181 Sylvan Dr siding permit Ail
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: 17-RAAR-3533
Job Type: RESIDENTIAL ALTERATION
Description: SIDEING REPAIR - REPLACE T-111
Estimated Value: $500.00
Issue Date: 3/21/2017
Expiration Date: 9/17/2017
PROPERTY ADDRESS:
Address: 181 SYLVAN DR
RE Number: 170648-0180
PROPERTY OWNER:
Name: BAKER ET AL, JULIETTE
Address: 181 SYLVAN DR
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $55.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $59.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
J� Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 322335445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@wab.us Date routed:
City website: http:1Mw .coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ent review to uired Yes No
(� wilding
Applicant: CROWK O Fr g&Zoning
'"� Tree Administrator
Project: �cP� C� �( Public Works
Public Utilities
Public Safety t t Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: ❑Approved. [—]Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: Dale:
TREE ADMIN. Second Review: [-]Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 06174/09
Building Permit Application ?
City of Atlantic Beach J S 3
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 17---f
Job Address: 181 SYLVAN DRIVE,ATLANTIC BEACH, FL 32233 Permit Number:
Legal Deslrip(bn SOUTH 1/2 OF LOT 719 SECTION No. 3 SALTAIR REk 170678-0180
Valuation of Work(Replacement Cost)$ 500.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Ckde one): New Addition Alteratio Repair ove Demo Pool Window/Door
• Use of existing/proposed structure(s)(Ckck one): Commercial esidenti 1
• If an existing structure,is afire sprinkler system installed?(Ckcbe one): Yes No 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:
REMOVE&REPLACE 4.5 SHEETS OF T-111 SIDING
Florida Product Approval k t'G V1,90, for multiple products use product approval form
Property Owner Information approval
Name: RUSSELL&JULIET KELSO Address. 181 SYLVAN DRIVE
City AT IC SEACN State n Zip 32233 Phone ]nnewn
E-Mail lubaaeo®1www —
Owner or Agent lif Agent,Power of Attorney or Agency letter Required) 0M EFI
Contractor Information A C 2owA_:, rip Fr N
Name of Company: tlGRBVtfJl/78`R9BPBIB qualifying Agent:
Address 6504 BEACH BOULEVARD City JACKSONVILLE State FL 7J32216
Office Phone O Job
. Sba/Codaoc =WW*'
StteCertification/Regisrationk r� C7XE-Mall xStill
L�1L S7.
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Architect Name&Phone g ,N Jost
Engineer's Name&Phone k
Workers Compensation �C.Ia.SpazK /vt�UM .'S/ /7
hemp[/M / Empbyen/Fxlwanon pate
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 the laws regulationg
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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
RECOR➢MI YOUR NOTICE OF COMMENCEMENT.
(Sirylure MOwner or Agent mdudkM Comroaor) 42butne of fOI1h8rtM)
Signed and sworn to(or affirmed)before me this 401 day of Signed and swam to(qr affirmed)b fore me this day of
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1 ur/r 01 1'1 .by Z/ kS44J 9e%., % ,by ; T,o
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ignatvr of Notary)
2 x OMAS W KINCHEN SR
OFFICIAL SEAL ;,f'(COMMISSION kFF026544
TERRY TTANABE o4 g°' EXPIRES June 11.2017
K)Personalty xnown N Notary Public Snle of Illinois rsomily Known 0
I I Produced Idennfi tion My".'mrw$sxx,Emirs Jan 3,2019 I Produced Idenofica 1 l]Kb1 W Fp�itlFNderyseniu.com
Type of IdentKkatio Type of Idernlf umor: