1627 PARK TER E - REMODEL PERMIT 'j r�1�j•
CITY OF ATLANTIC BEACH
LI : 800 SEMINOLE ROAD
� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0038
Description: interior& back porch remodel
Estimated Value: 100000
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 1627 E PARK TER
RE Number: 172020 0208
PROPERTY OWNER:
Name: Quinn Baker
Address: 1627 Park Terrace East
Atlantic Beach, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: CORNELIUS CONSTRUCTION CO.
Address: 71 19TH ST QA MARGARET S. CORNELIUS
ATLANTIC BEACH, FL 32233
Phone:
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
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.
01.raPJ• City of Atlantic Beach APPLICATION NUMBER
f Building Department (To be assigned by the Building Department.)
800 Seminole Road pp
iso Atlantic Beach, Florida 32233-5445
15!fir
r
Phone(904)247-5826 • Fax(904)247-5845 CS L CI ill-
A'....0110- 6 E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: a �t `L --k-s2 41 et(_Q-E-tt De
ent review required Yes-No
n �
Applicant: Cil f\L LOAS*4 JI CA\6v-N Planning &Zoning
Tree Administrator
Project: t -1 C `moi----rtt,U 1 k LOM Public Works
/I/e, 1 fv b-e i Public Utilities
ivo w. /►'tt� ,y7,1, Public Safety
QQ 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: ni
G�G
UILDING
PLANNING &ZONING Reviewed by: / rly
Date: S 3."f7
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 07/27/10
OFFICE COPY
crA� Building Permit Application
A City of Atlantic Beach
"Mir
800 Seminole Road,Atlantic Beach,FL 32233
r:v� Phone: (904)247-5826 Fax: (904)247-5845
Job Address: i(217 PARK TeRvic E ISA5T Permit Number: VI ba3
Legal Description 1.0rt 2. ELK 13 SELVA AAF )U4F RE#
co
Valuation of Work(Replacement Cost)$ my)),O& Heated/Cooled SF NA Non-Heated/Cooled N/
• Class of Work(Circle one): New Addition Alterationepa' Mov; Dem• 'ool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial 'esidential
• If an existing structure,is a fire sprinkler system installed?(Circle 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 BASE) C 19511, 1 ) I i`1TEi 9R D cRS, F 7 2/J)
r i,. _.- ..err / •..
"icy !.I(5,Yt.3- 1 c)CA/. n'I
Florida Product Approval# N A for multiple products use product approval form 30•/?
Property Owner Information
Name: QI)11J l-.J .551CA 5AkE-CZ Address: 1b27 PARK TI=1zRACc E
City f1TL)4IJ't1C 8C tit State 1C1 Zip *,z233 Phone 210— 508— )9)S
E-Mail .)ESS RENDIT3AKEls; A. GVII PHL. COM
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information n�1
') Name of Company: CbS1JE1-.1 U'S �►JSTUOMRGTI OQualifying Agent: MAR:AR :I G sJ EL-MS
Address Z I a F319 Y .741 ' City NEP(L)k_., 13014 State FL Zip 3 2 Z(o Lo
Office Phone ci0 4 • Zit Q Gj 7OC/ Job Site/Contact Number
State Certification/Registration# CBCC>4gQb7 E-Mail PCniZ1AEUv� C Y)1 A )L• Co TY\
Architect Name&Phone# ---
Engineer's Name&Phone# —
Workers Compensation
Ex�emptt Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to odthe 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' NG YOUR NOTIC OF MMENCEMENT.
/
itirittiii:/.4)
(Signature of Own: or •: including Contra r) `%' (Signature of Contractor)
S'.i,-'and sw rn to for affirm_• •efor- -t . C] day of Signed and sworn to(or affirmed)before me this 161�day of
at & Z-01 I ,b .� P1G�� ,�u« ,by 4 _ y-- �
(Signature of 1,• •• - (Signat e of'11-6--- ----1
ry`')
TONT GiNDLESPERGA �,.�... ► • �,
=+ ;�x = MY COMMISSION 0 FF 924951
�' '" EXPIRES.October 6,2019. . ':K` JENNIFER JOHNSTON
*i 14 MY COMMISSION A GG 0429114
[ ]Personally Known 0• �''•�d0. BondedThruNoaryPubVicUnderaters personally Known OR _
? o: EXPIRES:October 27,2020
[ ]Produced Identification _ [ ]Produced Identification '%,,p'..W Bonded Thru Notary Public Underwriters
Type of Identification: Type of Identification: ..w aiiiiimimionswo.