247 EXPIRES November 4.2017 •' �; MY COMMISSION #FF( 8 1` '• iEXPIRES November 4.2017 •••,2a�d�:' ±�os�r•^ (407)399.0153 FloridallotaryService.com (407)398.0153 FloridallotaryService corn