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157, 161, 165 169 OCEAN GATE DR - SINGLE FAMILY ATTACHED PERMIT i j�.-\J� ,. CITY OF ATLANTIC BEACH A' _ ,; 800 SEMINOLE ROAD .5 7,-'1 ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �J;;l>f' SINGLE FAMILY ATTACHED MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: — Job ID: 15-SFAT-2842 Job Type: SINGLE FAMILY ATTACHED DWELLING Description: SINGLE FAM ATTACHED Estimated Value: $117,000.00 Issue Date: 2/3/2016 Expiration Date: 8/1/2016 PROPERTY ADDRESS: Address: 169 OCEAN GATE DR RE Number: None GENERAL CONTRACTOR INFORMATION: Name: 201 MAYPORT CONSTRUCTION MANAGEMENT Address: 2768 STATE RD A1A #701 Phone: 904-334-1202 PERMIT INFORMATION: FEES: ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $265.50 UTIL REV RESIDENTIAL BLDG $50.00 BUILDING PERMIT FEE $531.00 STATE DCA SURCHARGE $7.97 STATE DBPR SURCHARGE $7.97 WATER CONNECT/TAP & METER $185.00 BUILDING O�II�($Ci( ltaNNCE 11I$f]O1QQ CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. i \r\J\l r'' ., �- f . s J CITY OF ATLANTIC BEACH ). 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 J;3)�`� Total Payments: $1,197.44 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. j lllf 'S\ CITY OF ATLANTIC BEACH lt,�;,; 800 SEMINOLE ROAD '� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 \ r-012191 1 SINGLE FAMILY ATTACHED MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-SFAT-2841 Job Type: SINGLE FAMILY ATTACHED DWELLING Description: SINGLE FAM ATTACHED Estimated Value: $117,000.00 Issue Date: 2/3/2016 Expiration Date: 8/1/2016 PROPERTY ADDRESS: Address: 165 OCEAN GATE DR RE Number: None GENERAL CONTRACTOR INFORMATION: Name: 201 MAYPORT CONSTRUCTION MANAGEMENT Address: 2768 STATE RD A1A#701 Phone: 904-334-1202 PERMIT INFORMATION: FEES: ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $265.50 UTIL REV RESIDENTIAL BLDG $50.00 BUILDING PERMIT FEE $531.00 STATE DCA SURCHARGE $7.97 STATE DBPR SURCHARGE $7.97 WATER CONNECT/TAP & METER $185.00 PERK/ATE OROSeCONNEGTOON\( 1: \'i$60‘00 CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. I t, (:) iS51'v CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD =" ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Total Payments: $1,197.44 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. (:' CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 SINGLE FAMILY ATTACHED MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-SFAT-2840 Job Type: SINGLE FAMILY ATTACHED DWELLING Description: SINGLE FAM ATTACHED Estimated Value: $117,000.00 Issue Date: 2/3/2016 Expiration Date: 8/1/2016 PROPERTY ADDRESS: Address: 161 OCEAN GATE DR RE Number: None PERMIT INFORMATION: FEES: ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $265.50 UTIL REV RESIDENTIAL BLDG $50.00 BUILDING PERMIT FEE $531.00 STATE DCA SURCHARGE $7.97 STATE DBPR SURCHARGE $7.97 WATER CONNECT/TAP & METER $185.00 PERK ATER'ORDS CONNEOTHDNN( I: N1 i$8Q16U CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r' ' �� CITY OF ATLANTIC BEACH r Y SJ .4 ;> 800 SEMINOLE ROAD Ti ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Total Payments: $1,197.44 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. rj.' • `� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD Ve ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 SINGLE FAMILY ATTACHED MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-SFAT-2839 Job Type: SINGLE FAMILY ATTACHED DWELLING Description: SINLE FAM ATTACHED Estimated Value: $117,000.00 Issue Date: 2/3/2016 Expiration Date: 8/1/2016 PROPERTY ADDRESS: Address: 157 OCEAN GATE DR RE Number: None GENERAL CONTRACTOR INFORMATION: Name: 201 MAYPORT CONSTRUCTION MANAGEMENT Address: 2768 STATE RD A1A#701 Phone: 904-334-1202 PERMIT INFORMATION: FEES: ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $265.50 UTIL REV RESIDENTIAL BLDG $50.00 BUILDING PERMIT FEE $531.00 STATE DCA SURCHARGE $7.97 STATE DBPR SURCHARGE $7.97 WATER CROSS CONNECTION $50.00 PERKJI\TERPOO e■TATAReakETER: \Vi$1%$& QJTY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r� i . `_;.)v CITY OF ATLANTIC BEACH J 'a ? 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Total Payments: $1,197.44 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 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: 169 Ocean Gate Dr., COAB FL 32233 Permit Number:/r.-SF, 7 -cZkYol Legal Description 38-2S-29E-7.42 B De Castro Y Ferrer Grant PT RECD 0/R 16531-224 Blk. #5 Parcel# 13 Valuation of Work $110.000 Proposed Work he ed/cooled: 1170 non-hea ed/cooled: 200 Class of Work(circle one): New(X) Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residential (X) If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval # attached For multiple products use product approval form Describe in detail the type of work to be performed: Construct 2-Story 3 Bed/2 Bath Single Family Attached Dwelling Property Owner Information: Name: Beaches Habitat for Humanity Address: 797 Mayport Rd City: Atlantic Beach State FL Zip 32233 Phone 904-241-1222 E-Mail or Fax #(Optional) Contractor Information: Company Name: 201 Mayport Construction Management LLC Qualifying Agent: Robert Peterson Address:2768 State Rd AlA#701 City Atlantic Beach State FL Zip 32233 Office Phone 904-241-1222 Job Site/Contact Number 904-334-1202 Fax#904-241-4310 State Certification/Registration# CGC-1506666 Architect Name&Phone# Engineer's Name&Phone# 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 certi 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)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 understand 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 this a plicatio 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.s eci t n ed herein 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 regulating construction or the performance of construction. � Signature of Owner Signature of Contractor Print Name J >Le,�p' - Print Name 1< 1.2 f fs a� Sworn to nd subscribed bp f9 re me Sworn to and subscrib�bef re me this 7A"Day of OV- e( ,20 lei this 7444-Day of C/ �� ,20 /C- Notary Public , Notary Public ; J" + KYLE MURRAY ' ' KYLE MURRAY Re ised 01.26.10 I c': `, •• MY COMMISSION S EE185723 e ••'r MY COMMISSION J!EE185723 --t. EXPIRES April 02,2016 "'-t EXPIRES April 02,2016 e417!NMI-8115A , m DO NOT WRITE BELOW- OFFICE USE ONLY Applicable Codes: 2010 FLORIDA BUILDING CODE Review Result (circle one): ICE COPY Approved Disapproved Approved w/ pp Conditions Review Initials/Date: • • S" Development Size Habitable Space 1170 £F, Non-Habitable zoo y,r Impervious area Miscellaneous Information Occupancy Group R -3 Type of Construction V Q Number of Stories Zoning District Rn'10- (j Max. Occupancy Load Fire Sprinklers Required Flood Zone X Conditions/Comments: OFFICE COPY Nov.3, 2015 Mr. Dan Arlington Building Official City of Atlantic Beach 800 Seminole Rd. Atlantic Beach, FL 32233 Dan Attached are the following materials in support of Beaches Habitat application for the building permit: Quad Q, Block#5 Lots# 13, 14, 15,16 #169, 165, 161, 157 Ocean Gate Drive, COAB 1) One (1) copy of the Building Permit Application each unit 2) Two (2) copies of roof truss plans 3) Two (2) copies of HVAC Energy Sheets 4) Two (2) copies of the Florida Product Approval form 5) One (1) copy of recorded Notice of Commencement 6) One (1) copy of letter to Kayle Moore regarding fire sprinkler/irrigation systems. 7) Five (5) copies of the Construction Management Plan 8) Two (2) copies of architectural plans 9) Two (2) copies of structural engineering plans 10)Five (5) copies of civil engineering plans 11)Two (2) copies R.O.W. Permit Please let me know if any additional information is required. Thank you, Sincerely, 'o.ert Peterson, Construction Director 904.334.1202 attachments o-m4;1 City of Atlantic Beach • ' ' ' Building Atlantic Beach '1► :?;; ": ! 800 Seminole Road IVED APPLICATION . - Atlantic Beach, Florida 32233-5445 (To be assigned by the Building De.NUMBER Phone(904)247-5826 DEC CE 0 9 2015 /� p��J g partment.) 1.01i af• E-mail: buildin de t coab.us904)24 5845 J f�a,'39 City web-site: http://wwww.coab.us BY: - Date routed: �,� {'� APPLICATION REVIEW AND T � TRACKING FORM Property Address: J a i Z' _ � De ent rejjwre,uired Applicant; No • ., . _i a, .; �� _� banning &Zonin. �- Project: _ ree m istrator O. - Wo , Public Safety 6111611111 acemstimimill.1111 IIII Review fee $ 53 Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified Date i Florida Dept. of Transportation ronm St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS 2eviewing Department First Review: (Circle one.) L1HPproved. ❑Denied. Comments: BUILDING 'CANNING &ZONING TREE ADMIN. Reviewed by: +� filer Second Review: Date: 2 r7 /f- p,�r,,� DApproved as revised. ['Denied. �' WORKS Comments: IC UTILITIES I-- PUB IC SAFETY Reviewed by: FIRE SERVICES Third Review: Dafe: Approved as revised. []Denied. Comments: Reviewed by: Date: d 07/27/10 1 ' i 1 i i t!..r1`l� ,S r Jri* �', Et CITY OF ATLANTIC BEACH �t CH• s, PUBLIC UTILITIES v 1200 Sandpiper Lane Ji3l�'' ATLANTIC BEACH, FL 32233 (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: /,Z-/0-/S' Project Address: /S 7 L9C&, j C9-r,= Dr No. of Units: Commercial Residential ✓ Multi-Family New Water Tap(s)&Meter(s) Meter Size(s) 3 /5/ New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaimed Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# 1S-S/cAT- 2 '3'9 Water System Development Charge $ E Q P Sewer System Development Charge $ l� L -�''i d F Water Meter Only $ /85-.04o Mu LT, -u.✓ II- fato P T`f Reclaimed Meter Only $ eo 5p C I s 4E4'8 Water Meter Tap $ Sewer Tap $ (notes) Cross Connection $ Sa. 00 Other $ TOTAL $ 235-. 0b APPROVED: Kayle Moore,PE '&1,1 (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED .1A/J41 City of Atlantic Beach ':' / j,i Building Department 2 `� 800 Seminole Road APPLICATION NUMBER ,.' -. ` ;� 2 (To be assigned by the Building Depart ent.) Atlantic Beach, Florida 32233-5445 , Phone(904)247-5826 �� �'e <r • r s• Fax(904)247-5845 -_�__� /�r r- w I�d .�j,s E-mail: building-dept @coab.us City web-site: http://w,N,,,�.coab.us Date routed: 2—gr e5-- APPLICATION REVIEW AND TRACKING FORM Property Address: /4i I Q / • / , �� ent review required No Applicant: I _- 1 /. � . _� !�anning &Zonin. �� Project: _ �� ree .mmisfrator EMI Mal Public Safety __ stimmunimmill IIIII Review fee $ "tea __ Dept Signature 1 Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified B Date Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants MEMIIIIIIIIIIIMMININI Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS teviewing Department First Review: (Circle one.) I' IHPproved. ['Denied. BUILDING LANNING & ZONING TREE ADMIN. Reviewed by: •� .. v✓ _ Second Review: Date: 2 /s-- DApproved as revised. []Denied. � j'V WORKS Comments: ' BLIC UTILITIES /Z--/ /_ / 5 PUBLIC SAFETY Reviewed by: =IRE SERVICES Third Review: ❑ Date: Approved as revised. []Denied. Comments: • Reviewed by: Date: d 07/27/10 J CITY OF ATLANTIC BEACH PUBLIC UTILITIES 1200 Sandpiper Lane ... r.Y;. ATLANTIC BEACH, FL 32233 (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: /2-/0 - /s— Project Address: /{o/ 8e.4.--Wr) Dc No. of Units: Commercial Residential Multi-Family New Water Tap(s)& Meter(s) Meter Size(s) 3/c{ New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaimed Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application#/s- SG04T — 2810 Water System Development Charge $ e(J DF Sewer System Development Charge $ A4(407- I r fpeitAr/ Water Meter Only $ / 3 S,CO Reclaimed Meter Only $ A/0 COC �I iaie (, Water Meter Tap $ Sewer Tap $ (notes) Cross Connection $ SO, 00 Other $ TOTAL $ 235". oc) APPROVED: Kayle Moore, PE 5(01/1 (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED rt'--'1,`,;, City of Atlantic Beach `i' * �t Building Department � �� 4 800 Seminole Road APPLICATION NUMBER ,� ;ndv� O (To be assigned by the Building Department.) Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 -7�. ;1 E-mail: building-dept @coab.us �7 Afir e5--' City web-site: http:/lwww.coab.us Date routed: 2-, APPLICATION REVIEW AND T RACKIIVG FORM Property Address: 65/ i yi 1 / ......E % De. - ent review required �'� No Applicant: i < � _ AI- . _, tom'arming &Zonin. _ Project: _ ree mmistrator MUM i r Public Safety` _- IIIII Review fee $ Dept Signature .___ Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified By Date immmmm.______1111111.111111111111M1 Florida Dept.of Transportation St.Johns River Water Management District aiW. led Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS teviewing Department First Review: I-�pproved. ❑Denied. (Circle one.) �H Comments: BUILDING LANNING &ZONING tat Reviewed by: � ��_. TREE ADMIN. Date: / 17 lc:- Second Review: []Approved as revised. ❑Denied. PU' ' WORKS Comments: a-: IC UTILITIES PU /2,-/0---1 SAFETY TY Reviewed by: = DA IRE SERVICES Third Review: Date: DApproved as revised. []Denied. Comments: Reviewed by: Date: of 07/27/10 ■ ■ a r - ,i CITY OF ATLANTIC BEACH PUBLIC UTILITIES 1200 Sandpiper Lane JF3I 9f' ATLANTIC BEACH, FL 32233 (904) 270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: /2 -/O-lS Project Address: /,$ a$mac a- No. of Units: Commercial Residential ✓ Multi-Family New Water Tap(s)& Meter(s) Meter Size(s) 3/c/ New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaimed Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# /.5--3 FAr 2$•-/f Water System Development Charge $ REo L el) v f-- Sewer System Development Charge $ �uL��� r ��ofE� Water Meter Only $ /11s-,p� i TY Reclaimed Meter Only $ — //a S Oc s Q.� Water Meter Tap $ (notes) Sewer Tap $ Cross Connection $ Sp, oa Other $ TOTAL $ 2 X35, APPROVED: Kavle Moore, PE X-c-"A (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED tL +%/,; City of Atlantic Beach v. i � Building Department -/,,r+L APPLICATION NUMBER Ti�; - { 800 Seminole Road (To be assigned by the Building De artm v, Atlantic Beach, Florida 32233-5445 P /e�t.) \\ Phone(904)247-5826 • Fax(904)247-5845 J/fl" Z 8 /2. ,A1.0,19•:- E-mail: building-dept @coab.us City web-site: http://www.coab.us Date routed: er APPLICATION REVIEW AND TRACKING FORM Property Address: J / I. Der • ment review required lani No 4.Applicant: .. 6 _- `� ! /. . _� arming &Zonin. _- Project: re '•minisfrator 76 e Mal Public Safety == Fire Services Review fee $_ _ _Q Dept Signature '-'l Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified B Date Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants IIIIIIIIIIIIIIIIIIIIIIIIIIIIII Division of Alcoholic Beverages and Tobacco Other: IIIIIIIIIIIIIIIIIIIIIIIIIIIIII APPLICATION STATUS Reviewing Department First Review: (Circle one.) RiPproved. ❑Denied. Comments: BUILDING PLANNING & ZONING Reviewed by: ��— TREE ADMIN. Date: �2 l7 / Second Review: L]Approved as revised. ❑Denied. ''4: IC WORK. Comments: j 'UBLIC UTILITIES /2/0—Is- PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ❑Denied. Comments: Reviewed by: _ Date: iised 07/27/10 I c s CITY OF ATLANTIC BEACH ,, PUBLIC UTILITIES s� 1200 Sandpiper Lane J;31�'' ATLANTIC BEACH, FL 32233 (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: /2 .,V - /S- Project Address: /69 e&?f'✓ a,97-E- D,_ No. of Units: Commercial Residential ✓ Multi-Family New Water Tap(s) & Meter(s) Meter Size(s) 3/'-/ '' New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaimed Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# (5— SF4T- 28V 2 Water System Development Charge $ D Fr t.-DP/ 0/i- & Sewer System Development Charge $ Water Meter Only $ /85—, 00 MI LTC-CN ,r— 19/1.0/W7 Reclaimed Meter Only $ ,v o S D C IS aa VII Q Water Meter Tap $ (notes) Sewer Tap $ Cross Connection $ SO. DO Other $ TOTAL $ 2.35S, Oa APPROVED: Kayle Moore,PE '/1 (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED ( i.r City of Atlantic Beach 1�� Building Department J� APPLICATION NUMBER J„:-, r) 800 Seminole Road b (To be assigned by the Building De a , 4, Atlantic Beach, Florida 32233-5445 g p dome t.)— Phone(904)247-5826 • Fax(904)247-5845 .16r- 2 0 'L 1..0109 E-mail: building-dept @coab.us City web site: http://www.coab.us Date routed: 0 APPLICATION REVIEW AND TRACKING FORM • Property Address: 1.Q / _ I De. . ent review required Ian No Applicant: Q �' ' 'ti .0 ' "/ L . _ , Lad anning &Zonin. �= " Project: _ / ree ' •mmistrator _- * �� i of .LJ _ WO 0. Public Safety =MI Fire Services - Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified By Date Imo Ilm. 1111.111111111111N nviro Florida Dept. of nviro ortatio St. Johns River Water Management District Army Corps of Engineers IIMIMIIIMIIIIIIIIIIIIIIIIIIIII Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: -- --- APPLICATION STATUS Reviewing Department First Review: fp . (Circle one.) pproved. ❑Denied. Comments: / BUILDING fee 4 PLANNING &ZONING Reviewed by: �'/i�/ TREE ADMIN. _ Date: / .� ,� AN Second Review: Approved as revised. 111Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ❑Denied. Comments: Reviewed by: Date: used 07/27/10 I I i 0.!..q%l City of Atlantic Beach o'•/t' �`g Building Department APPLICATION NUMBER j;', ` rr 800 Seminole Road (To be assigned by the Bu' Atlantic Beach Florid Building Department) a 32233-5445 N p nt.) Phone(904)247-5826 Fax(904)247 5845 v .J ��/ e`'•ws a E-mail: buildin de t coab.us g' p@ City web site: http://www.coab.us Date routed: 17 APPLICATION REVIEW AND TRACKING FORM Property Address: 64( ent review required iiin No Applicant: .. 6 if - `� . _ r • 4-- rming &Zonin• Project: _ � / ree '•mmistrator' ? .-____ 11111111.0"nal If el Public Safety =- Fire Services Ill Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified By Date Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants IMMENIMMINIMMO Division of Alcoholic Beverages and Tobacco Other: MIME APPLICATION STATUS teviewing Department First Review: Ap (Circle one.) proved. ❑Denied. Comments: d/BUILDING ��� �� W/>cle CANNING &ZONING ' / Reviewed by: t� TREE ADMIN. ri�� Date: /1-- J f Second Review: DApproved as revised. • PUBLIC WORKS Comments: enied. 3UBLIC UTILITIES PUBLIC SAFETY Reviewed by: =IRE SERVICES Third Review: ❑ Date: Approved as revised. []Denied. Comments: Reviewed by: Date: d 07/27/10 i I • ' ''* City of Atlantic Beach � rt L1��` `� / .: ,, Building Department APPLICATION NU `' ,, /� ' ,f 800 Seminole Road (To be assigned NUMBER 4 gned by the Building Depart ent.) Atlantic Beach, Florida 32233-5445 _ CO hone(904)247-5826 • Fax(904)247-5845 /� /r (P�� =''611)9%• E-mail: buildin de f coab.us g p@ City web-site: http://www.coab.us Date routed: .2-`'1 APPLICATION REVIEW AND TRACKING FORM • Property Address: 4 1 / *--- . • De ent review required MI No Applicant: �. i �� J 1 , ./ /. _v �. 4d arming&Zonin• - Project: _ n ree .mmisfrator _� �wi i a! .[J ' - Wo A. Mai Public Safety �- Review fee $ Dept Signature al Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified By Date Florida Dept.of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants IMENIMIIIIIIIMMINI Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS reviewing Department First Review: Ap (Circle one.) proved. ❑Denied. Comments: // -- BUILDING se e *aid (-ent,L1a CANNING &ZONING ,/�� TREE ADMIN. Reviewed by: —Second Review: ...4P" Date: %=�� PUBLIC WORKS Comments: ❑Approved as revised. Denied. DUBLIC UTILITIES PUBLIC SAFETY Reviewed by: =IRE SERVICES Third Review: DApproved Date: pproved as revised. ODenied. Comments: Reviewed by: Date: d 07/27/10 (K \ \,t-�'i:7j;; City of Atlantic Beach r /0,61-1 y Building Department APPLICATION NUMBER s�y -•; t 800 Seminole Road (To be assigned by the Building Department.) 'J "fir Atlantic Beach, Florida 32233-5445 r j ? Phone(904)247-5826 Fax(904)247-5845 a ``�K/ -o?,#J 9 pi.--,-,.,,y. E-mail: building-dept @coab.us �� • City web-site: http://www.coab.us I Date routed: x..� APPLICATION REVIEW AN ,= ,-_ - ORM Property Address: 61 a • De ment review required all No Applicant: _- `i 1 ' -/ /. . _� , t�'arming &Zoning Project: _ n ree •►nmisfrator �- ��� i it �LJ - WO , _- Public Safety �- Review fee $ Dept Signature In Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified By Date 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 2eviewing Department First Review: (Circle one.) pproved. ❑Denied. Comments: / BUILDING fGL 44kt d 60004%4 'CANNING &ZONING �i� Reviewed by: _ �� TREE ADMIN. Date: /; /,� Second Review: QApproved as revised. Etenied. �'tZLIC WORKS Comments: DUBLIC UTILITIES PUBLIC SAFETY Reviewed by: FIRE SERVICES Third Review: ❑A Date: DApproved as revised. []Denied. Comments: Reviewed by: Date: d 07/27/10 1 Permit Attachment _ of for_ Permit# issued ,20_ Atlantic Beach, FL 32233 Owner's Name: y.(cA t, R.E. #: ------ Property Address:15 7 IV /1 i (.3c6,.. Subdivision: 1 _A, Lot #/Block #: K REVOCABLE ENCROACH1VIENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT,issued on this by Atlantic Beach, Florida, a municipal corporation organized and day of t 20_4/1, Florida, hereinafter referred to as "CITY" and g ting under the laws of the State of It- hereinafter referred to as "USER", t�F�. ''� '� of Atlantic Beach, Florida, WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right enter upon the property of the City of Atlantic Beach for the g is Beach Right-of-Way/Easement permit numbers noted above (copiespattached)escribed in the City of Atlantic This work is generally described as: EW4 111 >4.. R. b. Gc . Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains to relocation or removal on thirty(30) days notice by CITY to the USER, said notice to USER given by certified .mail, return receipt requested, to the R shale s: 1 Y1'la, - I- ; .{ following address: The depositing of said notice of cancellation in the United States mail cancellation and the burden is upon USER to keep the CITY informed of USER'S proper address. notice of The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition. In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code, and all other land use and code requirements of the CITY,including City Code Section 19-7 (h) which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks." Page 1 of 2 The USER, prior to making approval from the City of Atlantic changes Wks ks Departmentans and/or method, must obtain written discretion of the CITY, be requested to submit as-built drawings showing the n e. g The USER shall,a t the g change the day of completion. P shall insure e ange within thirty (30) days nsure to the benefit of; and be binding upon, the USER and their respective assigns. cove successors and USER shall meet the terms and conditions of this permit and to all of the applicable specifications, to include utilities locate requirements and use limitations/requirements and/or nd/o rights-of-way and other public land. q PPlicable State and CITY laws USER further agrees that the CITY and its officers and employees shall saved harmless by the USER from public liabilities are hereby assumed by any of the work herein under the terms of this e all y the USER. p rmit and that all of said DA ED and SIGNED this r day of i) L.r 20 if By. St op - twn (to .e signed •. . esence of the Notary) KYLE HURRAY STATE OF FLORIDA MY COMMISSION EE185723 a EXPIRES April 02.2016 COUNTY OFF DUVAL 1 007)3880153 Fonds Senior , On this = day of (� tf and for said Count 201 Personally appeared before me, a Notary Y and State, owner Public in and who executed the foregoing instrument;, Atlantic Beach, Florida, the property owner of g g who acknowledged�to me that he or heex person(s) ut d the same freely in and voluntarily and for the uses and purposes therein mentioned. the same freely Notary Public in for said County and State CITY OF ATLANTIC BEACH, FLORIDA a municipal corporation: ' Approved. Doug a on,Public .rks Director For Permits where city sidewalk is impacted, City Manager approval required: Nelson Van Liere, City Manager • Page 2 of 2 i 4 � r r�:��T, City of Atlantic Beach El it � � Building Department /0,6 APPLICATION NUMBER r.;,-._ .s 800 Seminole Road (To be assigned by the Building De Atlantic Beach, Florida 32233-5445 r g partment.) Phone(904)247-5826 • Fax(904)247-5845 �� " ��y ���� `lai;lup E-mail: building-dept @coab.us 47 cr City web-site: http:l/www.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: 61 Q_ i De.. ment review re•wired Applicant: / :� No I. _� Manning &Zonin. �� __Project: / ree A .ministrator _- � I o � ! .0 Wo i- Public Safety emomminiemollirill Review fee $ - Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified B Date Florida Dept. of Transportation imm. ...______MMIEMIIIIIIIIIIMUM • St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: __ APPLICATION STATUS Zeviewing Department First Review: (Circle one.) Comments: ❑Denied. Comments: BUILDING 'LANNING &ZONING Reviewed by: /�� TREE ADMIN. Date: S If Second Review: QApproved as revised. ❑Denied. PUBLIC WORKS Comments: DUBLIC UTILITIES PUBLIC SAFETY Reviewed by: FIRE SERVICES Third Review: DApproved Date: pproved as revised. ['Denied. Comments: Reviewed by: Date: d 07/27/10 1 1 ry0:, City of Atlantic Beach • �� \�� Building Department ti APPLICATION NUMBER "'i t,-': 'i`'�''� 800 Seminole Road I' � ) .�,,;_;, ,? 2� (To be assigned by the Building Depart ent.) ,� ' .r Atlantic Beach, Florida 32233-5445 _ d,i I�d Phone(904)247-5826 • Fax(904)247-5845 /� �/r w O `..u;s19 E-mail; building-dept @coab.us 2_,NY 6--' ____ , City web-site: http:l/www.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: /t8 1 a _ .� De.. ent review required 1212 No Applicant: / • A 1 ' -1 t. . _ , Lae tinning&Zonin �� Project: _ �� ■ '/ ree •mmistrator MIMI .1 i k 0 r'- . 711ft in= NM Public Safety MI - Fire Services - Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept.of Environmental Protection of Permit Verified By Date Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants INIMMEMIIIIIIIIIIMIll Division of Alcoholic Beverages and Tobacco Other: IIIIIIIIIIIIIIIIIIIIIIIII APPLICATION STATUS 2eviewing Department First Review: pp((�� (Circle one.) /Approved. ❑Denied. Comments: BUILDING 'CANNING &ZONING Reviewed by: � TREE ADMIN. Date: Second Review: QApproved as revised. EiDenied. PUBLIC WORKS Comments: DUBLIC UTILITIES PUBLIC SAFETY Reviewed by: = QA IRE SERVICES Third Review: Date: DApproved as revised. ❑Denied. Comments: Reviewed by: Date: d 07/27/10 • 0-4;9-'4;1..;.. City of Atlantic Beach `f;�` , i1 Building Department APPLICATION NUMBER _,, ,f� 800 Seminole Road (To be assigned by the Building Department.) a �r Atlantic Beach, 9 partment. h, Florida 32233-5445 ) '� Phone(904)247-5826 • Fax(904)247-5845 ��–=+ � / fT��• _ Email: buildng depf @coab.us 2..,17 5-- _____ , City web-sitei http:/fwww.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: 64( O / I / i De.. ent review required Eti No Applicant: Q -' _- 1. . _, LCD' arming&Zonin. Project: _ _ ree Iln strator MI .,... i o! _ Wo A. Public Safety == imsommoimm Review fee $ Dept Signature IMI Other Agency Review or Permit Required Review or Receipt Florida Dept. of Environmental Protection of Permit Verified B Date Florida Dept.of Transportation mimmommmmm..._111.11.111111111111111MI St.Johns River Water Management District inalfrili Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: IIIIIIIIIIIIIIIIIIIIIIIII - APPLICATION STATUS reviewing Department First Review: (Circle one.) Comments: ❑Denied. Comments: BUILDING LANNING &ZONING Reviewed by: /".„,„---/ V TREE ADMIN. Date:_ �1, Second Review: QApproved as revised. []Denied. —� PUBLIC WORKS Comments: 3UBLIC UTILITIES PUBLIC SAFETY Reviewed by: =IRE SERVICES Third Review: Q Date: Approved as revised. ❑Denied. Comments: Reviewed by: Date: J 07/27/10 1 ( J9-> City of Atlantic Beach �� Building Department 4 APPLICATION NUMBER ! '•` 800 Semin 4 To be .--:ti'' �.,.�� s.-., s) ole Road b ( assigned by the Building Departme t.) 17.��. � Atlantic Beach, Florida 32233-5445 N���� � p�L Phone(904)247-5826 • Fax(904)247-5845 •J 6 /7.0;09:- E-mail: buildin de t coab.us g p @ Date routed: 217 ec' City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 61 Q / '� De. . . ent review required Yes No Applicant: �' pr_'J i , ./ d. . _� �! arming &Zoning • ree •ministrator _� Project: n `�'� i aL .0 _ Wo • ' Public Safety - Fire Services _ - Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept. of Environmental Protection ....1111111111111_ MI_ 1_ I_ IIIIIIIIIIII Florida Dept.of Transportation St.Johns River Water Management District iiillnilil Army Corps of Engineers Division of Hotels and Restaurants IIIIIIIIIIIIIIIIIIIIIIIIIIIIII Division of Alcoholic Beverages and Tobacco Other: IIIIIIIIIIII APPLICATION STATUS Reviewing Department First Review: Approved. ['Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: / `--------- TREE ADMIN. Dafe: 1 If Second Review: [Approved as revised. Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: QApproved as revised. ['Denied. Comments: • Reviewed by: Date: used 07/27/10 I 1..t?;. City of Atlantic Beach .45 Building Department J�+' APPLICATION NUMBER 800 Seminole Road (To be assigned by the Building Departure t.) - -0 Atlantic Beach, Florida 32233-5445 /5-- for- 28 4/2. Phone(904)247-5826 Fax(904)247-5845 9%• E-mail: building-dept @coab.us Date routed: /2/f /� City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /41 a et/ w ail' De ent review required Yes No ino Applicant: AP. Q ;� , / �I�(anning &Zonin ,� I ree Administrator LID Project: / cI Utilities, Public Safety Fire Services Review fee $ Dept Signature • Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date 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: TREE ADMIN. Second Review: DApproved 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 07/27/10 riL s►,�T;,;.I City of Atlantic Beach ,* P Building Department APPLICATION NUMBER �f 800 Seminole Road O (To be assigned by the Building Department.) a� �r Atlantic Beach, Florida 32233-5445 l) •J N 6� _ �jf/ Phone(904)247-5826 • Fax(904)247-5845 `!0it 9%• E-mail: building-dept @coab.us 2ff• City web-site: http://www.coab.us Date routed: E APPLICATION REVIEW AND TRACKING FORM Property Address: /4)g -'y DetAi D - Q/ � � e- ent review required Yes No Applicant: c7,44 Avor / S.rfah t,�ammng &Zonin. ree ministrator _- Project: _ / .4( aL TWO Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date 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: QApproved. (Circle one.) Comments: nDenied. BUILDING PLANNING & ZONING Reviewed by: Date: TREE ADMIN. Second Review: QApproved 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: used 07/27/10 I I ;,r!A% City of Atlantic Beach i ��` Building Department APPLICATION NUMBER c. `r 800 Seminole Road d (To be assigned by the Building Depart ent.) �us ;;.. :� r) �+ �r Atlantic Beach, Florida 32233-5445 ff�� /6_ id� p�� ti Phone(904)247-5826 • Fax(904)247-5845 /i O �`%9;0!Y' E-mail: building-dept @coab.us City web site: http://www.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: 111 I a / • De. . ment review required Yes No Applicant: Q L. _I �' _41 _arming &ZoniA111111111 • ,/ ree •ministrator Project: •i rL -.�:, - WO 11111� Public Safety _- Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date 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: DApproved. (Circle one.) Comments: ['Denied.. BUILDING PLANNING &ZONING Reviewed by: TREE ADMIN. Date: Second Review: []Approved as revised. DDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY _ Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. r]Denied. Comments: Reviewed by: Date: used 07/27/10 ;•,c!ve, City of Atlantic Beach �' ��� Building Department io,61-1 APPLICATION NUMBER 800 Seminole Road (To be assigned by the Building Department.) u �r Atlantic Beach, Florida 32233-5445 /c-�'� . �.d?? Phone(904)247-5826 • Fax(904)247-5845 / ' 9;:fa%- E-mail: building-dept @coab.us 2.-ff e5.- City web-site: http://www.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: /61 Q Ctrl 94/ De. . ment review required Yes No Applicant: ■ Q � _ _- -i / i j /. . _4 ine anning &Zonin. • • ree A.ministrator - _ Project: _ / I •.... : li 46 • - Wo . �I. • .m:+lr ,� Public Safety Fire Services - Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified B Date Florida Dept. of Environmental Protection amiim.lillIWINII. 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: IIIIIIIIIIIII APPLICATION STATUS Reviewing Department First Review: []Approved. (Circle one.) Comments: ❑Denied. BUILDING PLANNING &ZONING Reviewed by: TREE ADMIN. Date: Second Review: UApproved 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: used 07/27/10 OFFICECOPY Turner 113,.°mots 480 EoGEWOn MAC SOUK,4craowiiE,FLORIDA 32205 MI Pest Num;004.365.5300•fsu 9M.353.14W•TTmi tM1 Sae 5.3390•wow,T I n5nris•Agt !�Control ST.kl un,GA.-91247$•1301 Oulu,Fu.-352-351-4386 WON OEM,Fu.-311-7114383 Poor St.LIU,Fu.-77241124078 What's Bugging You? gamest,Fu.-Si1-161.3 Tana,Fu.-1134814311 NOTICE OF INTENT FOR PREVENTATIVE TREATMENTS AGAINST TERMITES as roe Lured by Flo;ida Bu''i`\lding Cori°.FBC 104 2.6) Address: 67 06-411,11,, - 1�-1..k V t✓ Lot: ( Block: a Date: vo 3,2-0 JtL' Iennitiridc(Vt�i�od Treat ALL STRUCTURAL CHANGES lit/RA S A ARE TO BE REPORTED Product Used FOR RETREATMENT • • J)is(nlium()Elaborate Trtr3ll,y}iraty 23%Active Ingredient Chemical used(active ingredient) Percent Concentration Application will be_pcyIutntc 1 unto structural woo31 4.!dried-in stage of cbnst(Ll}tjfli1 Stage of treatment(Horizontal,Vertical,Adjoining Slab,retreat of disturbed area) RORA-CA RF'lcrmiticide applicati4.lt sJ2aJ1 be applied according 4pI;J% registrated label dirccjioiis as stated in the Fioridafuilding Code Section 1816. (INFORMATION TO BE PROVIDED TO LOCAL BUILDING CODE OFFICES PRIOR TO CONCRETE FOUNDATION INSTALLATION) MAW OFFICE COPY isaTu•ner MAIN Onion 480 E061w000 Aw+ue,SoaN, Jecrsormuc,FLORIDA 32205 MI Peet Pint 91 533DD•Fax 964.3531488•Tou h'x:r:BIp•2Z5r33P •www,numilrasr,com ST.Mum,64.-912-5761381 Orru,Fu.-852-351.4386 Q Control Doom BEACH,Fu.-316.7184303 Parr St.Luca,Fu.—772492.1078 What's Bugging You? Mamas,Fu.-321-951-8325 Tuna,Fu.-1134814381 NOTICE OF INTENT FOR PREVENTATIVE TREATMENTS AGAINST TERMITES as re.aired by Florida Building Code.FBC 104 2.6) Address: /LC © -- _ Lot: i k-1 Block: Date: (Jo,/ 3 L ALL STRUCTURAL CHANGES liOItA SAItL''Igrnljtiridc(Wood'Frcat'pent) ARE TO BE REPORTED Product Used FOR RETREATMENT Pisoiliom Octaboratc Tettal ar;Tte• 23%Active Ingredient Chemical used(active ingredient) \ Percent Concentration Application will be p_eriurmcd unto structural WOW at drlt_l1411'tags of i nt1stt11rjj1)11 Stage of treatment(Horizontal,Vertical,Adjoining Slab,retreat of disturbed area) JiORA-(:A RI:7cnniticide application slu,ll be applied according to LI'A regisrrated label dircctiuns as stated in the Florida I3uildirtg Code Section 181 '101 (INFORMATION TO BE PROVIDED TO LOCAL BUILDING CODE OFFICES PRIOR TO CONCRETE FOUNDATION INSTALLATION) • s�Turner MAIM Omni 480 EOGRV000 kvswt,Sow,, dauormuc,Fiona.32205 !Pest beet;991a6s-5sDO•FAX 809-353.14e82_jo,l FNI, gip• 5:380b•Irww.tonstnrest,gew OFFICE COPY EP,Control ST.Mun,6t.-912476.1300 F 0 Oulu,Fu.-362-361-4386 Dtnaal SLIM,F .-886.781-0309 Pan ST.lute.Fu.-772692-0078 What's Bugging You? *mum UIIML,Fu.-821-961.8326 Tura,Fu.-8184814381 NOTICE OF INTENT FOR PREVENTATIVE TREATMENTS AGAINST TERMITES as re.uired by Florida Building Code.FBC 104.2.6) Address: f 40 I DC-P —s- ��an (. - Lot: 1S Block: c Date: ✓ v'-3011 ALL STRUCTURAL CHANGES IIUItA KAREE-1'rrutitk idc(Wood Treat molt) ARE TO BE REPORTED Product Used FOR RETREATMENT J)ist�ltiurn OctalxIratc Tetr.lu4lr;jtt 23%Active Ingredient Chemical used(active ingredient) Percent Concentration Application will bc.perlo_nucd unto Structur, iJOJ:►t drktl-in stage oftunsuncijnn Stage of treatment(Horizontal,Vertical,Adjoining Slab,retreat of disturbed area) BORA-(;Alt£Termiticide application shall be applied according to liPA registrated label directions as stated in the Florida Building Code Section 1814.11 (INFORMATION TO BE PROVIDED TO LOCAL BUILDING CODE OFFICES PRIOR TO CONCRETE FOUNDATION INSTALLATION) Elk OFFICEC 0 PY IR Turner 3hlaol Onat:480 EDGEw000 Avrut,Som. Jucusouo u,FUR%32205 Pest Eno&9D4 3I6:5B 9•Pit 034.353.14.88.770.07.30 801.71S.,63gb•Wyw.wssttrisr,ov El Control ET.Mum,6A. 812476.1880 Ocwu,Fu.-352-361.4386 Li V 1 Wm=Bract,Fu.-386.7884303 Part ST.Luca,Fu.-772492-0078 What's Bugging You? *UMW.par;321-861.3325 Tama,Fu.-813-6814381 NOTICE OF INTENT FOR PREVENTATIVE TREATMENTS AGAINST TERMITES as re.uired by Florida Building Code.FBC 104.2.6f Address: ' f• C,l�-u Lot: I ,t) Block: t S' o, : N4.✓3 2u() IiOIZAA}iL•"lnnitiridc(Wood rrcatmSgt) ALL STRUCTURAL CHANGES ARE TO BE REPORTED Product Used • FOR RETREATMENT • J)i mulium()elaborate Ttitallyth.tl• 23%Active Ingredient Chemical used(active ingredient) \ Percent Concentration Application will be.pg,Fiormes unto strurturalyAT11i1 al dri�tl_iu stage ofcouist.uclii?n Stage of treatment(Horizontal,Vertical,Adjoining Slab,retreat of disturbed area) BORA-(:A RI:'J ermiticide application shall be applied according($.!Li% registrated label dirccIioj%:IS stated in the Florida Building;(.ode Section J 8I6.I_8 (INFORMATION TO BE PROVIDED TO LOCAL BUILDING CODE OFFICES PRIOR TO CONCRETE FOUNDATION INSTALLATION) i • .1 ■-, VI 0 y -t b 0. �. �. .-. ,0 00 �1 0, vi w N 9, t� .p w N --� tr1 A ¢ < co co N cD co `•'' : 4 -0 - a �ndnx �!? z oaP:Jr, c4.) c4 c - o. y z co co o 0 p- 0 w a. c 50' c'' - z o 0 O � .0 zaov c .4, y ° cr " coo, XI 0 8 0. as O Cr '. `� O Z °0°• o _� °° C7 o p: a CD d I U C co C a0 x O c �;, N O cm o kji C It a `° a. v N = a a ti 4 F � � - F lv Do a —A) 0 a co (4, - o O g. toga - o a �' 0 C "t ..t,' ?) > O • 0 '0 0 d ►may•CA CA b Q' . v) `� W =' A) fD 0 o c' 4 < as co C. �- c- co Cri MI Fr cra CD 0 0 o W c0 ° n O d O CM 0 � o 0 coo > '0 CD 0 .. to o d c a. 0 a r• 0 tsi fa. 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