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178 SEMINOLE RD - ALTERATION PERMIT ,� '' - °I, CITY OF ATLANTIC BEACH A 800 SEMINOLE ROAD ! Z ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 \Ji31cr RESIDENTIAL ALT/OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-RAAR-2801 Job Type: RESIDENTIAL ALTERATION Description: window repairs to exterior trim & minor repair to windows, remodel 2 bathrooms & kitchen Estimated Value: $56,000.00 Issue Date: 12/22/2016 Expiration Date: 6/20/2. 017 _ PROPERTY ADDRESS: Address: 178 SEMINOLE RD RE Number: 170594-0000 PROPERTY OWNER: Name: MARTIN, JOHN E Address: 178 SEMINOLE RD ATLANTIC BEACH FL. GENERAL CONTRACTOR INFORMATION: Name: Glory Homes, Inc. ,TBA Address: 7027 Alpine ST Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $152.00 BUILDING PERMIT FEE $304.00 STATE DCA SURCHARGE $4.56 STATE DBPR SURCHARGE $4.56 Total Payments: $465.12 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ?s► J: 6� City of Atlantic Beach APPLICATION NUMBER ;\ Building Department (To be assigned by the Building Department.) ,1 800 Seminole Road _ Atlantic Beach, Florida 32233-5445 1 T3-:'110 / Phone(904)247-5826 • Fax(904)247-5845 1 1�— '.og E-mail: building-dept@coab.us Date routed: I L u t CUI ta City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ` SQ- 110`.. V_tx . De artment review required Ye No V. Applicant: C`1 lD(k \3iA-A-S\ Planning &Zoning I^ Tree Administrator Project: \1 -4 A LA)Ali 14) U �l S \3U S Public Works a rN,t \ kL r {e,0\O( Q' 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: proved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: rn Date: /02 'o2-o/6 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 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH OFFICE COPY 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: \ c QD �e v1-1 ' ,4--, b LPZ. 14J. • Permit Number: Inc- -A Ad-- a..zis-O Legal Description k b- 13' -25-29E? SA L7'H(i5f( I (o7 &I Z Parcel# Floor Area of Sq.Ft. )2(a l Sq.Ft i 53 Valuation of Work$ 5(i0(30.00 Proposed Work heated/cooled Son _ non-heated/cooled_ 4' _ Class of Work(circle one): New Addition Alteration tszall Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial f,�e,Senti If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No OTAIr Florida Product Approval # - For multiple products use product approval forme....17,-,1 • Describe in detail the type of work to be performed: w 1)o C>--- k(- 10 Q)cre ILI Of `C l t c-J L*t.)p Uu)S /wit,u/Ac /7- 2ev►-`c) CJ 1e L c 2. r644-T-0S c: L<t D( WCAtJ ------ C_ E © E IIVET\ Property Owner Information: Name:lB, (Lt(c,t `'lC t1t (2241.1(14iJ Address: 1 Z3 l 14u1J7,.,�Q SC DEC 1 4 2016 City 4-)u) v, I I-P State�CZip 3 ZZQ Phone GjO q .- "'J E-Mail or Fax#(Optional) ,yi-LIC trA 4_) C2f/ 1A-Z(,, C Ukn _ Contractor Information: Company Name: ( L )CLL{ U i�l(eS 1�C Qualifying� Agent:� 6 f O 2( 4 S P 0 41 ) Address: C) 2` ? i- 1L#'l 1'V •,-/-.SCityjf l(Soc0 Ll//1p State FL Zip 3Z2 5 Office Phone Cit y- V5"f-Y3 VO Job Site/Contact Number qe ' 835 CD 3;7 Fax# _ State Certification/Registration# CI C C9 cc/ IV/ Architect Name& Phone# i2r,0e'/ r /fin/' 7e/ ,41L6',f- 7/ /&.6.6)114,4-"(1V17-11C,/ c%4C7cSe--')t'/ltc g 3 ZZG-X Engineer's Name& Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address tQe1 io.u's pf, c%1/140A-1 C(.41 t' /o/ cdeecrrv/lio4)Aar 57" /700 J/'-C( DoN vII( e,FL 37 25c 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 sim x(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after work is commenced. I Anderstand 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 YOUR NOTICE OF COMMENCEMENT. 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 ,• , 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 r•: dating c,nstruction or the performance of construction. firm.,„ / Signature of Ownerrap, Signature of Contractor9c_ j� Print Name C(D V t e\ �. f P O a ( 1____ Print Name --31f. ; �,J �o.-��v� �-� --- Swo to and subscribed before me Sworn to and subscribed before me this Day of a LLL 6 ,20110 this ( 2-Day of E C'ce tib C v- ,20 ) Co 0, % yy-1 , C.(2-4 0.42,,,_., A c Notary Public Notary Public Revised 01.26.10 -A.- 1----„,;-.;.:,:- �„,el 1 LORAINE M IRONS I ,,, '•••:'•. DANA M. MOORE ,.:;a`',,,,,, �,! i:i MY COMMISSION#EE 106071 I r°. ^1.ei. Notary Public State of Florida -;•;,.-'4.:.••:,.s, i•: •o • My Comm.Expires Sep 14.2018 - ,o�ik�; EXPIRES:August27,2019 I ;%• ..)1:.`o; Commission #FF 159498 -----.--.I ���'''8„„�'' Bonded through National Notary Assn.