1238 BEACH AVE - ROTTEN WOOD & STUCCO ,,: l...A.,‘„,,
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CITY OF ATLANTIC BEACH
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'; 00 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
'!r;t >%' INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0240
Description: removing stucco, replacing rotten wood & studs if needed
Estimated Value: 100000
Issue Date: 11/6/2017
Expiration Date: 5/5/2018
PROPERTY ADDRESS:
Address: 1238 BEACH AVE
RE Number: 171827 0000
PROPERTY OWNER:
Name: MOYER RICK ANTHONY
Address: 1238 BEACH AVE
ATLANTIC BEACH, FL 32233-5730
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: PHILLIPS BUILDERS LLC
Address: 1250 SELVA MARINA CIR QA BARBARA CAROLINE PHILLIPS
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.
!, !..�v,. City of Atlantic Beach APPLICATION NUMBER
JS Building Department (To be assigned by the Building Department.)
800 Seminole Road D C ^ T
5 r Atlantic Beach, Florida 32233-5445vfi 1""w� T�� V
Phone(904)247-5826 • Fax(904)247-5845 10(a-�/r-
.�o;t �- E-mail: building-dept@coab.us Date routed: 11 t
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 0-3% 6ttlf, ha - _ De. - .-nt review required Yes No
Building
Applicant: int‘V-‘,‘)S el L a-AJF-,/S 1-1,r-1C . _'_annin. : .ping
Tree Administrator
Project: i LYw0J.L S"kNLC.-CD d-(b{0-2.1.-J03ct Public Works
Public Utilities
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: WAPProved. ❑Denied. ❑Not applicable
(Circle one.) Comments: (fro c-BUILDI t
PLANNING &ZONING
Reviewed by: �'� //- 3-/7
Date:-
6),
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. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
' Building Permit Application Updated 5/5/17
, OFFICE Cop City of Atlantic Beach OCT 2 7 2017
, ` 8 0 eminole Road,Atlantic Beach, FL 32233
Phone: (904)247-5826 Fax: (904) 247-5845 -- -
Job Address:
Z O AU'- • R.Q , 1 . 32-233 Permit Number: ESI -oa`ta
Legal Description RE#
Valuation of Work(Replacement Cost)$ I d 01 OW. Heated/Cooled SF 4,64j ? Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteratio Repair ove Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial `esidential
• If an existing structure,is a fire sprinkler system installed?(Circle one :AO. No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Des ribe in detail the type of work to be performed: l/JaCVON p STUDS I r N cCprO
P 1 .EQ(PtC,srty G e cmc.)
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: 1CK 4t3yE- -/ /►2{ .14- Q019-0 S Address: 1238 S icH t
City A-7LfrWTlc 40:1-Cµ State ft Zip 32233 Phone 7r7-.413-32/5—
E-Mail RI Cr• 4/P yOZ- e DR-Fltfil A rfflOti ttt2a a a '/
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) 0•1,t/OLS
Contractor Information
Name of Company:P141(.(.l 14V4 �'
U7� Lc,C.. Qualifying Agent:
Address c al Z dGT:s<1 t 1VQ. City 1:).1:? State 12-; Zip_?L..2-33
Office Phone 344 -Lei 9 9 Job Site/Contact Number
State Certification/Registration# C-8G12.1 72 14 E-Mail })1-11WLP.!'lgi/i ld.e,CIJ T-A/Ler
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation sf'>Lf vlfrr
Exempt i Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to .. -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 ATTO• ' BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
i!");i4L,(Signature of Owner or Agent) (Signature of ontractor)
(including contractor) '01
�n d and sworn to(or affirme.) befor�Jme this j�1 day of Signed and sworn to(or affirmed)befor- e this •2day of
l(iZ , () , by ►�021T �.,` 1� fit' , 2�) � , by uO`I !II.
(Signature of Notary) (Signature of Notary)
.r
vrp4MARISOL CUELLAR ?�, • MARISOL CUELLAR
Ter Personally Known OR sr ]Personally Known OR ? Commission#FF 118951
4+. Commission#FF 118951 Expires May 4,2018
[ ]Produced Identification :. ''"L Expires May 4,2018 ]Produced Identification l•.►1�,
-"�'+ bonded Nu Troy Fen Insurance 800-385-7019
Type of Identification: , fronded ThniTroy Fein Insurance 800-385-7019 ype of Identification: