108 SEMINOLE RD - DECK NOT BUILT rs=-L�l,yu� City of Atlantic Beach APPLICATION NUMBER
mss - Building Department
' `i 800 Seminole Road (To be assigned by the Building Department.)
Iry
��:w Atlantic Beach, Florida 32233-5445 L� b��-- 3N
�.,.lir Phone(904)24,7-5826 • Fax(904)247-5345 1 0 2017
\J.319A' E-mail: building-dept@coab.us •''' Date routed:
cia lo9, I1 9—
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1016 St fvRi( v . e Department review required Yes No
itergiow
Applicant: OW r '-iiin. &tonin.
Tree Administrator
Project: i r)c-O a33 5..V, 6 k_ ..coot- u iicworks�
q MAL 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: I✓4Approved. ❑Denied.6 -7`/.3--/9
(Circle one.) Comments: Jee AQad COM014
BUILDING
t:s 7 C-kk5r3L.7kLj 7ii
PLANNING &ZOO r 1 48/9
y: A Dater
TREE ADMIN. oL r\ ,,,-,6
id. HDeni d.
PUBLIC WORK q�
PUBLIC UTILITIE
( V'� S �
(ScC
PUBLIC SAFET ) y: Date:
FIRE SERVICE d. @Denied.
l?) jj t L-- 0 ( :t 1 C�
{,,, < c� req
/: Date:
Revised 05/14/09
=r` '. - Building Permit Application
.6 Ter- City of Atlantic Beach
---
800 Seminole Road,Atlantic Beach, FL 32233
`'a ' Phone: (904)247-5826 Fax: (904) 247-5845
Job Address: / PQ �/5 E y}A 1244 D J'Q KA Permit Number: IA- )6 3 44
Legal Description 4)l2 /e:`t cl (,7 V P i t,}NS T La,-'\ y t-P RE#
Valuation of Work(Replacement Cost)$ 22/r�,-'-' ) Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): ENew Adciiti Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial esidentla
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes 6) 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 perfored: r. 01,..>f< I[ (,), d e�•.K ;, ;=. c r ;h,per ;'r w *et e rt,i LitN„r-d,�
rr.,11 hti'i4 j+_ per1Mr_4- rOhesc$: si'dl- '1'- f to it' •r_t 7G (Iv -P.E.efi w a.e_i 1:). it 0+4, ,. s
;,9Gu,rtc4 •
NI
l- c ' /!4'V/,922-9p 1
Florida Product Approval# for multiple products use product approval form
Property Owner Information(1 f�
Name: 'R it v3 ct % Airier q � e c`-5-; Address: /3'1 T (/ h�0C-f
re
City rG��f'�t� State �5 Zip /�7� Phone �t:x "3i %— Q IJfS'
E-Mail r -e_ si 4 i7D Le. t`: rn 't-eJ2.„4z-®.01,Q'1--
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information ;,;-• i c•cot) eLa-a -pct1/4+; ►'—I yiin
Name of Company: Qualifying Agent: )7- 9b--'`=`1(
Address City State Zip
Office Phone ob Site/Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation _
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 MA ----''
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. ,
(Signatu a of Owner or gent including Contractor) (Signatur of Contractor)
Signed and sworn to(or affi ecl) before this Y say of Signed and sworn to(or of Y med)before me this day of
/.t,Ck rC.' t , A i7 , by1
IMIPAIIIIMairti Ailli
'".."®"v... ign. re of Notary)
::�aY fik.. TONI GINOLESPERGER (Signature of Notary)
-'1 n :';'-- MY COMMISSION#FF 924951MP
' ' " EXPIRES :October 6,2019
''e cF;°�' Bonded Thru Notary Public Undersdters •
` 4• • " n •' [ ]Personally Known OR
[ ]Produced Identification /�no [ ]Produced Identification
Type of Identification: a U"? 1 Type of Identification:
/0, 42 / sof
X 42Z, xz .r
44c 40,yK ,_
\r/ iff
(4§ Yr K3 PO 7
/p ) 462
(6114-44 Th4 3/X/76 66r ciPQ
lu. ker 71p
.
*,„,...,,, ,
.."---0
.c..7 75.7‹,..: 1.- - 'AP sA--r. eae,- s,,, -•. ..• _
3L.
,I
"' ""'"'""1oimlrsm4om%W4smqr."''", 7 ItTn9I .i' ,
1 .
• $ . 1_
.,,
$
....,_t........ ......r.........4............:,.....................,..........fr--e- - 1-•.-- ' -
• . I ri A
eV' .
ti ..
46.,•0 -_,......
• .,.......16.--,....",..5......-...........„--..--,....,
, .
-t
r
' ft,• Oil"
1 r
(...1)
1 ; 4 6. • : t : '
. : A . ;
1 ' • A
- 4Mlig
, —..........•-mo ..t.,• 11..0 ,
...........--
01/4....)
4 . , . ' • - ; i
. . •
.•
I
•
w.,,-...-.......—I..-..... ........ L ...Si
— -4,' t. - ---t---i....- • .,_ .
Si* I
I ! .
i i
. , •
AINtrier- )44
1 . ..' ..rest
. e ,r, . • fah\1 . z ....,,... ., •.........
.irwe . . . : . • ...- t.....: . { i : ,
.. , .
%.,
4C.L. . % i i i, t . / • 4.
. .....:
....... Y..11,,r. *.e....7,4,G,••",,,:,..wor ,... ..............1.......0 44.. ,.. • , .C4It. . .
tiZI trl
k
(
. ..
t • '- z 0101161111.
...9. s (15 r•k
i
i
M
•
I 1.
i :
.
, .
. , : •. -.--,v,r1.1 ', •i• : ••• •
i'
1 t I ....i....-4 1...... .....!..... .....-4....-. . .
'. . ' "r I i'acoor,4 ..... •-.
0 ,: .‘ .• ---t'-'-',—-*T- t ..,- I
i t
' i ! _ .. . . .
....... .,_)_, ,...- :,: 1. ,.
. i : }
"'" 'f`'''''"..."''''.....1.w^w.l."."'. ."."••-•"':".'""
, . .1....."+"""""r'.....1. ,, 1 ' .
: .1..' ' , -,.‘" -
i 1 •
i i
4.7
sstb k.\
WT. 4
1 •
...., s'
i
kiN & i
I `
.
.i...- 1".' . 4,.... .,. ...,. ............ . ., .
....i......., i.......4 .
_. __..
t e 1
I ,
I 1 I i E . i i
..1 ... ,
... • , .
•
3
___ ........
r ....... ..
.„: .„
f _
•
.•..
•
,.............
. _
Z W I =I I I <las, P ' .
E .4' 29.6' 4 ._•> . . a .•
ce
co el,
• I • o -
w W
U) W • a ;
80 > 1 ziO z
CA w
111.1 5' 5' Zo<CI
QI ••� •
�' �z� L., '.w •:
In 2-(c. 0 • ~ • C
I-
LOT 607
FENCE Wm 0 • Z .
JOGS f01 41 • O- • ..• .
0.4'X3.7` WWN • U •• I •
25' Ct
to P-c
^F W I p •
0 l 125.00' -('R) I..• . 1/2.
1/2" (IP)r w a – 12493-�(M) REBAR
(CNR) 4.9' I . .
,111
•—X-
- –� bYj, I0 .,6 04 CONC. WALK' n .a 4: II 0.8'
w 0.5• 4.6' • �_.?r0..19:8'. . '� a
am 60.4' 1. ..•90
:.-2, 9....'
1&2 STORY •
tri N 0.5• 4.3 n VINYL SIDED RESIDENCE n UPPER . CONCRETE -- 4I. '%'•8•
N BTM I 6 AC NO. 108 �� .. DRIVE I.� g o N
1/2" :i •.�,1 a PAD L' I NORTH 1/2 LOT 608 • • .• •.■• 44.08' .. : • •�'5
ASSOCREBARLB 5488oIIII SOUTH 1/2 LOT 608 • •
_ . '• : ' O 125.06' (M) 0.1'
M •. ..°oy I I I 125.00' (R) CONCRETE A : . e '
`� 0' -1.0 1&2 STORY DRIVE
.� PF. \•ISER VINYL SIDED RESIDENCE
p� �' .M . NO. 106 ••
N •. A i. • • I
•' d
Q CONCRETE WAU(
1/2 . Off' •klill . .
RMARASSOC SUR 0. 4 a 1/2•
LB 5488 a a •
. • 0• • ..
••
•
a •
ASPHALT BELVEDERE S'
tr u a. 50 R/W
0
FLOOD ZONE "X•f AREAS DETERMINED 1
\\\*4\ C4"---. FOOT OR WITH DRAINAGE AREAS LESS hi
E Y p
•--)' kk\ b_42
R 'Q`S
C� ,
A SSOCIA
IJ O 0
SS `d
�' I HEREBY CERTIFY
DIRECT SUPERVISION
STANDARDS FOR LAND
THROUA 17.052, F IR
ir
BY: / ____
• AR ES B. HATCJ
HARLES L. ST•' IN
RAYMOND J. SCHAEF
JOB NO. 63658
City of Atlantic Beach APPLICATION NUMBER
Building Department ,
(To be assigned by the Building Department.)
i. 800 Seminole Road
Atlantic Beach, Florida 32233-5445r , L� 12#
Phone(904)247-5826 • Fax(904)247-5845 l !�rl11
\<...q:,7/;1111building-dept@coab.us Date routed: D3 l��j
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1046 StAn' fit L Q,J, Department review required Yes No
uil in
Applicant: in &z-onin
Tree Administrator
Project: r JccUk a33 S . (��Ck AS-Dot 'u.lic Works
Public Safety
Fire Services
Review fee $ 2 5- 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: 47Approved. ['Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING ��,bJ 3// a/i7
Reviewed by: /`� � Date:
TREE ADMIN. Second Review: ['Approved as revised. ❑Denied.
P O KS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
/1. ...
118 -
£. 1..
,4
,\ . / :
J
ti / SEWER CLEANOUT/SERVICE CAN'T BE COVERED
-
/ -
®./ r -- ^w..
�'~- WATER METERS CAN'T BE COVERED
-�' allI\ '„ \ ,,,,.,
,11 ,
\ , . .,,..
\ 4,
1
' 4.,„. ,,
,.._._
,_.
_ _____ 4
6' ft-tf4t 4111110b., . >
r
`via '' t.a'
`,
61 46 • ,,, ,
'Qi/„ { f
2a ' � `
11*
55 41% ;� --- -
a W z
Z Ii1d I I • - . "u()1°-
n n - •
O O I I'.
y 29.6' •9\
Q • 0 . 4
0 5.6'
W W ( •" :. • •-.
cn \
O > zu, I z
J <O .71 , a ; 0
�� 5' 5. aw< I QI •.A•• �• .�
W
IX Q. 3 . O
� o:z� L� I. W. �••
o< Ia. I—
WLo CCo 0 LOT 607 ). -. .', . .¢. . -/
FENCE M C 7 • • ZO.
JOGS N wEE
0.4'X3.7' \ w<via_La
a rJ; •
n < W
25 •
I
'_ I o I I 125.00' ) I,. •:a . : •• ,/2.
1/2" (IP)134 9' J �` I — 124.93'" ! REBAR
(CUR) ; ' "
=7f—� x— 90y). I �' 04` 141
CONC. WALK'' ' • • . ❑_
0.5' 4:6' x0.. ,� d :
BTN 19:8'
60.4' ..e :•9p
o 3. CONC. 1&2 STORY I. • o. I. o
4.3' PATIO, WOOD ••
in a o.s'J) I n VINYL SIDED RESIDENCE CONCRETE • a
N BTM $ AC kNO. 108
LUPPER DRIVE !89
❑ EVa. •• •.l •ls .A �.
1/BAR 3 4 19 ehBT I NORTH 1/2 LOT 608 •• , 5
ASSOC SUR
LB 5488 \ 0. ' ' SOUTH 1/2 LOT 608 �" .• •
-
• 125.06' (M) • . 0.1'
�o aI I up 125.00' (R) 1 .I. ,_
a '.
a/%p�. 'ISER 1&2 STORY ^ CONCRETERII
VE
A . I
1� A... • TYP. VINYL SIDED RESIDENCE . . '
O in ,M • N0. 106 •• .
NN -• ui . • ` 60.4' I
••• d •
�
�, Q CONCRETE WALK a
'•i. 14. . �_ _ .
15
1/2"
REAR gyp, •.
ASSOC SUR 1
LB 5488 a O p a 1/2'
O ►a •
• •
G
a • A
ASPHALT BELVEDERE S'
50' R/W
b—n�' FL000 ZONE "X'- AREAS DETERMINED 1
V~ FOOT OR NITN DRAINAGE AREAS LESS Tii
.......r...., .... . i
IN
V E Y O
------ cc,A, c \.--‘t,11 w 27 9-
J j `3
O
,. S t/
I HEREBY CERTIFY
DIRECT SUPERVISION
STANDARDS FOR LAND
THROU� 17.052, F •R
�..� BY: ____
• AR ES B. HATCJ'
HARLES L. ST•• IN
RAYMOND J. SCHAEF
JOB NO. 63658
•
• '
v...„ '
• • , ' 1 f. .
1.-
) v‹., 1.• .1,72' s,••`'‘.. (-4 4. 1--—-
11.11.11mo...,••••••••••••••1••••••• ••......••••••14.vipor"."7-71Pir.rrt .
. e
111.k)
t .. ,
411;114. ' 9)
. I 1
r 0
.
1
' .
i ; ; I : 1- 1 . -1- : , : ! : t • eV` ..
..- 4......L....... 4..... .... . .! : . ..'......: . , . ; t
• - •-.
4-. t.. - 4. .1.4
.
4 „agormakza."4 ...tet.;,...,2,,,,,,, %,,,,,y$4!"-. aly,„vizej,r_s ). _ .s. ....,,,,.........„, •
. G ; ,.. •
%Id
• ! i i
414'L.
e pi • . •• ,
, 1
• ...t.. i .w.l. .. .I .. .4i...,1, ;
I i • ;.'
;
--....—.-----t....... ,
n .......,.. ....
las j
•
•
•
. .
• •
•
" /....... : i 4*.t , : t • :. 1
.-----_
i t ...
...... 1
• !
..1.!...Virs.v•X.' - -.4 1-•^-•!--- T. .--4 .--- -.4., I'
,
. i, , • vitas/ : : , 6 Z • .
!
. • 1 : I i i
• i
• •
. ... . •• •.,
,... .c.i.,.
1 i •
• 1 ' i : I • t
t .
..„.7,. ,
. ,. . ..
. -
‘47.1 ki) '.;. , . . ''- •' '" .r •••r—.1,— - —0.- +.. - .. -....1..- --.:.-. :
i 1
/
. V 1 i t t f i
s qti, r'(
: ; . t
_.. 1.... .-...41.1111"'.. '' ' '... :. ..., , '•-, 1......: % 1 ,,I,....
6 ...... m t
: ....-1,••...i. .. .
.1 - ''• •
: 1 '
2 ; : •
II .
1•••••-•.t r •••—-4 ... .. ..-
.. -,
II. 114%
• i t :
• • 3 - ;
t .
----/e. .
i
. -4--•••••--,.-:----;-------;•-• : -
?..k
i •
. • ......-.......... ,,,, , .......i......
..,
, % 411,
4
. ii... , 4 -of '40 ... ' „. . • ..„,
•321 %.,T% c....1'. . .i • : 4- '
'.....,
i : '• I. i t
f i • .:
•.a ' 4, '
i• 4.• • a ' a I ,
i
..1 ,
............. ..„.
... .......................... ....... ,........ ,,..,„,,__, ,....x„,....,,, .,•,,..„,!.•
1 . ,. t
...4.
de>awillid .41-" ;"--• efl ' '...'"
J ,•,,,, •
t ..,.
00 .
,
$
ari lho , s
41or
;_ .' 14 Building Permit Application
jko
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
`r''r'~ Phone:(904) 247-5826 Fax: (904) 247-5845
Job Address: / /73 U e 11A rte()I Q 'r.� Permit Number: t4 b�K` 344
Legal Description ,,,f,l 1. ie.'i ot- (p 01 i."-_:N .7' Jrbr1S yaci9 RE#
Valuation of Work(Replacement Cost)$ a2 -Vi — Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New- Additio Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercialesidential"
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes C""J 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: 72., 0:5 ,, it e� ,4,e, v, ,,..t,=• c e „ti pe,c;t- .44.e fgr-i et r lb c ;„rc,
{rt.;,ri h o+e;ri- Pe"/A•e-,5k-erChcLe--44- s 1.a- ev.44- t to it,e,ori- X lfv %`.r•tofi v r d-el i,-,1, '' o+-i, `- , ...94"0tx,rkti .
re,
e2 9VIEr ,,1?,�-�f, I
Florida Product Approval# for multiple products use product approval form
Property Owner Information p
Name: 'Pe YN( ,,, Cu,tb 1,1 rtd'C1, r -erJ Address: 1577 81rPe11i'c(I)
City i�f 1( )cij State (SJ Zip (1.27f i-.7.5 Phone .20 3gr'jc)-- 0'si81
E-Mail 1----e s1 h i1D f IL Et.-_,) i'Yi i4ilsc.D•i-ye.
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information re);' 1 reel- d_a.1't -P�- .i *F-11 yin
Name of Company: Qualifying Agent: �3 Z—I910--gs /tol
Address City State Zip
Office Phone ob Site/Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation
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. J /.
cJcoit.e, /
(Signatu e of Owner o .trent including Contractor) (Signatur of Contractor)
Signed and sworn to(or affi es) befor- e this 2( say of Signed and sworn to(or aff med)before me this day of
Afrot rCI'& , At'i7 , by �� , ! y
_ ----1-:-.
_ /
"�,��
' XTO IN GINDLESPERGER lgn re of Notary) (Signature of Notary)
?' *: MY COMMISSION#FF 924951
'9 EXPIRES:October 6,2019
•''%:F c''' ''•-•'''' Bonded ThuNemPublic Underwnters •
[ ]Personally Known OR
[ ]Produced Identification (.� J(�{J� [ ]Produced Identification
Type of Identification: ' `0 0"?8j~4190`0 Type of Identification: