1785 SELVA MARINA DR - REMODEL PERMIT J
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814 new window.
RESIDENTIAL ALT/OTHER
,„0„,„
MUST CALL BY PM FOR NEXT DAY INSPECTION: 247-5814AAR 2401
JOB INFORMATION:
Job ID:
16-R
Job Type: RESIDENTIAL ALTERATION
Description: Renovate and remodel bathroom, install
Estimated Value: $6,000.00
Issue Date: 1/11/2017
Expiration Date: 7/10/2017
PROPERTY ADDRESS:
Address: 1785 SELVA MARINA DR
RE Number: 172019-0000
PROPERTY OWNER:
Name: RODRIGUEZ, JASON
Address: 1785 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: 3 Rivers Construction Services LLC
, CBC1257732
Address: 6694 NW 31St St CIR
Phone: 386-209-4214
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $40.00
BUILDING PERMIT FEE $80.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BD PLAN REV. 2ND $50.00
SUBMITTAL
Total Payments: $174.00
1'ERMfI IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
„:51,i_vi ;, City of Atlantic Beach APPLICATION NUMBER
/ > Building Department (To be assigned by the Building Department.)
:- `�� 800 Seminole Road f (�_ �p �Ql
�� ” �� Atlantic Beach, Florida 32233-5445 l `� l -R
Phone (904) 247-5826 - Fax(904) 247-5845 13-5
.A•L 9•• E-mail: building-dept@coab.us Date routed: ICI 1{�] �
- '/ael(o
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1785 Se(uu Marina Or. D ment review required Yes No
uildin
Applicant: ,3 Is,,,,rs 40,0icx, Se-r1‘ceSLL Planning &Zoning
Tree Administrator
Project: 'X-'kAlroan--) rO\h„'fi,,n a"^ck `'\dc2.e_t) Public Works
Public Utilities
-1-t^ c1.\ W e Public Safety
Fire Services
.4. SSC). ,
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt I 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: , Date: //— 06
TREE ADMIN. Second Review: I 'Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. I (Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
cyIL/1142 ` el CITY OF ATLANTIC BEACH
800 Seminole Road
N n, Atlantic Beach,Florida 32233
r, iii, s0 Telephone(904)247-5800
7.5
r FAX(904)247-5845
II 01
REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COMMENT
Date:
1,1 C 4 1 t e Received by: Resubmitted:
Permit Number: 1 t0- t2 k4-C- 21D I �����
Original Plans Examiner: Project Name: ROtIfi �U.e�kst ieni ,
Project Address: I7gSeWC. ryLarincc O . 4-f OY1-1-'c 6,0__A /r,.`; 323
13
Contractor: 3 ewers ConslrU c-fi enc,ervt!Ce& Contact Name: ('uv-t- M(Dona?
of
Contact Phone : 38(a- a4C1- a01 4 Contact e-mail: 3rver c•S ot)cQ 3mai I. 0-0111
Revision/Plan Check /Permit Fee(s)Due: $ ,'22. 00
Description of Proposed Revision to Existing Permit:
pevist,,rl 0.c v.ltv\dows avid srecArafi& plAY►s
,� z Co . -
C .n lb Illk " • . 0 1 ' in '
Additional Increase in Building Value: $ 0. 0 C Additional S.F. O,QU
• Site Plan Revised: Public W/U Approval:
By signing below. I (Print name) T`)P Y tJ MCO Y � affirm that the above revision
is incl sive of the proposed changes.
(:)6 -C2-- t( (4C V ‘
Signature of 14 •ctor/Agent(Contractor must sign if increase in valuation) Date
Office Use Only
Date:
/I- -/ 6 Approved: (V Rejected: Notified by:
Plan Review Comments: 1
rOv a S S't. 1rnv�/.O, (6/to cd- rt /Vac oc-_
lel
P )I Pay I -' — —
Dep._ ment review required Yes o
tilting
Plann -oning — 111 lans Examiner
Tree Administrator
Public Works // - cc-/ La
Public Utilities
Public Safety Date (mated 4'l3 Ree 3
Fire Services __-
��
Is;
S. CITY OF ATLANTIC BEACH
r. AJ 800 SEMINOLE ROAD
J R • • 1 ATLANTIC BEACH, FL 32233
(904) 247-5800
'1.J1119�
BUILDING DEPARTMENT REVIEW COMMENTS
Date:
' Permit#: 16-RAAR-2401 Site Address: 4215 Snowy Egret Trail,
Site Address: 1785 Selva Marina Dr. Orange Park
Review: 1 Phone: 386-209-4214; 386-249-2074
RE#: Email:
Homeowner: Jason Rodriguez
Applicant: 3 Rivers Construct. Serv., Phone: 904-338-8388
LLC
pplication is disapproved for the following issues:
1. From the 2014 5th Edition Existing Building Code, chose a method of Compliance from ,
chapter 3 and Alteration level. This information shall be submitted on the cover page
)
(G1.0) under applicable codes. Resubmit 2 copies.
2. ut 2 copies of the Florida Product Approval Forms for the component and cladding
items on your project,fill out last page completely.
�_- J_c c. / / c /
Mike Jones
Building Inspector/Plan Reviewer
City Of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233-5445
Ofc (904) 247-5844
Fax (904) 247-5845
emai I-'d 2-Pviv‘., CO .,r.-#n.46 IO/L7/!6 Iry
1
t—�,�r TREE Ex VEGETATION AFFIDAVIT OFFICE COPY
'' ' .�"�i„ City of Atlantic Beach
Department of Community Development
Planning&Zoning Division
800 Seminole Road Atlantic Beach,FL 32233
_'3 (P)904 247-5800 (F)904 247-5845 PERMIT#
SECTION I -APPLICANT INFORMATION IVOwner(s) F Legal Authorized Agent*
NAME OF APPLICANT 4,,3ru d. fooe_/6-l/r2
NAME OF COMPANY
ADDRESS OF COMPANY
PHONE CELL EMAIL
CONTRACTOR CERTIFICATION NUMBER
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION II-SITE INFORMATION
STREET ADDRESS OF PROPERTY 1785 S -aiA- M RAA De i(/E-
If an address has not been assigned to this property,contactI the AB Building DepartmentrIJat(904)247-5826 to request an address.
LEGAL DESCRIPTION 30 -aq 0-25-AC S 104 ./ c& , t)p:f 5(o1 6U)/L I
LOT 1p BLOCK II SUBDIVISION
REAL ESTATE NUMBER ( -1 a DI q -UOad LOT OR PARCEL SIZE: SQ FT AC
RESIDENTIAL ✓ COMMERCIAL OTHER(SPECIFY)
111111111111111`'
I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation"of the Municipal Code of
Ordinances for the City of Atlantic Beach, FL and/or I have participated in a pre-application meeting with the Administrator of those
regulations_Subsequently, I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
fro - he above-de r . *�properties in conjunction with this project.
-w,
SIGNATU' OF OWNER SIGNATURE OF OWNER
Signed and sworn before me on this '7. ay of l9jJCJ b,v , ,7_61(_, ,by State of r(0)2(DA.
-I t (kc, a t 6-u . 7 County of --)u v
Identification verified: Ps��XiYla(((i b/0 //
Oath sworn: fes.Yes r No
-. s '
���,,, YOLANDA NEGRON i\it Signature
' Not Pubtic•Stats of Florftltl ,,, . n
t ��ti�f�'�c-f r!
•4relti•z Commission*FF 949401 jam,Commission expires: �� aU
REV-11V My CAM.Expires Apr 17,2010'
,, �`�•`� Bonded through Nato al Notary MM. t'
BUILDING PERMIT APPLICATION
OFFICE COPY
• CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 pp �
Job Address: 1785 Selva Marina Dr.Atlantic Beach,FL 32233 Permit Number: 1 € 4F i a4/Ol
Legal Description 30-29 09-2S-29E SELVA MARINA UNIT 5 LOT 6 BLK 11 Parcel#172019-0000
Floor Area of Sq.Ft. —STFT
Valuation of Work$6,000.00 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprnkler system installed?(Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed:Renovate and remodel bathroom,install new window.
Property Owner Information:
Name:Jason Rodriguez Address: 1785 Selva Marina Dr.
City Atlantic Beach State FL Zip 32233 Phone 904-338-8388
E-Mail or Fax#(Optional)
ii
Contractor Information:
Company Name:3 Rivers Construction Services LLC Qualifying Agent:Curt McDonald
Address:4215 Snowy Egret Trail City Orange Park State FL Zip 32073
Office Phone 386-209-4214 Job Site/Contact Number 386-249-2074 Fax#
State Certification/Registration#CBC1257732
Architect Name&Phone#Jason Canning 904-755-5589
Engineer's Name&Phone# 2 /2tv-Pes. c..3@i'im.at .G Ovv\
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 performed 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) or if construction or work is suspended or abandoned fora period of six(6)months at any time after
work is commenced I understand that separate permits must be secured for Elecirica!Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Hers,
Tanks and Air Conditioners,eta
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 YO1JR NOTICE OF
COMMENCEMENT.
I hereby certify that I h,. •• ,mined this a.plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will complied with eth i • '' Ghon ogratingof apermit
cddoes not
pn.�me to give authority to violate or cancel the
provisions of• other federall,sl P rf of
Signature of er., �:/��/ � Signature of Contractor
�09
Print Name SvA) m2/6a1-2 Print Name //t<i'r cPpri.c.I__
Sworn to and subsyxd.�_yd before me Sworn to and subscribed before me J--� //,�,
this 1 r) Day of to-4-n ( .2016 this ay of 6C j 1 W
tar).Public U . Notary Public
Revised 01.26.10
Marcus D.Tibbs
,��` ely. State of Florida
•�„��. YOLANDA NEGRON _ dat
1` `, 'rotary Public•State of f• torrN01
E1 , it "$1MYCOMMSION! F1a39
•
`r "„ Bonded through*ono Nota ANIL
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OFFICE COPY
Jason Canning, Architect
Architecture, Planning, Interiors
1812 Atlantic Boulevard
Jacksonville, FL 32207
0: (904) 647-8690
P: (904) 755-5589
F: (904) 406-7227
iason@canningarch.com
To: City of Atlantic Beach
Re: Response to Plan Review Comments
For: Rodriguez Residence
1785 Selva Marina Drive / 1
Atlantic Beach, FL 32333
Revision Number 1 (I ` 0 IX(/'
November 1,2016
Permit#: 16-RAAR-2401
Initial Review Mike Jones
1. From the 2014 5th Edition Existing Building Code, chose a Method of
0 Compliance from Chapter 3 and Alteration Level. This information shall be
submitted on the cover page (G1.0) under applicable codes. Resubmit 2 copies.
Response:
See revised sheet G1.0.
2. Fill out 2 copies of the Florida Product Approval Forms for the component and
cladding items on your project, fill out last page completely.
Response:
Product Approval Forms are noted on G1.0. Also, see attached Product Approval
Forms.
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