357 SHERRY DR - REMODEL cl CITY OF ATLANTIC BEACH
A rj 800 SEMINOLE ROAD
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ATLANTIC BEACH, FL 32233
Olt ! INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0029
Description: bathroom & upstairs remodel
Estimated Value: 10100
Issue Date: 5/25/2017
Expiration Date: 11/21/2017
PROPERTY ADDRESS:
Address: 357 SHERRY DR
RE Number: 169825 0175
PROPERTY OWNER:
Name: POPPELL RICHARD R
Address: 357 SHERRY DR
ATLANTIC BEACH, FL 32233-5349
GENERAL CONTRACTOR INFORMATION:
Name: THOMAS E KOHN
Address: 15 GUANA DR THOMAS E KOHN
PONTE VEDRA BEACH, FL32082
Phone: 8032430395
Name: KOHN CONSTRUCTION LLC
Address: 15 Guana DR
PONTE VEDRA BEACH, FL 32082
Phone: 8032430395
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
11 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
.,-tLAnCity of Atlantic Beach APPLICATION NUMBER
�s ; Building Department (To be assigned by the Building Department.)
re 800 Seminole RoadG;
j �, ��f Atlantic Beach, Florida 32233-5445 ��5�'1 — 6 Oa 1
Phone(904)247-5826 • Fax(904)247-5845 G,
i� E-mail: building-dept@coab.us Date routed: ,S. I t 111
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3S \N�-i(L{ 0( . nt review required Viey No
Building,
Applicant: D A( e_-6r)SA(LAC,an Planning &Zoning
Tree Administrator
Project: b ate.I D In 4 i-k_i)S (S I m o kj 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: Q pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: !I/ Date: i.S 'cP 5l /7
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie .
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
-- , yr • • • . BILE COPY ,
Iv,",:c-7,--, Building Permit Application
,,, City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
' - `'~ Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: ;C-7 S 1(iEL, Permit Number: E_e, I 1 - 0 Ode)
Legal Description RE#
Valuation of Work(Replacement Cost)$ to,leo., 0e Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move D o 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): Ye 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(Z) (,G( o,,w• i-�t� lei-. 7 •wer(- r`h,tcS e .-& f^(.c 4.-
44uAd Sc�civ V di5 . Q--1'4..k ()Kt-6%Ls /4,-w ft4I..-S 4-tot. "AA5 ofe 4 ?or .0l.rc4.
o.- (. 1Li5 1-'05 -zf
-
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: e.lc�� r< a. ()oppe j( Address: 3s1 Sht'/fY D„,
Cityk)1l ie.- 13.r6-cl, State P)4 Zip ;,ZL33 PhonE? q17 731 6�S S.
E-Mail po?pG(. r(t_ e quo,f. (0 e....
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) //
Contractor Information r
Name of Company: .-`'"" (ice sr v 0r/ 0-c ualifying A ent: e--(-2 •41% /624'‘`-
Address
('(‘`-
Address i c 6VGr y c Dye e City State AA- Zip not 2
Office Phone e64 Z tf S 6 91r Job Site/Contact Nun3bber $0 3 2 `f'3 O 3 9.5—
State Certification/Registration# E-Mail /e.((f . /cvrLC f c 1 .(- Go AA--
Architect Name& Phone# 0y4
Engineer's Name&Phone# ,- q-- `--
Workers Compensation ' '1 - '. U u •
C< ii ►}
V 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 stanc AII of-aEthaas 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
RECO ING Y/qu r NO7I E OF COMMENCEMENT.
"li £ l ,
1
\'� (Signature. Contractor) (Signature of€e*+sctor) Vet--
Signed
and sworn to(or affirm d) before me this 1 day of Signe and sworn to(or affirmed)befor- m-i if day of
_ Vv 'J) UI7 ,by/1 , : 9 i ;I 1 ( C ) �,by ter.. iil
4•:: .: . . 'BETH A. :'_ ,/.�OW4pIr/, _/_ •
- . -:'nn FF... . .
:SFS 16,2017 ( :na ure of ota ) •. .ture of Nota
'4„-A.r„iC, . .. . . `•1 rIniwanco9003957019
,STI1 N NUNI:Z
Notary :-.;J c- State of New York
NO. 01N116276196
[personally Known OR [[ Personally Known OR Qualified in Nassau C.Qupty
roduced Identification �L , 6U . 5 `� C --.
,z, ‘2, Identification ' -~'r-'.r xpires 411 2
Type of Identification: /�_. � `���� Type of Identification:
>=,',:,e to
.^',� : sago a rtners
May 4,2017
TO WHOM IT MAY CONCERN
Regarding the construction and alteration of my property at 357 Sherry Drive,Atlantic Beach,Florida 32233,let it be
known that THOMAS E.KOHN is acting as my Contractor and Agent with regards to this work and is offered rights to
act on my behalf relative to the execution of agreements which enable such work to be commenced and completed.
Richard R Poppell
357 Sherry Drive
Atlantic Beach,Florida 32233
4 S—e( Nel la R.Poppell)
(Richardppe 1)
Signed and sworn to(or affirmed)befo e e this l day of , �(4--
14
By
-____
c
(Signature of Notary)
). Q ci iq?,>?76 i
REVIEWED FOR CODE COMPLIANCE
CITY OF ATLANTIC BEACH
SEE PERMITS FOR ADDITIONAL
REQUIREMENTS AND CONDITIONS
REVIEWED BY: 1y DATE: 5 'a'1'l7
FflE COPY
SAGOPARTNERS, LLC. -350 WEST 23RD ST-SUITE 6B - NEW YORK, NEW YORK 10011
T +1 212 206 7382 M +1 917 734 6858E RICKSSAGOPARTNERS.COM
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