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372 3RD ST - DRIVEWAY 1 f CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD N� ATLANTIC BEACH, FL 32233 J /-• INSPECTION PHONE LINE 247-5814 DRIVEWAY PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-DWAY-2751 Job Type: DRIVEWAY Description: REPAIR DRIVEWAY NEW CONCRETE Estimated Value: $3,500.00 Issue Date: 1/11/2017 Expiration Date: 7/10/2017 PROPERTY ADDRESS: Address: 372 3RD ST RE Number: 169788-0000 PROPERTY OWNER: Name: HOLMES LIVING TRUST, MARK, * Address: 275 BEACH AVE GENERAL CONTRACTOR INFORMATION: Name: ELITE CUSTOM HOMES & RENOVATIONS INC ELITE CUSTOM HOMES-JAMES KELLEY, CBC1260429 Address: 2304 Peach DR Phone: 904-686-4818 PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS: Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A sewer cleanout must be installed at the property line.Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible. Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line (247-5814)to request an inspection from Public Works 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(Advanced Disposal and Realco Recycling). Container cannot be placed on City right-of-way. Full right-of-way restoration, including sod, is required. FEES: DEV REVIEW-SINGLE & 2-FAM $0.00 PER\11'F IS APPROVED ONI,lIN ACCORDANCE WI'I'II ALL 0111' OF ATI.AN 1'IC IWAC11 ORDINANCES AND '1IIE FLORIDA BUILDING CODES. �� 4 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD .'!;;: ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 4-401119 UTIL REV MODIF OR ROW $0.00 Total Payments: $75.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND 771E FLORIDA BUILDING CODES. ,sr=�`�r,�, City of Atlantic Beach APPLICATION NUMBER Building Department 800 Seminole Road (To be assigned by the Building Department.) Atlantic Beach, Florida 32233 5445 (�(,c j Pt- _Z`7 C, ( Phone(904)247-5826 • Fax(904)247-5845 o;i1>r E-mail: building-dept@coab.us Date routed: I z 9 i City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ?Z �-�- Department review required Yes No Applicant: ELI ( C uS r.;v.11 10,,n£ anning &Zoning) Tree Administrator Project: (R G pft.1 R S) VF Lx.3 a ublic Works bac Utilitie 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: N,pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by' Date: 4//f//` 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 City of Atlantic Beach APPLICATION NUMBER e Building Department E 4 (To be assigned by the Building Department.) J• - ,�,:�,p 800 Seminole Road Vff ^� Atlantic Beach, Florida 32233-5445 DEC i I C ,` Oft.) A_L( `Z ( 5 ( Phone(904)247-5826 • Fax(904)2 - 845 2Q16 . o E-mail: building-dept@coab.us Date routed: z C City web-site: http://www.coab.us B' j j / ^! APPLICATION REVIEW AND TRACKING FORM Property Address: 37 z 3 �-�- Department review required Yes No ff Building__.__..__ Applicant: E(-� T T . C c.),sT ,l C �C:,-Y� anning &Zoning Tree Administrator Project: I G Pf-t ( t Ve L y lic 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: [Approved. ❑Denied. -61,2-47,1b (Circle one.) Comments: Jeer ,74,/ _/{o _ B fora [ BUILDING fL�,p� G(J PLANNING & ZONING / Reviewed by: d /Date: /2-AS-4 TREE ADMIN. Second Review: I 'Approved as revised. I ID •nied. 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 LA,y;yJ, City of Atlantic Beach . -'.1,„,,,, APPLICATION NUMBER �s -jijiti Building Department 1: (To be assigned by the Building Department.) r • . ` ", 800 Seminole Road wor i'l u Atlantic Beach, Florida 32233-5445� C�� Cr ;— ��(,� l _�7 C Phone(904)247-5826 • Fax.(904)247-58 54O/5 r,o E-mail: building-dept@coab.us'�, Date routed: ` Z- C I .0 City web-site: http://www.coab.us ,-`\\ APPLICATION REVIEW AND TRACKING FORM Property Address: S7 z -3 F-ct -K- , Department review required Yes No r___ ( Building.__-.__.._..__ Applicant: Lt t C C usTon,l 6-ne CrTanning &Zoning) DTree inistrator Project: (\GP t P. (2_(V F.w Pr u Iic works is Utilitie 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: Approved. ['Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:_4i t✓, /C Date: /27\i/ IG. TREE ADMIN. Second Review: I 'Approved as revised. ❑Denied. k0•WOR S Comments: cri _ PUBLIC UTILITIES 12-/ 2 -t4 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 -\sBUILDING PERMIT APPLICATION j ir CITY OF ATLANTIC BEACH .� / 800 Seminole Road,Atlantic Beach FL 32233 ��,''t,r. Office:(904)247-5826 • Fax:(904)247-5845 r Job Address: S 7�', rd A--A/ i > A Permit Number: Legal Description RE# I (o�'l 7 2)PD --00 0 c Valuation of Work(Replacement Cost)$?z)0C0 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 Resider • If an existing structure,is a fire sprinkler system installed?(Circle one): es 0 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: RE.POv� '—No i t tJ a 0Cy`i �� Z 3 e ty -(-)tow-,- tG,H T a F WALT 6',tie-�c.\tit I t—}0 Ke- Florida Product Approval# N.D d ( RGC25 for multiple products use product approval form Property Owner Information Name: lilac R. l4o['s Address: 3 7b 3 ra City 4-aloofit-- ' 11 State E1 Zip 3.2237 Phone 90q— 24"6 034-3 E-Mail 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: AMe 6i4-4/vv. /1 R Pt' � Qualifying Agent: ( &'4`4'5 I ��.y/ Address: 2309 Pe4cdi Pr City .;.wcfG6 -;''!lC- State Zip 32z4-& / f Office Phone c" 'Y X 3 --"-i 3C-2 Job Site/Contact Number Wa1, -6 ,4—Ltce 1 . State Certification/Registration# G 13G/V4 0112 7 E-Mail s A 4x,--511,--,.494i Zit- ® //,,00 t'C � Architect Name&Phone# f Engineer's Name&Phone# • Worker's Compensation xen nsurer / Lease Employees / Expiration Date Application is hereby made to obtain a permit to do the work and installations as indicated. I cert,fy that no work or installation has commenced Tnor 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. his permit becomes null and void if work is not corn en.•d within six(6)months, or if construction or work is suspended or abandoned fqr a period ofsir(6 months at any time after ork is co,m.nc:.. I understand that separate permits must be secured for Electrical Work,Plumbing, Signs, Wells,Pools,Furnaces,Boiler -at' ,T'nk a Air Condit',, • s,etc. Signature of Property Owner: r f 1 Signature of Contractor: ifek'rr"*"./11( Before me �j this el Day of b et-D-trl.b-9--{ t \l0 Before me this cl / 401rDay of -D 2ul...rt1 1/4Q¢.{ 1 , c,(c., Notary Public: \'.i AA— Notary Public: 1 - 1511- I h !-r lo% ;(i Ji,t tat ,FtE JoHN37G)t�l exon red this application and know the same to _ • . -•, • - •', , 1.ws and or 404,"� re .. ., notA po d lrll be com lied with whether specified her I ' P ,e g;, „ <,�__�tf )'es not pr i ,e a , . �a. , ;fpr crPcel the provisions of any other federal, sic lip- q Ir, ,r� ' ' rrrr., ,,, ,hr Pe' 1 , t,.s..."Siiiig l�ryrueiicurw«v�tMrs ri ,•• �` •'a1� az81� L _" —_—• I :,, ?;' EXPIRES: c �, f}'tl '''''l,l:�'' Bonded TFw No i:5t,��i � 13.E 75' )3.r" '1!1- . LT Q 3 Hb" 24.10~ 26;0" IZ' _fir. __.--____ .__ . ._. 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