385 3RD ST - SIDING \,,, ,
,iiil
CITY OF ATLANTIC BEACH
0 800 SEMINOLE ROAD
�
ATLANTIC BEACH, FL 32233
,
;3 yr
INSPECTION PHONE LINE 247-5814
RESIDENTIAL - NEW SINGLE FAMILY RESIDENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0022
Description: NEW HARDIE SIDING
Estimated Value: 2330
Issue Date: 1/29/2018
Expiration Date: 7/28/2018
PROPERTY ADDRESS:
Address: 385 3RD ST
RE Number: 169825 0150
PROPERTY OWNER:
Name: BUSBY BARBARA M
Address: 385 3RD ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: LANG'S GENERAL CONTRACTING LLC
Address: 2201 SAWGRASS VILLAGE DR QA JOHN R. LANG
PONTE VEDRA BEACH, FL 32082
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.
?S.. City of Atlantic Beach APPLICATION NUMBER
�s � Building Department (To be assigned by the Building Department.)
r 800 Seminole Road ii
r r� Atlantic Beach, Florida 32233-5445 F.�1 Z Z
j
Phone(904)247-5826 Fax(904)247-5845
�,; E-mail: building-dept@coab.us Date routed: ) 1 1 9 ( E
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 c 3 ` — S ( ent review required Yes No
Building
Applicant: t AfvC' S (`1 R i ,AL cool an g &Zoning
Tree Administrator
Project: Si I ti , V EP pt-( Public Works
Public Utilities
Public Safety
Are 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: Zsl A pproved. ❑Denied. ❑Not applicable
(Circle one.) Comments: �
C.,4 %—%— V.;;14-- ( "A - 177_0 L- 4-4 4 '4 St f..LTe.4
BUILDING
PLANNING &ZONING
Reviewed by: r Date:O t 28 (tc,?
TREE ADMIN. Second Review: ['Approved as revised. Denied.
❑ pp ❑ III 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
' kt, Building Permit Application Updated S/5/17
City of Atlantic Beach
/1 800 Seminole Road,Atlantic Beach, FL 32233 "," 8 2018
Phone: (904) 247-5826 Fax: (904) 247-5845 7
Job Address: 385 3rd Street _ Permit Number: R E- I B -0O Z Z
Legal Description 5-69 16-2S-29E .093 Atlantic Beach Lot30(EX E 30'),E7.11' Lot 32 Blk 5 RE# 169825-0150
Valuation of Work(Replacement Cost) $ $2,330.00 Heated/Cooled SF 1853 Non-Heated/Cooled 792
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 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: Remove damaged cedar lap siding from chimney and replace
with Hardie cement board lap siding. Prime and paint to match
existing
Florida Product Approval# 13192.2 _ for multiple products use product approval form
Property Owner Information
Name: Barbara Busby Address: 385 3rd Street
City Atlantic Beach State FL. Zip 32233 Phone 904-249-0410
E-Mail bbusby1@bellsouth.net _
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Lang's General Contracting&Renovation, LLC Qualifying Agent: John R. Lang
Address 13653 Macapa Road City Jacksonville State FL. Zip 32246
Office Phone 904-422-6690 Job Site/Contact Number 904-860-4589
State Certification/Registration# CGC062543 E-mail jr1ang01@gmail.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation State National Insurance Company 09-30-18
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 Ofd COMMENCEMENT.
4:/evi )r2') r tint. -. Oz,// —
(Signature of Owner or Agent) (Signatur- Contractor)
(including contractor)
igned and sworn to(or affirmed)before me this /F day of Signed and sworn to(or of •d)before me this 11 day of
;46r/ , b jail ilcf dot ,byOh(N l a.
tr..I.N (Signa btr � �__
ltr,�
* MY COMMISSION t FF —�---
JENNIFER JOHNS?ON
EXPIRES:August 11,2018 2R.
:;::;,:.'4,:. My COMMISSION#GG 020
�010,o c• BeRdedlbfY�IWNcluyUniAn i t EXPIRES:October 27, titers
tit::.�j��.'9e Thm No'ary Public UnderN
[ ]Personally Known OR ersonally Known •• i Bonded
biel Produced Identification i )Produced Identifica
Type of Identification: lip,V4-7--3-!- L ��— Type of Identification: