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277 BEACH AVE A - UTILITY �� ' :�` � CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 UTILITY SERVICE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: UTIL17-0011 Description: DUPLEX-SPLIT A OR B (ADD SECOND TAP) Estimated Value: 0 Issue Date: 7/28/2017 Expiration Date: 1/24/2018 PROPERTY ADDRESS: Address: 277 BEACH AVE A RE Number: 170192 0000 PROPERTY OWNER: Name: HOLMES MARK H LIVING TRUST Address: 275 BEACH AVE ATLANTIC BEACH, FL 32233-5214 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: Address: 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. 4 A U `fIH7 - DCI .1=aL'Ti� City of Atlantic Beach PUBLIC UTILITIES DEPARTMENT 1200 Sandpiper Lane :_s• Atlantic Beach, FL 32233 % t iiijr (904) 247-5834 NEW WATER / SEWER TAP REQUEST Date 746117 Project Address 277 A--4`1J ISe4c1, Ate. 1 3 Z 1'3 3 Number of Units Commercial Residential Multi-Family 3 I ' New Water Tap(s) & Meter(s) 1 Meter Size(s) /cf New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaim Water Meter Size New Connection to City Sewer Applicant Name VV\jik `, \cA KA.CA Applicant Address 174 +6-414-1 tUc_ P" -c Z ti) City ACJ State Fl, Zip S223) Phone & - O 34`3 Cell -'Z --23 4-o Email /A4 Lam' IA 17' e .,KGA.,4-, f{A Applicant Signature y-Y\ . „"`.,.. CITY STAFF USE ONLY Application# (-iT I L- (7 - Go I 1" ck.F., ,-,-- e_ Water System Development Charge $ i 1 q 0, o p Sewer System Development Charge $ , 0 5-0. 00 ` �P�� Water Meter Only $ , Reclaim Meter Only $ S O C IS ,LE-.6 b. Water Meter Tap $ f300 % 00 Sewer Tap $ Cross Connection $ c5O, (0 Other $ TOTAL $ (Notes) APPROVED Kayle Moore, P.E. `Z.L✓-\ Date 77;?/t Public Utilities Director or Authorized Signature ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED rs�5, City of Atlantic Beach APPLICATION NUMBER �- Building Department (To be assigned by the Building Department.) t2\ 800 Seminole Road 1 ;-i.::).',,,„ ``"5-=- r U Atlantic Beach, Florida 32233-5445 Ti L( Iy — 001 Phone (904)247-5826 - Fax(904)247-5845 x�0.709.- E-mail: building-dept@coab.us Date routed: 7 / 1 L (17 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z77 iJ &P Q Pk\jE AorL Department review required Yes No Building Applicant: MARK L-4cLrn CS- _ i Z&Zonin reeAa i or Project: N G wict-TCZ_ TAP �� Public Utilities `jkpc AP @, u PL Public Safety Fire Services Review fee $ Itatirc L4 Dept Signature t.C. c 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: l APPL7ATION STATUS Reviewing Department First Review: TApproved. Denied. ['Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: ../B. i''‘ 1.1".`--- Date: 7/g/t7 TREE ADMIN. Second Review: Approved as revised. ❑Denied. I 'Not applicable j z1, wv 0. • Comments: 11111Pv 'UBLIC UTILITIES PUZLIt SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ,S rsf:Lv;yJ, City of Atlantic Beach APPLICATION NUMBER '' , Building Department (To be assigned by the Building Department.) 4;. - 800 Seminole Road • j , w �r Atlantic Beach, Florida 32233-5445 V 'T(U 7 ._ 0 0 pi Phone(904)247-5826 • Fax(904)247-5845�;�i9% E-mail: building-dept@coab.us Date routed: 7 /0. 6. 7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z 7.7 3 CRLti-1 FAVE Ao(-13 Department review required Yes No Building Applicant: NAS R < LA c)Lrn .X ala irrrt g&Zone t n ,V ree mi or Project: I &1D LOA-(�-�_ _r14 f ublic Works Public Utilities I\co TA ii (.9 Pc, ety 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: /[Approved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by Date: 7 22-c-i—17 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ❑Denied. ['Not applicable Comments: Reviewed by: Date: Revised 05/19/2017