387 8TH ST - WOOD DECK >,- !_."\i`.1----
r
J s, CITY OF ATLANTIC BEACH
yJ 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-DECK-3687
Job Type: DECK/PATIO
Description: replace deck boards like for like - issued over the counter
per Mike Jones
Estimated Value: $1,000.00
Issue Date: 4/5/2017
Expiration Date: 10/2/2017
PROPERTY ADDRESS:
Address: 387 8TH ST
RE Number: 169980-0000
PROPERTY OWNER:
Name: WEBER, THOMAS & JULIE, *
Address: 387 8TH ST
PERMIT INFORMATION:
FEES:
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
BUILDING PERMIT FEE $55.00
Total Payments: $59.00
•
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
;ate Building Permit Application
i* .3
ji jCity of Atlantic Beach
km" 800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax:(904)247-5845
Job Address: 3 8 � ST" Permit Number: 11- ()EG K- 3(0E-3--
Legal Description ' V&A-E RE#
Valuation of Work(Replacement Cost)$ c3(:)(-:) Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repai, Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residentia
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes 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:
13 0%GZD
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: UL—t EAONJ W Ea'e(L- Address: 38q- a S I
City ATLiNt.iZ1L S3U+ State FA— Zip 3z7-33 Phone c -• 3 t'L• 419-2
E-Mail .JLAA.-t E/MNnr—W03 _.L"i - ,"
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information {�.1 o N
Name of Company: Qualifying Agent:
Address City State Zip
Office Phone Job Site/Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation
Exempt/Insurer/Lease Employees/Expiration Date
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
RECORDING - NOTICE OF COMMENCEMENT.
ignature of Owner or Agent including Contract r) (Signature of Contractor)
igned and sworn to(or affirmed)before me this 51 day of Signed and sworn to(or affirmed)before me this day of
by
JENNIFER JOHNSTON
' ti MY COMMISSION S GG I -'
EXPIRES:October 272020 / '
(Sigratu•ofNotary) (Signature of Notary)
•: Bonded Thu Notary Public Underwriters ----i�w�----...---- ---...
.,. .1111104 r+R iF i JENNIFER JOHNSTON
gfr. COMMISSION M GO 042964
:,1 MY EXPIRES:October 21.2020
[ ]Personally Known OR [ ]Personally Known OR Bonded ThruNotary Pubic Underwear,
[)4 Produced Identification [ ]Produced Identification
Type of Identification: 01.(..q1-1`,S WA-AS( Type of Identification: