859 Ocean Blvd deck permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
-cot S)
RESIDENTIAL ADDITION
MUST CALL BY 4PM FOR NE)IT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RADD-2271
Job Type: RESIDENTIAL ADDITION
Description: NOC REQUIRED - front deck addition
Estimated Value: $33,871.00
Issue Date: 11/14/2016
Expiration Date: 5/13/2017
PROPERTY ADDRESS:
Address: 859 OCEAN BLVD
RE Number: 170246-0010
PROPERTYOWNER:
Name: MURPHY, ALISON J & ROBERT,
Address: 859 OCEAN BLVD
GENERAL CONTRACrOR INFORMATION:
Name: Raney Construction, Inc.
,CBC060368
Address: 19900 Independence Boulevard Groveland, FL 34736
Phone: - -
PERMIT INFORMATION: PUBLIC WORKS:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing
activities. Contact Public Works(247-5834)for Erosion and Sediment Control Inspection prior to start
of construction.
All runoff must remain on-site during construction.
Roll off container company must be on City approved list and container cannot be placed on City Right-
of-Way. (Approved:Advanced Disposal, Realco Recycling, Republic Services,Shapell's,Sunshine
Recycling and Waste Pro).
Full right-of-way restoration, including sod,is required.
FEES:
ENG REV RESIDENTIAL BLD $100.00
PLAN CHECK FEES $109.68
UTIL REV RESIDENTIAL BLDG $50.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BUILIHNG CODES.
AML CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
BUILDING PERMIT FEE $219.36
DEV-REVIEW SFR UNIT $50.00
STATE DCA SURCHARGE $3.29
STATE DBPR SURCHARGE $3.29
Total Payments: $535.62
PEIINUT IS APPROVED ONLY IN ACCO11DANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLOIUDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
BwItUngElepartment—_ - (Tobe assigned by4he Building Department:)
800 Seminole Road
Atlantic Beach,Florida 32233-5445 16-9-A06-Oalj
Phone(904)247-5826 - Fax(904)247-51145
E-mail: building-dept@coab.us Date routed: Inbol 1(0
Cityweb-site: http:/Mow.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ISCI oc'tan B\'JA.
Applicant: t-&A&N caftsk"'u) CPrtfinning &Zonin'bl
Tree Administrator
Project: ;rwj�- A�� OLitu�m
Public Utilities
Public Safety
ire Services
Dept Signature�.
Other Agency Review or Permit Required Review
of Pe 'it=PBY Date
Fionda Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management Dstnct
Amy Corps of Engineers
Division of Hotels and Restaurants
15�lvlsion of Alcoholic Beverages and be=
Other.
APPYCATION STATUS
Reviewing Department First Review- LyjApproved. ElDenled.
(Circle one.) Comments: /VO &
BUILDING
PLANNING &ZONING Reviewed by: W�4 Datelo_71�G
TREEADMIN. Second Review: ElApproved as revised. E]Denlal.
PUBLIC WORKS Comments;
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ElDenled.
Comments:
Reviewed by: Date:
Revised 05114109
k A- Ua
BUILDING PERMIT APPLICATION 16-O&CK- 6
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 OFFICE COP
Office(904)247-5826 Fax(904)247-5845
Job Address: 859 Ocean Blvd, Atlantic Beach, Fl 32233 PermitNumber: JlV_V-APO"�'
Legal Description RES LD 3-7 UNT PER AC Parre # - !>1
Floor Area of SqXt. y(l Fft�
Valuation of Work$ 33,871.00 Proposed Work heated/cooled 0 non-heated/cooled 154
Class of Work(circle one):<��ddition Alteration Repair Move Demolition poeil/spa(i�
Use of existing/pro osed structure(s) circle one) Commercial esideati
No N JA
If an existing structure,is a fire spriWer system installed?(Circle onell: Eoi��
Florida Product A
,gproval# see attached
For multiple pro nets use p`m_d_uc_ta_p_pmva_l fo—m—
Describe in detail the type of work to be performed: R�goove existing multi-story wood dec replacewith eckat2 ad
floor, add metal roof removing sliding g ass door on 3 story and replace with windows, ah privac at east
side of 2'floor deck per variance approval.
Property Owner Information:
Name: Robert&Allison Murphy Address: 859 Occan Blvd
City Atlantic Beach — ip-L2233 Pharie 303-
E-Mail or Feet#(Optional) State FL Z
Contractor Information.
Company Name: Raney Construction Inc. Qualifying Agent: Arthur V. Ran
Address:19900 Independence Blvd City ve d
Office Phone 352-429-0304 Job Site/Contact Number 904-234-2891 3 577 - e.1Z q- OW&
State Certifimtion/Resistration 0 CBC060368
Architect Name&Phone#Larry Willis&Associates Designers and Planters 904-268-381
Engineer's Name&Phone#Lee 1. Engineering, Inc. 9D4-519-1934, cell 904-234-3518
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Leader Name and Address
Ou licahon is hereby made to obtain a punnit to do the work and as indunmed I ce?16 then no wm*or installation has mems;mWd u,r k
5 issuance of a remit and that all work will begelbrined to meet the standards of oil laws mgulafin§consm,,tion in this Jurisdiction. Posen
becomes nulland wid Vwork is not commeoced wi in six(6)months,orloconel,wetion orwark issuspen edorab _I
at.yame after work is commenced. I understand tharseparate,permits must be seeuredforE aadmw%.(;rawrfiodA.�,ixVmomh,
Bodare,Heaters; Tanks andAhr Conditionem,de kauic;d Work;Pk-b-g
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.
lhemby cerq&hhatlhme mad and esamened thes apphoo0on and know the suans,to be me and correet AllprmsumeoflaweandordammeregmememS
this type ofworkmll be emeephedwith a adheminornot. The grooming ofaluesnut does notpresume to give authority to violate a,Cancel th,
preansionsofanyotherjederal.. a constrecomartheperformanceofcomerucition
SignatuiaofO er Signature of Contractor ue--
Print Name P e t" Print Name APjyr'� - -
4W�
Swo d subscribed before me Swom to and subscribed before me
Tl,,M!D,y of 20 1 TThis Day of 1;��Ik C
BRrrrAXV N KEPP Mi ME=1.M,
My COWISSION F
My COWISSION F
Notary Public 60 'y Public
EXPIRES O�11. 11 WIcd 01.26.10
"MMW F�M -
NOTICE OF COMMENCEMENT
11PREPARE N DUPLICATE)
Permitnio. 149- 19&D0-=11 Tax Folio No.
Sum�of Fc�da CMmy of D.1
To whom It may concern;
The undersigned hereby Informs you that improvements will be made W certain real property,and In
accordance with Section 713 of the Florida Statutes,the following Information is stated In this NOTICE OF
COMMENCEMENT,
Legal description of property Ming impwvecl� RES LD 3-7 UN ITS PER AC
Address of property using improvarl: 859 Orean Blvd, Atlantic Beach, FL 32233
glass door on 3rd story and replace with windows,add minsvoy scresn at east side of 2nd floor clsol,par varianoo al,soval.
Owner Robert Murphy
Address 859 0oaam Blvd,Atlantic Beach, FIL 32233
Owners interest In she of me impa"emeart Omer
Fee simple Titsholder(9 miner than owner)
Name
Address
Cori Imcbm.Raney Construction,Inc.
Add,,, 19900 Independence Dr.,GmwIaM,FL�i?216
Prior,No.904 234 MI Fax No. st`1�2149
surely fit MY)
Add.. Amount of bond$
phone No. —Fax No.
Name and address of any person malkinga ban for Me construction dme improinariends.
Name
Address
Phone No —Fax No.
Name of person willun the StatevfFlorkla,otherthen himself.designated by omnar�pon-whom notices or Mier
documents may M sa�d:
N., Jerre Edwanis
Address 378 Ahem St,Atlantic Beach, FL 32233
Plxbne No� an"�Ml Fa No,844-583-2149
In addition to himself,owner Mentmates the following person to receNe a copy of Me Lenora Notice as provided in
Section 713.06(2)to),Florida Spatulas,(Fill in at Owners optbn).
Name
Address
Phone No. Fee No.
Expiration date of Notice of Ccrimmunceement(Me expiration date is we ll)year from the clate 0 recording wAfts a
different date is sjueeffiern:
THIS SPACE FOR RECORDER'S USE 0 NLY Q
WE? I I , i
In
Number Pages 1 6 P-96219, 4 U
'er:'
Doc a 2016261085 OR 13K 1777 Me.,Jus 9 hanen
ft. nds 2
Recorded I I/15f�01 6 at 08 09 AM 0
Ronnie Fus,,,11 CLERK CIRCUIT 6OURT DUVAL
COUNTY
RECORDING$10.00
153= im
OFFICE COPY
Norsk.
D �IGN
1011012016
RE:Deck Plans for 859 Ocean Blvd.,Atlantic Beach, FL 32233
To Whom It May Concern:
Norsk Construction and Design,Inc.releases ownership of architectural plans/drawings to Raney
Construction for the above mentioned property.
If you have questions, please feel free to contact our office at 904-372-7166.
I!
Respectful
Z
le Edwards, President Norsk Construction and Design
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10
CITY OF ATLANTIC BEACH
800 Seminole Road
Atlantic Beach,Florida 32233
Telephone(904)247-5800
REVISION REQUEST SHEET OR FAX(904)247-5845
CORRECTIONS TO REVIEW COMMENT
Date: Received by:_ Resubmitted:
1-t 1!00 Ltt KADo-
Permit NR r: I , -
Original Plans Examiner: Project Name:
Project Address: A
Contractor:'2Affi,!J tact
Con Name:
Contwtft�a qd4. ,%Sq.2Gq, Contact c-rmul:J�Aww (?&T1SeAMJ�,6, LLS
Revision I Plan Check/Pcmnit Fee(a)Due: S_
Descriltion of Proposed Revision to Existine Permit:
10 -1
,Ai,j4kd
An"J
Additional increase in Building Value: $ Additional S.F.
Site Plan Revised: b �&- --f—Public W I U Approval:
By signing below.I qml—) :ran.%; L. "U.)"45 affirm,that the above revision
is inclusive of the pMsed Chang".
-J 1 1,0,10 0 1(0
G42�
S—ignat Umf Cofftractor/Agent Wmmw�siP if in�in vWmim)
offi.UR ly
ApMr..d: Rdmw G W by:
Plan Review ECotmnments7: --�o�U'�Y �01
NDo rhment rev aw to uIred Yos No
Building
Plannin orm Plans Examiner
Tree nistrator
Public Works d
Public Utilities
Public Safety Date
Fire Services
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road "a-MOO-zatJ
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: —in Ltok
City web-site: http:/Mr�wcoalous
APPLICATION REVIEW AND TRACKING FORM
Property Address: C6sci DuAll S\�A- DeLpartmentreviewrequired Yes No
u, 7
Applicant: tanAN CbiNafwA�L)iri Id 05'.zoni-Rh
T inistrator
Project: �,Dm- A�LL alw-VAA (VUbric-Work L� -
Public uvinies-)
Public Safety
Fire Services
Other Agency Review or Permit Required --ke—view or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
DM(Ision of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: E]Approved. [&Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed bv Date:Ay,�
TREEADMIN. Second Review:
,gApproved as revised. [-]Denied.
PUBLICWORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed b 4A;;r'z 6'f_���!Daatee:�JLz
FIRE SERVICES Third Review: ElApproved as revised. DDenied.
Comments:
Reviewed by: Date:—
Revised GW1"9
BUILDING PERMIT APPLICATION
CITY OF ATLANTTc BEACH
800 Seminole Road, Atlantic Beach, Fl, 32233
Office(904) 247-5826 Fax(904) 247-5845
Job Address: 859 Ocean Blvd, Atlantic Beach, F1 32233 —PermitNumber:
Legal Description RES LD 3-7 UNER PER Parcel#
our �rea of
Valuation of Work$ 33,871.00 ProposeAcork heastlttcoolled 0 noEh"teated/cooled 154
Class of Work(circle one):<Z:�ddrtion Alteration Repair Move Demolition pool/spa
Use of existing/pro osed structureQ) circle one): Commercial
If an existing structure,is a fire spriWer system installed?(Circle one)q4&�� N/A
Florida Product A.Sproval# see ch
c�For multiple pro nets use pro ppd al form
Describe in detail the type of work to be Ferformed: R�pove existing multi-story wood dec%repl;ce withAeck at 2�
E I cN
floor, add metal roof, removing sliding g ass door on 3 story and replace with ivindows, ad y L a east
side of Zn' floor deck per variance approval.
Property Owner Information:
Name: Robert&Allison MuMhy Address: 859 Ocean Blvd
City Atlantic Beach State FL Zip 32233 Phone 303-
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Raney Construction Inc. Qualifying Agent: Arthur V.Ran
Address:199001"dendence Blvd city cland
Office Phone 352-429-0304 Job Site/Contact Number 904-234-2891
State CertificationfRegistinnion 4 CBC060368
Architect Name&Phone#Larry Willis&Associates Dmismers and Planners 904-268-3814
Engineer's Name&Phone#Lee J. Engineering,Inc. 9D4-519-1934. cell 904-234-3518
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
A d 'a "'a 'am has commenced pnort,
P 'e-by e d
_,a.
d 7'k
be,
o —e.'
T d.oadA�C
y
es'
W r
AZON 'To OWN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN AT`TORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
I hereby eerty�that I have mad and�wed thi,�ppfieatiaa aad knew efie e w be�a and carrect All p�isioas ofkms and orafinaa�es gmeming
this fyN q(wk toll be—P ied ah eii,�, sl hereinornot. 7-hegrmdngofapemitd"sn�pm�metog�eauthopiiytowol�or�ith(
P—Mon,Of--y arher�ideral.. g�Iru,fion or the pef�a qfc."Cilon
Signature of Oviner
Print Name f o * — Signature of Contractor
Vic?"I Print Name K-,r-jVj_v V.
Sworn to and subscribed before melf-Oftmaq Sworn to and subscribed before me
Tbis_��D Day of .20 IL9 This_��Dax of 'SLL
My= . , .
�=NSKEO
ao
FF 7, z IMA Y C�SS"R"0
Notary Pubbc a�Public fio�!FMSqep.1.1 N Cdol.26.10
f
TREE & VEGETATION AFFIDAVIT
City of Atlantic Beach
0
Department of Community Development
Zoning D"nlo'
il le Road Atla'
Planning&Zoning Division
8 800
005eminoleRwd Atlantic Beach,Fl. 32233
(P)904 247-5800 (F)904 2,47-5945 PERMIT#
SECTION I-APPLICANT INFORMATION F Owner(s) Legal Authorized Agent'
NAME OF APPLICANT j--jwi MAYO i
NAMEOFCOMPANY
ADDRESS OF COMPANY 1119W lhdozdaw A'A
F1
904-934-Me"L %'4-ba--716.4 EMAIL
CONTRACTOR CERTIFICATION NUMBER CR)CAU03Ld?>
ATL8CH BUSINESS TAX RECEIPT NUMBER
SECTION 11-SITE INFORMATION
STREET ADDRESS OF PROPERTY ()C_eoy,)
LEGAL DESCRIPTION
LOT BLOCK SUBDIVISION
REAL ESTATE NUMBER no2*-poio LOTOR PARCEL SIZE: SO FIF AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
I offirm that I have wiewed the Pr0VISIOns of Chapter 23, 'Protection of Imes and Native Vegetation'of the Municipal Code of
Ordinances I'm the City of Atlantic Beach FL andlor I how participated in a pr"pplication meeting with the Administrator of those
regulations. S land (hot no regulated trees and no regulated mgelation will be damaged destroyed and/m removed
fromfheal,4- t ties in conjunction with this project
SIGNATURE OF OWNER
Zoned am=before me n this QL day of f,�Dqd" , %ko ,by Stateof R&id(A
Countyof 7j�kWa
Identification verified: Qc�
Oath sworn: 1571 Yes F- Nor
BRITTANY N KEPP t,,ySIgnature- ' j
A My CONA $SIGN MFFa2W,6
'Ev EXPW&o�11.20" y Commission expirer. Q�plpnlr 11 , 1019
Ordered By f
The Law Offices of Rod Schloth
2187 S Third St
Jacksonvitte Bch, FL 32250
904-372-9351
beach@rod-law.com
PROF'EM ADDRESS: 859 OCEAN BOULEVARD ATI-ANTIC BEACH, 32233 SURVEY NUMBER: FI-1 204 1982
FIELD WORK DAME:11�11 REVISION DATE(%(—c �ez
0 p 5 �E8
mq� IG 1271 -32'� r '2,Rm WmG�z
R W.W or '.T I��L M-e',v, ec�) .11 C 102M
'e,.LL .111 `cr�Te`r.
2 15
SORURYSURVEY 0"2" 7�' 505-15M-f %.I�0) e bY32-1 F C 40..Q'
,e.".1. 1 1 ErOWIGW� %AW3 rl�.2'�t �40�.M
DUVAL COUNTY 5m"We %.G5.) alt,I.,
3,73M
?01-
90
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W LL
310
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.4 cm�.m "..'2�.m e)
I h�aty cetify:.t NOTEI
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Z.7.011L tl�19�ckm 0 20
�,d Of P.11, dc��r,let,d',, 0 �111
Ch.,W 5J�I
GRAPtHC SCALr (I. Feet)
I inch = 40' ft
ZONING REVIEW COMMENTS
City of Atlantic Beach
Building and Zoning Department
800 Seminole Road Atlantic Beach,Florida 32233-5445
Phone: (904)247-5826 Fax: (904)247-5845 Email: dneves*coab.us
Date: 10/31/16
Permit: 16-RADD-2271 Applicant: Raney Construction
Review: pt Address: 19900 Independence Blvd, Groveland
Site Address: 859 Ocean Blvd Phone: (352)429-0304
RE#: 170246-0010 Email: Not Provided
Correction Comments
1. Variance: Plans show a spiral staircase that is in violation of the approved variance.Please revise plans
accordingly.
2. Survey: Section 24-67(c)requires a certified survey. Please provide a certified survey.
3. Tree Removal: Please submit a Tree Removal Permit Application if any trees are to be removed. If no
trees are to be removed,then please fill out an Affidavit of No Tree Removal. Both forms are available
on the city website under"Planning and Zoning"and at City Hall.
Derek W. Reeves
Planner
dreeves@coab.us
City of Atlantic Beach APPLICATION NUMBER
B uticimnigDeparimment- (To be assigned by the Building Department)
800 Seminole Road
Atlantic Beach, Florida 32233- 24
Phone(904)247-5826 Fax
E-mail: building-dept@coab.0 Daterouted: IDLY011142
City web-site: http://�.coab us
APPLICATION REVIEW AND TRACKING FORM
Property Address: C%s oce-&t, mqA- De artment review required Yes No
i0Rw11Nng`_-)1
Applicant: tAn;,,�J Ugrak"an 2ra-nning &Zonln�j
Tree AdminisTrator
Project: OUWA�on 'c a
4'�ubfi_cUbl tfis�
Public Safety
Fire Services
—ileview or—Receipt
Other Agency Review or Permit Required of Permit Verified By Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St—Johns River Water ManagementD,�nct
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages andio-bacm—
Other:
APPLICATION STATUS
Reviewing Department First Review: OApproved. E]Demed (9/1) /Sp-/�W
(Circle one.) Comments: Ju
BUILDING
PLANNING&ZONING Reviewed by: Date—AC11 "_
TREE ADMIN. Second Review: ElApproved as revised. E]Denief
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [-]Approved as revised. [JDenied.
Comments:
Reviewed by: Date:
Revised 0511W09
______W1JUD_1NG_PERMIT—APPLICATION
CITY OF ATLANTic BEACH
800 Seminole Road, Atlantic Beach,FL 32233
Office(904)247-5826 Fax (904)247-5845
Job Address: 859 Oman Blvd. Atlantic Beach,F1 32233 PermitNumber: Ail_f-ADB- a�"tf
Legal Description RES LD 3-Z UN PER AC -- - — -- - - Pargel#
ipoor Area of Sq.Ft.
Valuation of Work$ 33,871.00 Proposed Work heated/cooled 0 non-heated/cooled 154
Class of Work(circle one):(::�ddition Alteration Repair Move Demolition poolfspa(j��
Useofexisting/pro osedstructure(s) cireleone): Commercial eside
If an"isting strucrure,is a fire spriWer system installed?(Circle one): es No N/A
Florida Product A.Sproval#__ see attached
For multiple pro ucts use product app"ovWrom—
Describe in detail the type of work to be rerformed: Rpgnove eyisting multi-story wood dec replacewith eckat2a'
floor, add metal roof removing sliding g ass door on 3 story and replace with windows, ah privac at east
side of 2"'floor dec�per variance approval.
Proputy O"er Information,
Natne: Robert&Allisonlifurphy Address: 859 Occan Blvd
city Beach State _ one 303-
HL—Zip 2233 Ph
E-Mail or F�#(Optional) K r3 Top
Contractor Information:
Company Name: Raley Construction Inc. Qualifying Agent: V
Address:19900 Independence Blvd ity Groveland
Office Phone 352-429-0304 Job Site/ContactNumber 9 -234-2891
State Certification/Registration# CBC060368
Architect Name&Phone# 68-3814
Engineer's Name&Phone 1 18
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
A
rlicationts he,eby mmic to obhoin apermit to do the wrk and installations,m moscausl Icer*ihano ok tall h hot
t , ism,ence ofaPemit and that all em*will begerfonned to meet the sbandani, �fajl'j�jr I ,o o,,. a on unmencedpnorte
becomet null andioul Vwrk is not commenced w bisix(6),nonthsoritcons truction in thisjurisdicifion. Thu=
Ms;7
atanytimeafieric.okiscomenenced. lumims hniion o'Wm*is JeY��atom doncdX;a ciodAsix
lend mat sepanne petmite mug be semoedfor ElectriaW---
Boiliff,Heaten, Tamb andAm Cond"t mtin�,me M, Kk boh, es,
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 WFM YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMtENT.
Iherebyeer*d�Ihavemadand�meddwapplg�mandkn�Aes=ewbe�mide�t Allpwnsems oflawn and ordmemcee gustming
this type f",*.Il be comphed��4th s a edhereinornot. The iormfing ofaNmjtdm nonlnennu togree mohonly to wolom m-cameel d,
P—Mons of my otherfedenti ni a cnm�c1bmorthmperfomanceofcom,,nbm
Signature of 0 Signature of
Print Name a e V f" Print Name
Sworn to and subscribed before me Sworn to and su 7scribed�cfte rnu-_A�
This *0
-,_Day of 20 1 Day of m I kin
BRFrTANY N
Notary Public W COWASSADN#F JAY�s"*Ff
40-W EXPREZOmteeti. I Public
City of Atlantic Beach APPLICATION NUMBER
ButIdhngDepartnmmt___–rCE1Vr7 (To be assigned by the Building Department.)
800 Seminole Road 16_
Atlantic Beach,Florida 32233-5445 9-A 0- 3a
Phone(904)247-5826 Fax(904)24R84PCT 1 1 2016
E-mail: building-dept@coab.us D�to m,t�d: 10LIOL 11
Cityweb-site: 1,11p:/M�.mab.us BY.—
APPLICATION REVIEW AND TRACKING FORM
Property Address: IS61 oc-e-ao fsW. 4C
y
,�aontmvrleWre wred Yes No
Applicant:
tAAAN biNfik"u) r_Pre–nning &Zonin%
ee Administrator
Project: �(Wk A�LL Ouim�m utrIc Works_:,I
rPublic Utilitieo
FP ublc��Sia�le� �
IFireno S",
Services
M'Pept Signature
OthorAgency Review or Permit Required Review t
of Penmft=PBy Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
&her.
APPLIOATION STATUS
Reviewing Department First Review: 5/pproved. [–]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE Second Review: EIAPProved as revised. E]Denled.
?p W Comments:
P
ICU
PUBLIC S Reviewed by: Date:—
FIRE SERVICES Third Review: ElApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Rwised 06114*9
BUILDING PERMIT APPLICATION
CITY oF ATLANTic BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 859 Ocean Blvd, Atlantic Beach, Fl 32233 PermitNumber:
LegaUDescription RES LD 3-7 UNT' PER AC Parcel 4
Floor Area of Sq.Ft. __Tq 7t
Valuation of Work$ 33,871.00 Proposed Work heated/cooled 0 non-heated/cooled 154
Class of Work(circle one):(:�_ w dition Alteration Repair Move Demolition pool/spa
�Ne
Useofexisting/pro osed.structure(s) circleone): Commercial
If an existing structure,is a fire spriler system installed? (Circle ole)1*11 � N/A
Florida Product Asproval# see attached
For multiple pro nets use_pnduet_app_rov@Tom—
Describe in detail the type of work to be Ferformed: R%nove existing multi-story wood dec%replace vit kgta2al
floor, add metal roof removing sliding g ass door on 3 story and replace with windows, adl privacy t&a t
side of 2'floor de-ck per variance approval.
Property O"er Information:
Name: &bert&Allis;onMuEphy__.Address: 8590ceimBlvd
City Atlartuc Beach State_EL Zip 32233 _. —Phone 303-
E-Mail or Fax 4(Optional)
Contractor Information:
Company Name: Raney Construction Inc. Qualifying Agent: rV.
Address:19900 independence Blvd City Groveland
Office Phone 352-429-0304 Job Site/Contact Number 904-234-2891
State Cortification/Registration 4 CBC060368
Architect Name&Phone#Larry Willis&Associates Designers and Planners 904-268-3814
Engineer's Name&Phone#Lee J. Engineering,Inc. 904-519-1934, cell 904-234-3518
Fee Simple Title Holder Name and Address
Bonding Company Name=it Address
Mortgage Leader Name and Address
1pficadon is hereby made to obtain a permit to do the uork and installations at indavied I runty,dust no uark or imeallation has commen
isdaince of a permit and that all wwrk utill be . wd.pnorzo
,rdbrmed to meet the dandants,of all Zows mgulah;3 construction in thisposde, 0. apermis
becomes,null andwid jfuork is not commossoad wr h six(6)monda,orifcondruction orwarkissms orab
at anytime afier war*m commenced. lonaternand thatsepanvelonmin mud be securedforElecirle p_e ad andonePr a modfifsir 9 months
an
B&AM,Heaters, ranks andAir Conefithmerv,da d Work Phunhing, Wm, igis, �mh, unorm
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 WrM YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTTCE OF COMAIENCEMENT.
Ihemby cerdy,that lhave read and esammed#as applicamon and Amuse the same m be true and corect Altionoodons,ofl"s and ordmanors gmerning
thar ippe ofuork mil be complied with s q edheremormst. The gnmung ofateersoutdoe,notpredane ingive authority us violate or,docel sho
Prenossone f."otherfederal r re a eamuuchnnortheperforousueofcou,naction.
Signature of Ovine Signature of Contractor
Print Name e V f" Print Name Nylitw&�WAI
Sworn to and subscribed before me Sworn to and subscribed before me
This Dayof 20 1 1
Day of �111_ mlo
8PJ"AUV UK
MYCOWISS40NOF
Notary Public s;�
4- W EXPRiEsoclabW11, Public T ed0l.26.10
1911�1.
Ordered By:
The Law Offices of Rod Schloth
2187 S Third St
Jacksonville Bch, FL 32250
904-372-9351
beach@rod-law.com
PROPERW AUDRESS: 3S9 OCEAN BOULEVARD ATI-ANTIC BEACH,Fl.,rd.32233 SURVEY NUM9ER: FLI 2NA 982
HELD WORK DATE:V2�MI2 KVISION DATE(S): -0
O.P 9B&4
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Ordered By;
The Law offices of Rod Schloth
2187 IS Third St JA,
Jacksonvffle Bch, FL 32250
904-372-9351
beach@rod-law.com I NO
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PRCIPFR�ALORESS: 859 OCEAN BOULEVARD AT1-4NTIC BEACH, FID,Dde 32233 SURVEY NUMBER:FL12� 982
FlEl-DWORK DATE:4121.12
R�VISJON DATOS): �IDQI
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