576 COASTAL OAK LN - CERTIFICATE OF OCCUPANCY t CERTIFICATE OF OCCUPANCY
;.\w PERMANENT
-4,010>`
Issue Date: 06/16/2017
RE Number: 169505-2035
Address: 576 COASTAL OAK LN
Zoning: SPA
Owner: HICKS ANTHONY R
Contractor: COASTAL OAKS CONSTRUCTION INC
157 BEAR PEN RD
PONTE VEDRA BEACH, FL 32082
Permit Number: 16-SFR-1820-05
Description of Work: NEW SINGLE FAMILY
Construction Type: VB
Occupancy Type: DETACHED SINGLE-FAMILY DWELLING
Approved:
}1c- -AgerdbA
Building Official
I
VOID UNLESS SIGNED BY BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
CERTIFICATE OF OCCUPANCY WORKSHEET
Date Requested: Co /Z L 7
4-- ` Q ak_S ecD►mss-CR.VCZ'co• cContractor Name: O 0..5 �
Permit #: ICC ` SFR — ` S a a
Property Address: 5-7(p e 0 a S-c-C-A CD Q-k, l .r\
Legal Description:
Improvements to the above-described property have been completed in
accordance with the terms of the permit and are certified to be ready for
occupancy as: Pit
Single-Family Residence '1 r-e._
�
❑ Commercial q
H Other:
Lowest Floor Elevation:
Required As Built FFE
The following must be completed before issuing Certificate of Occupancy:
Department Date Notified Date Approved Approved By
Fire Dept. IV jli fJ (A, KV R
Public Works (2 / ( 7 k014\ 1 ' ç )
Public Utilities ' 1 S t,
Building 6 . 16 .17
Planning
brYIYQ__
Tree Mitigation C \40' D V_
Satisfied
a Pi.o4,0 c.,(�ji 7 6 I,- ,t,C
Final Survey with FFE ✓ Yes No
J
All Re-Inspect Fees Paid es No
Termite Treatment Yes No
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�j' BUG �� 5tt1 =;
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41--1) SERVICE Phone 904-743-8272
bugoutservice.com Toll Free 1-877-BUG-U-OUT
TERMITE TREATMENT RECORD / CERTIFICATE OF COMPLETION
Bug Out Service, Inc. verifies to the Builder, Building Inspector, Homeowner, and Lending Institution, in compliance
with Florida State Law (Chapter 482-226), this building has received a complete treatment for the prevention of
subterranean termites. Treatment is in accordance with the rules and laws established by the Florida Department of
Agriculture and Consumer Services.An annual inspection and renewal of the annual termite protection contract is
necessary for continued protection.
Location of Property(Street Address,city and State) Lot Block
P., L -77-7. 1:
If termite infestation should occur within one year from the date of treatment in this building, Bug Out will retreat the
structure using the standards in effect at the time of retreatment.The property owner shall have the option of extending
the limited warranty beyond the first year for no less than four additional years. If during the term of this guarantee,
additions or alterations are made which affect the structure and create new termite hazards, or interfere with the
treatment method used, this guarantee will become null and void.
r 1
Soil Treatment: f^ Technician Treatment Treatment
g[+ `)e-1--- co_s...,-,6) Record Date Record lime
Chemical Used: Premise Pre Other/, �” Concentration 0 5°Io
Gallons applied: ? Cf Method of applica on:_Pressure sprayed) _Soil rodded
Square footage of soil area treated: Linear Co-Masonry Voids treated:
Tubs and-Traps- ..c--" -`, —� --_� ��?? ,
'Final Soil Treatment: ` °J`1" %%UL t_ ��,( L)
;, _� ,_. -'z
r
"Wood- adient:
Chemical Used: Bora-Care Concentration 1:1 Solution
Framing area treated: 24 inch barrier treatment MAY 2 5 2017
Method of Application: Pressure sprayed Gallons Applied
Baiting System: a Sentricon'
Product Used: Sentricon Colony Elimination System Linear Feet: Colony Elimination System
Monitoring System:
Product Used: Linear Feet:
Builder:
fi
By (Signature): ' i Date: '(-
1Title: 7___:( 69
White-Job Site Canary-Job Site Pink-Bug Out
Reorder from Rush to Excellence
904-367-0100 Form#4045 Rev 08/14
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