1837 SEA OATS DR - PAVER WALK r, ler.
! t__'% CITY OF ATLANTIC BEACH
;? 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
` "!,,3 �%' INSPECTION PHONE LINE 247-5814
RESIDENTIAL OTHER - SINGLE OR TWO FAMILY RESIDENTIAL OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES017-0031
Description: PAVER WALK WAY
Estimated Value: 1000
Issue Date: 10/4/2017
Expiration Date: 4/2/2018
PROPERTY ADDRESS:
Address: 1837 SEA OATS DR
RE Number: 172020 0546
PROPERTY OWNER:
Name: LYON JONATHAN R
Address: 1837 SEA OATS DR
JACKSONVILLE, FL 32233-4511
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: KETTELL INC.
Address: 1860 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.
0.A1.1;yel City of Atlantic Beach APPLICATION NUMBER
Js �, Building Department (To be assigned by the Building Department.)
- v800 Seminole Road R1
0so I
Atlantic Beach, Florida 32233-5445 7 _003
Phone(904)247-5826 • Fax(904)247-5845 �2/ ji�J;3 EE-mail: building-dept@coab.us Date routed: (�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: l 7 SES A De• - ment review required ira "No
Applicant: 1 \ E rj . I C - _ ing &Zonin•
j I --
Project: 11�V _ - Dec.c__...‘_ LO ''I-T is Works -
'us is 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: <proved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
C-137—.11LDING)
PLANNING &ZONING 7
Reviewed by: /7)1 ' Date: d' - /'1
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. [1]Denied. ❑Not applicable
1 Comments:
Reviewed by: Date:
Revised 05/19/2017
ril-Anjy,, City of Atlantic Beach APPLICATION NUMBER
a' Po ? Building Department (To be assigned bythe BuildingDepartment.)
... ,�� 9 P )
j 5 800 Seminole Road
3 ; ¶ Atlantic Beach, Florida 32233-5445 RCSO 17 --Cx
Phone(904)247-5826 • Fax(904)247-5845
��j;t !,)%' E-mail: building-dept@coab.us Date routed:
�/3 /is?
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I � S ..P., �.Jl�-ZS Cia_ ent review required Yes No
Applicant: 1K E I T L j_, l IL)C.:_, ,, Iarthiing & Zonin
Tree Admingtrat6r
Project: PR c_42__--� _ 1i)ecr•i. WALK_ (R icb"fr work
ubCltitttics,
1 Safetty
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. I INot applicable
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed b / — Date: • ,—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. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
01-tvrJ,, City of Atlantic Beach _;,: a. APPLICATION NUMBER
, " is Building Department (To be assigned by the Building Department.)
r - v 800 Seminole Road 1;• 7 {
r - Atlantic Beach, Florida 32233 ,5 AUG 0 3 20n I RC—,S0 i 7 —� � I
N Phone(904)247-5826 • Fax(•a-;� 247-5845 a
�o;t of E-mail: building-dept@coab.usIy: Date routed: EV:3 /i7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I ! Sp., ��ZS Cia__ Dueidinglment review requireduired Yes No
•
Applicant: K E j Tom_(_,_ I IvCL., 1ging & Zonin
Tree'' mini r
Project: PR VC,-12--S -- D •r..j- LU K-POrrc Works)
41/4. Citttfti ...—)
iribbIlti::Safety
Fire Services
Review fee $ Dept Signature i
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:,..40A44/4/714. 7_Date: , lir
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: Approved as revised. nDenied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
,-,(Th"
City of Atlantic Beach APPLICATION NUMBER`' .\ BuildingDepartment "
p (To be assigned by the Building Department.)
r 800 Seminole Road AUG ,� `
vj �} Atlantic Beach, Florida 32233-5445
?i�17 RC-SD` 7 --�
v Phone(904)247-5826 • Fax(904)247 845
,;;lwE-mail: building-dept@coab.us }' Date routed: e/.3 11 '7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 13 7 , .c A-rz Of Des , ment review required Yes No
Applicant: 1-‹ II-Q—L 1I3C., 7.- mrni g nm
11 .111111.11
Project: 1-7- RV&_s _ D ,,,.. -_ L3c /':is works --
'00
•ub is Safety
Fire Services
/
Review fee $ Dept Signature "-1.-
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 b
44---c"‹. Date:
TREE ADMIN. Second Review: A roved as revised.
pp ❑Denied. [Not applicable
2?g, WO,8 Comments:
PU�J-IC UTILITIES
ts-3—1"?
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
` t': Building Permit Application Updated5/5/17
A
4.
City of Atlantic Beach OFFICE COPY
800 Seminole Road, Atlantic Beach, FL 32233
1 A`01=Iyi53 Phone: (904) 247-5826 Fax: (904)247-5845
Job Address: S..:4 rer�/ S f) 17(-'/ L' Permit Number: Rd` 7 -003 (
Legal Description 36-20 at-z-S-74 £ �iIVAf'•.nnkOA ) q 10.-71 61 L RE# 1&2ZU-os-ie`
Valuation of Work(Replacement Cost)$ POO Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New dc: Alteration Repair Move D Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): CommercialResit de �-�,
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No ,N( /9/
• 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: J.
X tll �� pc.1) I ( <ce6 ,) -�'h 1---)i-,t, (� ritVe-o—S' i 4i/ /UL:z /1i_- AA
Florida Product'Approval# for multiple products use product approval form
Property Owner Information �i
Name: LtQO•� Address: /O '1 f 5 Ori,vee
City 44-16„,h'` 664.v� State rt Zia 32Z 3'S Phone /obi Z,q/ 311 77
E-Mail gc,..-- ,.� )3 (J i i f./t', -
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information �1 / T ,l /
Name of Company: 1 /TI-e`), .Y+�/L- qualifying Agent: Ketir C-�
2,1
Address I%c t w� e.f,1 City_�� A i, /er,,,A_State/ Zip S z z 3 3
Office Phone 906/ �� 72-7(v Job Site/Contact Number Oz/ 3 77 /QJ g'
State Certification/Registration# E-Mail ,AA 6 Mi ,.,. , , E.
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation O- Pi* -
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 YOUR NOTICE OF COMMENCEMENT.
U1., ^ /--
(SignatureCof Owner or Agent) Signature of : ra
(including contractor)
S' ned and sworn to(or affirmed)before me this I day of n/Signed and sworn to . - 'rmed)before me this J day of
_.
- vv {, • •-2- by ii I-t'4.s,S V , - / , by ',. /
_
`i ,.... affIff
s`
(Signature ofi'.. ary) (Signature of No 0"Ce
[ ]Personally Known 0: �l� DAVID NAT [ ]Personally Known OR ;' 7.1 DAVID NATHAN SLATOFF
( ]Produced ldentifica aR` NATHAN SLATOFF [ ]Produced Identification COISSION x FF
935021
Type of Identification: ' MY COMMISSION to FF93502t Type of Identification:_ EXPIRES__Noy X19
EXPIRES November 09.2019 Apr , 3.4c.,,,,,,
1407 •53
FlorqaNq• ger ice r.,xr
•
TREE & VEGETATION AFFIDAVIT
City of Atlantic Beach
- ., ,� Department of Community Development
Planning&Zoning Division
800 Seminole Road Atlantic Beach, FL 32233
(P)904 247-5800 (F)904 247-5845 PERMIT#
SECTION I-APPLICANT INFORMATION
F Owner(s) (Legal Authorized Agent*
NAME OF APPLICANT C.,L- 4.'r?`i
NAME OF COMPANY )3E,7b?e/I/, ,
ADDRESS OF COMPANY
PHONE oG/372 6 CELL *pj7 7yy EMAIL (n 7 (
eokiN
CONTRACTOR CERTIFICATION NUMBER
ATLBCH BUSINESS TAX RECEIPT NUMBER ' 7 _ e/j/ j
SECTION II-SITE INFORMATION
STREET ADDRESS OF PROPERTY r
1 Q .
If an address has not been assigned to this property,contact the AB-Building Department at(904)247-5826 to request an address.
LEGAL DESCRIPTION 36 _ 7 o G — Z c', _ ' E
LOT BLOCK
SUBDIVISION 72-, • 4,v
REAL ESTATE NUMBER 17?') oS L�G SQ FT
LOT OR PARCEL SIZE: (ee /,,
AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
I affirm that 1 have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation"of the Municipal Code of
Ordinances for the City of Atlantic Beach,FL and/or I have participated in a pre-application meeting with the Administrator of those
regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
from the above-described or adjacent properties in conjunction with this project.
SXNA FdFO
SIGNATURE OF OWNER
Sign d and sworn before me on this day of
y��}—• ,by State of pi
County of
Identification verified: K
Oath sworn: r Yes I— No 1
DAVID NATHAN SLAT•
1.7-Signature
*' MY COMMISSION H FF935021 11)
."% EXPIRES Novemb.r 09.2019 My Commission expires: j l ( /77
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