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851 MAIN ST - SIDING iy�\JrJro, CITY OF ATLANTIC BEACH iii 800 SEMINOLE ROAD 1r ATLANTIC BEACH, FL 32233 i a �...);3 9� INSPECTION PHONE LINE 247-5814 RESIDENTIAL - ALTERATION RESIDENTIAL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RES17-0192 Description: HARDIBOARD SIDING Estimated Value: 2200 Issue Date: 10/11/2017 Expiration Date: 4/9/2018 PROPERTY ADDRESS: Address: 851 MAIN ST RE Number: 170944 0010 PROPERTY OWNER: Name: SAPIA PETER C TRUST ET AL Address: 1655 SELVA MARINA DR ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: KAYLEY CORPORATION Address: 6817 SOUTHPOINT PKWY STE 1804 QA WARREN G BREW JACKSONVILLE, FL 32216 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$7,500. { '1A Building Permit Application A City of Atlantic Beach OFFICE COP 446-ooke 800 Seminole Road,Atlantic Beach, FL 32233 °'t'`'t's �( /15-5- Phone: (904) 247-5826 Fax:v, �(9904) 247-5845 Job Address: C.Z) r " � `t" �. ; 11� rmit Number: R S(�1- Legal Description T4-12 �av�C(.r a{t iG k\-- e.c Irdl'3 �: 4Mt �lk s -itE# t 1 CC 14 q ' 00`Ci Lt t-cc - o ��-3 t w3k-�t1 , Seck“o "�„- .�. x(3.0.-,:� Valuation of Work(Replacement Cost)$mop,c6 Heated/Cooled SF Z1 G Li Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration •epair ove Dern Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial Residenti • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail t`h�e type of work to be performed: (A.. perms- .\ s\' e t -S o- V kY' 'S (9. J1,...er-� (Z9 1� ���"• tw•_� c0 • Z La�s�e�1 ,d � `� t l-e�., , el��S ls wl� S i-> � �C� - a•� ice. . O Florida Product Approval# lel 7 1 , I for multiple products use product approval form Property Owner Information Name: Qe\.cc C- ""cam Ta-1'S- Address: (6 -'S2`.t c. }t6s-;--- - City �k--f... c- 03„a...". State tri- Zip 3 2-333 Phone gt'oy t 4 cl- $`7 c,,,><, E-Mail PSIS V.z.55 e, oc. --cc.-”- Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information / �.j Name of Com any: 110 4G-EY OJ P. �r- Qualifyin Agent: J (aZIA) b< 4.�P(.,/J Address 6�i .ij(J( A 2r P< 7 J City ��( . State 0. Zips f 2 /[7 Office Phone �/O�' c ( �9 31 Job Site/Contact Number 0,40, 7 2 e„i 4/24 c. State Certification/Registration# -,t3 c©Sv7, ci. E-Mail (OA/. i? A- c y�fi Y Caro. C()A Architect Name&Phone# Engineer's Name&Phone# Workers Compensation i`i,P. 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 TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ID -..1- V C -CA?yk 0._ ,fik i (Signature of Owner or Agent) (Signature of..i . or) (including contractor) or Si ed and sworn to(or affir ;d before met i __ day of Si end n sworn to(or affirm-d before e this , day of by A � ! -_ f.r , Si , by C. I 1 �/ . 4- , (Signa e of Nota ) (Signa41e of Notary) 4 4. ;;��'""'t�;. CHERYL. A GARCIA , .✓`�'+ •;: CHERYL A GARCIA •- MY COMMIS:, a •: MY C!�IMMISSION#FF977394# ' / / at ' ersonall Known O 77394 ersonall Known O' '� y e. EXPIRES".., 020 y •a,. Ea` :F: ,vbrch 31.2020 [ ]Produced Identificati pp�j3p t� FanaaNc com [ ]Produced Identificat . ;j'it6 ,,.,awotaryS•w,c•.Con Type of Identification: Type of Identification: City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) \s2) 800 Seminole Road / , Atlantic Beach, Florida 32233-5445 !� E�� 7 - 19 \\v\ �v Phone (904)247-5826 • Fax(904) 247-5845 't01119E-mail: building-dept@coab.us Date routed: 0 /a li 7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM ( .E .s,$) Property Address: BS I ► v \P 1 De artmn n review required Yew No uildin 1/ Applicant: 1l fA y LE.y C©2-p Planning &Zoning Tree Administrator Project: ( C I N-)C, ` \C PLA-0_6-inEvir 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 T94-'r Florida Dept. of Transportation St. Johns River Water Management District Gr Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: r pproved. Denied. Not applicable (Circle one.) Comments: UILDIN PLANNING & ZONING Reviewed by. 2Date: /0 - `I-I 7 TREE ADMIN. Second Review: PlApproved as revised. ❑Denied. fNot 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