631 BEACH AVE - SIDING ;- �J CITY OF ATLANTIC BEACH
u+l , �- 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
`"! - INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0076
Description: REPLACE CEDAR SHAKES, WATER BARRIER, SHEATHING AND
20 WINDOW
Estimated Value: 60000
Issue Date: 3/5/2018
Expiration Date: 9/1/2018
PROPERTY ADDRESS:
Address: 631 BEACH AVE
RE Number: 170113 0000
PROPERTY OWNER:
Name: HUDSON MICHAEL A
Address: 319 12TH ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: SIGNATURE HOMES & DEVELOPMENT
Address: 1474 South 3rd Street QA REX JONATHAN WILLIAMS
Jacksonville Beach, FL 32250
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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
Js SA Building Department (To be assigned by the Building Department.)
800 Seminole Road j o c
Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 Fax(904)247-5845
9%' E-mail: building-dept@coab.us Date routed: Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: COJ 6�E��t p, tie Department review required Yes No
uilduilding (�
Applicant: Scam c LP_E 140MES lanning &Zoning
,{ , Tree Administrator
Project: C��(Z�� c S L v R r E_2 Public Works
', Public Utilities
BFRRLG1 1O Public Safety
Z 0 tN) t N 0 O t.0 Fire Services
Review fee $ Dept Signature
Review or Receipt
Other Agency Review or Permit Required 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: [ pproved. ['Denied. Not applicable
(Circle one.) Comments:
UILDIN
PLANNING & ZONING Reviewed by: i/'1 2' Date: 3--/ •ool ir
TREE ADMIN. Second Review: Approved as revised. ['Denied. o 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
47'A u Building Permit Application Updated 12/8/17
K- OFFICE COPY City of Atlantic Beach
��� 800 Seminole Road,Atlantic Beach,FL 32233
R, Phone:(904)247-5826 Fax:(904)247-5845 i�ES O� /
Job Address: i ( I/.J€.t e,. n,Per it Number:/� 1/U`
Legal Description 6-4-3, (6-25 -AGE ,26( Broom es P �s+3P( 10f ,3/1 fl16'3 _c()�
Valuation of Work(Replacement Cost)$ 6 03000 Heated/Cooled S 1!. / Non-Heated/Cooled /1(4
• Class of Work(Circle one): New Addition Alteration epair Move D of Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): es No
• Submit a Tree Removal Permit Application if any trees are to be`removed or Affidavit o No Tree Removal 1
Describe in detail thq type of work tP be performed: Re.rr.oVG 0,,it d Ce?I f,�,ZC Claw,a Ce,)c r 54,G,E,5t
vs)G'k`G r 6 0.r t.e,c- ME.w.k,c At a° iJ,r.c�0v.b E3 M LC
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o-S i'1cGeSSO, C�/. II
Florida Prodict Approval# L. 6525,I j0Vbk inu.. • \\ for multiple products use product approval form
Property Owner Informatio (+ M6nov. Wt4(J;
Name: �Sht01n'j--Aw�„0,Ac.. kkU 51. Address: 6j 31 Re4cL AVC. e
City fl t3 State�I Zip •3).) 3 Phone S71--1501
E-Mail A a�;a�Q rockccee occApt{ow(,CO k1
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information W ll r
Name of Company: Si v�k Ore. na��d- DCV. Qualifying Agent: FC)( 1 I Cc w S
Address He"! S, J3(-- S-}, Cityj g State [_ Zip 3).).SO
Office Phone 7 I if—O7 Job Site/Contact Num er 751`'I 86
State Certification/Registration# CRC O 'S 1'1.6 E-Mail �}C®S1 Q nrv�S ci . Gbr`^•
Architect Name&Phone# Cl C- b U c� J
Engineer's Name&Phone#
Workers Compensation /0C5OD.$)— fl Dct Ctii ti)S ) g0st,nESS--Tr.3uS`i-fa Fu
Exempt sure /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. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
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 PR'O'PERTY. IF YOU INTEND
TO OBI, N FINANCING, CONSULT WITH YOUR LENDER OR AN A ' 0 ' NEY BEFORE
RECO' 'I , YOUR • I OF COMMENCEMENT. '
IX ire , la ./,
(Signatu 7 of Owner or Agent) ( ignature of Contractor)
(inc uding contractor)
Signed and sworn to(or affirmed)before me this IA day of Sig ed a . sworn to(or affirmed)before me this'5'1 day of
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`s Commission I FF 925690
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� �HiiWsQ(�n Expires �kersonally Known OR •'',�P:'a.c, JENNIFER JOHNSTON
V ,• li cl u cE04461iifatiC 2019 [ ]Produced Identification :,t. n woe i, MY COMMISSION#GG 042984
n n EXPIRES:October 27.2020
- - Type of Identification: =, ��c
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