178 Beach Ave remodel permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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-2534
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR REMODEL - REPLACE PERMIT 13-3027
Interior renovation 1st Floor and 15-RAAR-1643 Vault Ceiling
Estimated Value: $500.00
Issue Date: 11/30/2016
Expiration Date: 5/29/2017
PROPERTY ADDRESS:
Address: 178 BEACH AVE
RE Number: 170210-0000
PROPERTY OWNER:
Name: 178 BEACH AVE LLC
Address: 6 E BAY ST SUITE 500
GENERAL CONTRACTOR INFORMATION:
Name: CANTRELL CONSTRUCTION, INC
CGC062514
Address: 1015 ATLANTIC BLVD QA MARK FRANCIS CANTRELL
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: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
sari, City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road tO/ (�n ^M A R_25, �(
Atlantic Beach, Florida 32233-5445 �F
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@wab.us Date routed: t
City web-site: hhp://w .mab.us
APPLICATIONREVIEW AND TRACKING FORM
Property Address: 1 7 CJ SewL4 fAV F De artment review re uired Yes o
^ ing
Applicant: 1�� Q / l O/`7� T &Zoning
Tree Administrator
Project: l f\J ` E,(?-I r)g- Long)-(< Public Works
Public Utilities
(� Public Safety
Fire Services
Other Agency Review or Pemtit Required Review or Receipt Data
Of Permit VerHled B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: proved. ❑Denied.
(Circle one.) Comments:
BUILDING / //
PLANNING 8 ZONING Reviewed by: Date:!
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 06114/09
Vt,rtr
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office (904) 247-5826 Fax (904) 247-5845 Co-R A A R-Z53q-
Job Address: 178 Beach Avenue, Atlantic Beach,FL 32233 Permit Number:
Legal Description Lot 5 Block 31 Atlantic Beach PB 5 a e 69 Parcel# 170210.0000
Floor Area or Sq.Ft. Sq.Ft
Valuation of Work$ 1500 Proposed Work heated/cooled non-heated/cooled
k Z4or-pa-MA—s 04 yyn# Pe ro-4 bf .
Class of Work(circle one): New Addition iteration Repair Move Demolition pool/spa window/door
Use of existing/pro osedstructure(s) circle one): Commercial Residential
fF anexisting structure,is a firesprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval# OFFICE COPY
For multiple products use product approval form
Describe in detail the type of work to be performed: V"t,?, £Y/3'reA76 eri AM
RQp[OkAA !� 13- 30Z7 m4errx ren -4, 1s1- F'(nor anc-(
Property Owner Information:
Name: 178 Beach Avenue LLC Address: c/o David Edwards,200 W Forsyth St.,Ste 1300
City Jacksonville State FL Zip 32202 Phone 904-699-5333
E-Mail or Fax#(Optional) dedwards@edcolaw.com
Contractor Information: ,r�, /�
Company Name: eR�L-L *ie��'u Qualify�in�gP Agent: /rl t41C l( Lir✓(
Address: 1� lK A4L„ rc 6/rlu City fHLFwY)'L J1164- S[a[e 0 Zip3-3
Office Phone 54S — IM 2 R Job Site/Contact Number ` Fax#
State Certification/Registration# GGG e O 7.S 1
Architect Name&Phone# —
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
APPlimtion is hereby made to obtain a permit to do the work and installations as indicated. 1 certify,that no work or installation has commenced prior to the
issuance af permit and that all work will be per(armed m meet the standards ofall Imvs regulating construction in this jurisdiction. This permit becomes null
and void Ifwark is not commenced within six(b)ma dis, or if construction or work is suspended or abandonedfora yyenod ofu (b)months at any time after
work is commenced. /understand shot separate permits mast be secured for Electdcal Work, Plumbing, Signs, Welb,Pocks, Furnaces,Boilers,Healers,
Tankaand 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 YOVIR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this,application and know the same to be true and correct. All previsions of laws and ordinances governing this
type of work will be complied with whether speciped herein or on. The granting of a permit does not presume to give authority to violate or cancel the
Provisions of any otherfederd,state,or local law ukumg construction or the performance ofconstruction.
Signature of Owner Signature of Contractor
Print Name 1 G�YGt'S Print Name _ .1y1 ArA lc_._,C...R*f7R �-
i!/�_�....._..... ... ......__......_......._......... .._...._............ ............ .. _
Swo and sor d 1 o e e SwoRdsoubsiftd before me
this Day of 20 thisy f 201 2
Notary Public UNotary Public
Revis 1.26.10
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