1957 SEMINOLE RD - SIDING y
A .-,
-- CITY OF ATLANTIC BEACH
\� :4) 800 SEMINOLE ROAD
1,. J J3 ��, 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: RES17-0114
Description: REPLACE SIDING ON SOUTH WALL WITH LAP SIDING
Estimated Value: 3500
Issue Date: 8/4/2017
Expiration Date: 1/31/2018
PROPERTY ADDRESS:
Address: 1957 SEMINOLE RD
RE Number: 169542 0512
PROPERTY OWNER:
Name: MAYEDO CAROLE ANN
Address: 1957 SEMINOLE RD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: BOSCO BUILDING CONTRACTORS
Address: 2158 MAYPORT RD
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.
s.,..\,, City of Atlantic Beach APPLICATION NUMBER
�- ,. •_ ,sBuilding Department (To be assigned by the Building Department.)
,h4 `i 800 Seminole Road {� j' _ ( I
'), Atlantic Beach, Florida 32233-5445 1\ i
c • �r
Phone(904)247-5826 • Fax(904)247-5845
"9.119'" E-mail: building-dept@coab.us Date routed: Z
c--
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: L S7 S EYnin c . o2Department review required Yiey No
(. uildin
14—_____lanning_Applicant: 'E COCQ 2U ( LIQ I C g &Zoning
1 Tree Administrator
Project: Rcca& S ( D (luC C) ;.) Public Works
I - Public Utilities
Soo - W 14cL_ 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: f proved. ❑Denied. Not applicable
(Circle one.) Comments:
UILDI
/VOT
PLANNING &ZONING
Reviewed by: rn Date: ?'/ 7
I
TREE ADMIN.
Second Review: Approved as revised. Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. Denied. I INot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit Application �
OFFICE COPY City of Atlantic Beach U `
JUL 2 5 2017 lb
800 Seminole Road,Atlantic Beach, FL 32233
°i{9r Phone: (904) 247-5826 Fax: (904)247-5845
Job Address: Iq✓ / C /3DW V-0/301 /iTL f Fe/ Permit Number: Re ` -01 4
--.
Legal Description 42--14 - 25- 2 e / rprAChtt-StOri1 tot-36 ?LK. 1 RE# `� �2
Valuation of Work(Replacement Cost)$40/549 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration (FepaMove 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): 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 thetype of w•rk to be performed: csa,e . p ,,5.0.tvty fie- . tt-i-1 LA.a_ AA)/
Florida Product Appro . t%2i /3/92• / TQC for multiple products use product approval form
PropertOwn eAor Information
Name: ( RVO( ' ,& Address: lvl/S? 44ote.
City �.'f L4rr ll' 2 fit / State Fc. Zip 971.14?? Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information `� �?�-�
Name of Com an : CO 7lA.IQA Qual'y�ying Agent: '/'" '" 2 10
Address IW PO 1.* City - tTt )C State r—c, Zip 32133
Office Phone ?A-t( - O'f2O Job Site/Ciptac Number VACA14 '-72,V411" 4� ri_�OfoD
State Certification/Registration# E-Mail " `MA 7tZt.Ud ie-c0^
Architect Name&Phone# l2 W
Engineer's Name& Phone# b /
Workers Compensation Ckel4vf1 _
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 YO - R NOTICE OF COMMENCEMENT.
(Signature of Owner or Agent including Contractor) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this- ' day of Signed and sworn to(or affirmed)before me this.. lday of
�VZy ,.2 /7 , by C•4RAA-e /'MY,o%De 3-44y , v.0/7 ,by Topp A-to
6)4 Z. Qdef«; oe4
(Signature of Notary) (Signature of Notary)
"' - WIWAM L POPE
r,f'•,•, MI WIWL POPE r_ MY COMMISSION 3 FF 242630
Personally Known OR p ' ', 4;= MY COMMISSION II FF 242630 At Personally Known OR 4c EXPIRES:October 19,2019
[ ]Produced Identification, • F a: EXPIRES:October 19,2018 �'
[ ]Produced Identification • Bonded Tin Nobly Pubic tMa«wilaa
Type of Identification: 'n``' Bond•dThruNotryPobkUneawntns Type of Identification: