850 SEMINOLE RD - FIRE ALARM & DEVICES i
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* CITY OF ATLANTIC BEACH
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_ l 800 SEMINOLE ROAD
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TATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247-5814
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FIRE SUPPRESSION SYSTEM
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-MCHF-3600
Job Type: MECHANICAL FIRE PERMIT
Description: ADD FIRE ALARM PANEL AND DEVICES
Estimated Value: $15,000.00
Issue Date: 4/4/2017
Expiration Date: 10/1/2017
PROPERTY ADDRESS:
Address: 850 SEMINOLE RD
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: JACKSONVILLE SOUND & COMM
JACKSONVILLE SOUND &COMMUNICATIONS INC THOMAS
MILHON, EF20000375
Address: P.O. BOX 551629 CIR QA BRYAN A STROSS
Phone: 904-737-3511
PERMIT INFORMATION:
FEES:
Fire Alarm Systems $35.00
Total Payments: $35.00
PERMIT IS :APPROVED ONLY IN ACCORDANCE. WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
�t--^.sir Building Permit Application
- 4 „ City of Atlantic Beach
51 800 Seminole Road,Atlantic Beach, FL 32233
P--0;n9%. Phone: (904) 247-5826 Fax: (904)247-5845
Job Address: i'.605e-r•i^2te- i-d Permit Number: ( 7- ne\C•N F_3A0O
Legal Description RE#
Valuation of Work(Replacement Cost)$ 13e 000 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition , teratio Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): 4104# 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: clak_ .pi ft ,,/,_ta,en„ pc,,ir.Ll 4-a4-ev,'c.,t S.
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name:
PO(,LcE T��L O i Address: O S 0 Se 4 do (P
City State Zip Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information Ja-e1C.s0cw,lle-- 00t..)C� ckn d CornMvn•Co--hor.S
Name of Company: 35C- 51s.k_M.5 Qualifying Agent: '1Z !Met M i ‘A'-‘Oa
Address Soak �„t�.Qp Vim- City J"adGSon..i Lk State ice[. Zip 2.2-1!o
Office Phone 61.04.--1S-7- 351( Job Site/Contact Number
State Certification/Registration#EGacpOOO!i15 E-mail --r, rr-L 1 hon ;mc.3qs-1- i t . A.e_'f
Architect Name&Phone#
Engineer's Name&Phone# Q � Ask
Workers Compensation �?;16��1� •
Exempt/Insurer/Lease Employees/Expiration Date
111 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. ,,nn1'77
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in cotnp� arftt±5kith 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 YOUR NOTICE OF COMMENCEMENT.
ractor)1--%WIT-4—t-c(---2-7:5 ak ii /
(Signature of Owner or ,_- including Contractor (Signature ofZ of
' ned and worn to(or affir -• •efor• • e th' ay of S. d and s orn to(or affirme•l •-'•re me this a y
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°��ke4MY COMMISSION#Fr 924951
1i-"` i EXPIRES:October 6,2019
:ISSION*FF 92' ` � Bonded Thru Notary Public Uncerwriters
:MISSION#FF 924951 ,—
[1ersonally Known Ot ., `' riES:October 6,2019 [ ]Persona ly Known OR /C
-:- `NrUNotary Public Unde• ;ers [ ]Produced Identification i,n ,a 3 l -544-7 1 (j`0
[ )Produced Identificator .,.:— — I V `
Type of Identification: Type of Identification: 1