140 16th St stucco repair permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL-ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-S814
PERMIT INFORMATION:
PERMITNO: RES17-0081
Description: stucc;o repair& replace deck boards on 2 balconies
Estimated Value; 9))0
Issue Date: 7/18/2017
Expiration Date: 1/14/2018
PROPERTY ADDRESS:
Address: 140 16TH ST
RE Number: 1718780000
PROPERTY OWNEM
Name: RIDER GREGORY
Address: 140 16TH ST
ATLANTIC BEACH, FIL 32233-5804
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: E & R ENTERPRISES OF NORTH FIL
Address: 2628 WEST END ST QA EDWIN CHARLES PLITTBACH
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$7,500.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road C—.S f 11 —DO
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us Daterouted:
Citywelb-site: littipW�.coalb.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 14o 1(0 AWme!�revv re uired _yes7_N_0_1
,,d,n(,
OFIJ FL_ Planning &Zoning
Applicant: Tree Administrator
Project: (WOL'tir Public Works
_JEt- �� Ioctkmi 49 Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Recellpt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
StJohns River Water Management District
Army Corp._.fEngmee.
Division of Hotels and Restaurants
Division of A colholic Bevew._.and—Tob.=
Other:
APPLICATION STATUS
Reviewing Department First Review: %CApproved. ElDenied. ONotappiicable
(Circle one.) Comments: L *- 114�0 "�N9-4- -c—
BUILDING lk e�c_v_
PLANNING &ZONING Reviewed by: _A_y.*k__ Date: -z �08(41
TREEADMIN. Second Review: ElApproved as revised. [-]Denied. ONotapplicable
PUBLICWORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:—
FIRE SERVICES Third Review: [-]Approved as revised. [:]Denied. E]Not applicable
Comments:
Reviewed by: Date:—
fteylsed 05F1912017
Building Permit Application Updated 5/5/17
City of Atlantic Beach
goo Semi no le Road,Atlantic Beach, FL32233
f,'x Phone:(904)247-5826 Fax: (904)247-5845
Job Address: 140 l(ol"" ST. PermItNumber: f-CS['+-00F'/
Legal Description 10- 11 IV-2.S - 2qe tA*4r>At_6y Lvp3 SAI93E#-1716-78-CCOD
Valuation of Work(Replacement Cost)$ q Y, Heated/Cooled SIP_Non-Heated/Cooled_
• Class of Work(Circle one): New Addition Alteration pair Move Demo Pool Window/Dooe
• Use of existing/proposed structure(s)(Circle one): Commercial Cldimtua
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes 6C>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:
ReFLAe-C Dtc-?—V- BoA OA/ Q 8ALZo1V19Se F�&44T .Fl*
Florida Product Approval# for multiple products use product approval form
Property Owner Information 16'r 14
Name: "171 a ITbla-M Address: I
city 411-4 (TfCir- =15PWV7V4C"- -State F L- zip 3-4-2-33 Phone
E-Mail
Owner or ow(T of Attorney or Agency Letter Required)
Contractor Information 0K1Tt*?.F ILI
NameofCompany: 64i L 4 At Affilying ent: L-Avi"J PunsilitC4
Address 240,243 L#JW-S'r 4 - '�3--city-AT—L�4-471L�gtate Pd- AF zp--31!�
OfficePhone 4�%*- '2"70- JbSne/ContactNum er- - (.2(v- -J,51-
-t- ' ?G -C%% Q !
State Certifica ion/Registration#(ZC%CIW4[SA E-Mail 42AW, CID M
Architect Name&Phone#
Ent k Phone
Workers Compensation x py insurer/Lease Ernployae�I Upiratio D t #7-30- �R13 t 11 1 In
I
Application is hereby made to o�ap c r mit�to d4fFeime-pwo rk a n cl i n s t a I I at!o ns a s I n d icat . rtffV that no wor or ins a a ion as
commenced prior to the issuance of a permit and that all workwill 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 accu rate 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 FINA I C LT TH YOUR LENDER ORAN ATTORNEY BEFORE
RECORD G R CE F CID ENCEMENT.
y c:5�& C - pc�(�
signature of owner ent) (Signature of door)
(including contractor) 7Z d Of
th
Signeda d mor o(or affirmed)before me this. -Nayof Al.;J sw rn to or affirme
A I by tlydr,
DI
(signature of Notayr ........... TOM GINDUESPERGER
"6N MyCoArSSION#FF924851
Rnp Nam EIPIRES Ween 6,2`19
1K,
I Personally Known OR I Personally Kn
'�ycluced identification I Produced Identification
p'erpf Identification: fL&Wstic1�11t, Type of identification: