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0 BEACH AVE - DECKS CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 .f 9 r' RESIDENTIAL ALT/OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 17-DECK-3306 Job Type: DECK/PATIO Description: replace existing entry decks Estimated Value: $15,000.00 Issue Date: 4/6/2017 Expiration Date: 10/3/2017 PROPERTY ADDRESS: Address: 0 BEACH AVE RE Number: None PROPERTY OWNER: Name: OCEAN GROVE HOMEOWNERS ASSOC Address: 1660 - 5 BE 5 BEACH AVE GENERAL CONTRACTOR INFORMATION: Name: BROADWELL BUILDERS Patrick John Broadwell, CBC1257323 Address: 335 COUNTRY CLUB LN JOHN PATRICK BROADWELL Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $62.50 BUILDING PERMIT FEE $125.00 STATE DBPR SURCHARGE $2.00 STATE DCA SURCHARGE $2.00 Total Payments: $191.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ; ,.-\,i City of Atlantic Beach APPLICATION NUMBER .rj �5�iivoBuilding Department (To be assigned by the Building Department.) 800 Seminole Road (�i �' Atlantic Beach, Florida 32233-5445 I IJI,C K r 3 3L� / Phone(904)247-5826 • Fax(904)247-5845 Q t a a I l 2 ', %o;;l,' - E-mail: building-dept@coab.us Date routed: T City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I&(O '6p-k0V\ M Q ' Department review required Yley No _ uil in Applicant: c3r DCt.cil,W Q.`1 t<, R�(Q(S . Planning &Zoning) Tree or Project: •( Q-�LtL L -\t'Sfiy1c, A L Public Works �J 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: Noe__ UILDIN PLANNING &ZONING ) n Reviewed by: Date: x"27" TREE ADMIN. Second Review: Approved as revised. ❑Denie . PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I (Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 psi-tv.., City of Atlantic Beach APPLICATION NUMBER �S '-,;*•-�� Building Department (To be assigned by the Building Department.) .: u 800 Seminole Road �� r Atlantic Beach, Florida 32233-5445 11 IJ!✓C K— 3 30.6 Phone(904)247-5826 • Fax(904)247-5845 I y;t�sr E-mail: building-dept@coab.us Date routed: ` a a l i City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: t &10O .Q-11(,i1 Q - Do artment review required Yes No t u = -- Applicant: f3r Dacttn)Lk\ 5 �11 .(S . Planning &Zoning Tree : . or Project: _ c t,cAttl_L Vr`%S*Y A,L(,t_ Public Works 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: XApproved. UDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING 3/1/iReviewed by: ,►� (,� Date: 7 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑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 800 Seminole Road, Atlantic Beach, FL 32233 OFFICE COPY Office(904) 247-5826 Fax(904)247-5845 - Job Address: P Beach Avenue-#244-#4406-Atlantic Beach, Florida Permit Number: '1-106.6 K 3. (pro Legal Description Lots 9,10,11,&12 Ocean Grove Unit 1 Bk.15 Pg. 82 Parcel# 1\0q1—c-ia- DO CO Floor Area of Sq.Ft. Sq.Ft Valuation of Work$15000.00 Proposed Work heated/cooled _ non-heated/cooled 645 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 sprinkler 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: Replace existing entry decks Property Owner Information: 11Th E O E (1�/J • Name:Ocean Grove Homeowners'Association Melissa Hess, President Addre 1 #4 Beach Ave. ►-`—�! City Atlantic Beach State Fl. Zip 32233 Phone(904)699-4406 ; FEB 17 2017 _ID E-Mail or Fax#(Optional)Hess124@bellsouth.net ' Contractor Information: Company Name:Broadwell's Builders Incorperated Qualifying Agent: Patrick J.Broadwell Address: 335 Country Club Ln. City Atlantic Beach State Florida Zip 32233 Office Phone(904)813-5697_Job Site/Contact Number_(904) 813-5697 Fax#(904)813-5697 State Certification/Registration#CBC-1257323 Architect Name& Phone# Engineer's Name& Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address i �. TREE & VEGETATION AFFIDAVIT, r r� , City of Atlantic Beach 111 FEB 1 7 2017 11 1Ie Department of CommunityDevelopment ` \, Planning&Zoning Division 800 Seminole Road Atlantic Beach,FL 32233 (P)904 247-5800 (F)904 247-5845 PERMIT•#- �..._ _. SECTION I-APPLICANT INFORMATION E Owner(s) Legal Authorized Agent* NAME OF APPLICANT Ppr,gx.c.K J „R(.1l1A1�;( 1-4_.-- NAME OF COMPANY 1 SOA O>)13- ADDRESS OF COMPANY 335 Cav,TR Y Cw 6 L_,j- A YUIJ T s 8F-ACr(f (_�. T2-2-33 PHONE CELL 904-913.• EMAIL loroadbuiide_ccmcer,ti - CONTRACTOR CERTIFICATION NUMBER CA c (25 7 323 ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION II-SITE INFORMATION 0 Oral 44- ilia STREET ADDRESS OF PROPERTY pIAc Prot r\Tf 'rrc 1, F0C Fes, 32,23 ) ' i r If an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address. LEGAL DESCRIPTION r A t LOT .946 lt) BLOCK SUBDIVISION ()cod Gdzvog Ur-'TT I REAL ESTATE NUMBER I(O ctSla_OOOO-OT OR PARCEL SIZE: SQ FT AC RESIDENTIAL l� COMMERCIAL OTHER(SPECIFY) 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 from the above-describ••oradjs'int properties in conjunction with this project. 116' (CP VAMP- SIGNATUR OF OWNER SIGNATURE OF OWNER Signed and sworn before me on this day of v't ao,Nv0(`, , for_ ,by State of County of 'v1V c, Identification verified: di./No��S \ L Q,X13 Oath sworn: r Yes No Notary t nature My Commission expires: ,.,,Y,•ti REV-TVA-v10.12 ��,►* '; JENNIFER JOHNSTON st .. ;*; MY COMMISSION t�GG 042984 -f. .c EXPIRES:October 27,2020 �[ .ci Bonded Ttru Notary Public Underxrtiters J{