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801 ATLANTIC BLVD COMM ALTER CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J �~ ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 COMMERCIAL - ALTERATION COMMERCIAL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: COMM18-0003 Description: repair hardie board lap siding Estimated Value: 900 Issue Date: 3/15/2018 Expiration Date: 9/11/2018 PROPERTY ADDRESS: Address: 801 ATLANTIC BLVD RE Number: 177641 0000 PROPERTY OWNER: Name: JAX FEDERAL CREDIT UNION Address: 562 PARK ST JACKSONVILLE, FL 32204-2918 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: C. ZORNES BUILDERS INC. Address: 966 ALPIN RIDGE CT QA CHARLES DANA ZORNES, II ORANGE PARK, FL 32065 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 Building Department (To be assigned by the Building Department.) 800 Seminole Road _ Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: To k A::kAo-a1 L De rtment review required Yes No Buildin Applicant: ISS Lt-r Planning &Zoning ,1 Tree Administrator Project: ��CL-' \�,, ( ' 1 WC U bDurl� St(Acr1h 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 B 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: [qApproved. ❑Denied. []Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: J 15� ,201 TREE ADMIN. Second Review: A roved as revised. Denied. ❑ pp ❑ ❑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 Building Permit Application Updated 12/8/17 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FL 32233 o Phone:(904)247-5826 Fax:(904)247-5845 COJob Address: eC7\ � S}��IJ Permit Number: ` P M J-00 6 Legal Description -Z.S Z'� , X03 `)(I--Nadc 2 136/q75 RE#T1 7 6 y�" 042-00 � Valuation of Work(Replacement Cost)$ /Q 00, Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Re ;p 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: .'2 To I 441_A� 1-44"' p—� C 6 wk-Ck k*3 13 c Florida Product Approval# , L 13 i q'1. , y� for multiple products use product approval form Property Owner Information �01 R�\A✓�'� �'�� Name: S aAc A Oi Address: City \C State Zip 3 ZZ� Phone E-Mail '2p 5 6CA S , Owner or Agent(If Agent, Power of dttorney or Agency Letter Required) Contractor Information n Name of Company:(1, �R Ie-S ��-+ , �1/"-% Qualifying Agent: Address 9" lD,l.ly- 12lNZr_ c City O(AMC P State L Zip 3 2t)65 Office Phone q0j -214�_7M 6q Job Site/Contac N mer z19-340 State Certification/Registration#(2AY 05 7 11 E-Mail L Z0I-Ne} )301�� _9/►4,7 i �`` Architect Name&Phone# Engineer's Name'&Phone# Workers Compensation -a e— fiirTyp/Insurer/Lease Employees/Expiration Date Application is hereby made to obtain a permit to a 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 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDE O AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT: C � _ (Signature of Owner or Agent) (Signa re of Contractor) (including contractor) 1 Signed anill sworn to Lor affir ed)before me this day of Si1igped andlsworn to r affir d befoge�me this day of KEISHA FOUCHE I(EISHA FOUCI MY COMMISSION#FF 1 MY COMMISSIO 2018 Si nature of Notary) '4 18(Si ature of Notary) '* EXPIRES:August 30, (Sig '= ust 30, 'i' EXPIRES:Aug �°'• '�= PublicUnderwaers ' •ec ers Bonded Toru Notary _>;i, Not_, PutllcUnderw Bocded Thru •Y KEISHAFOUCHE roduced Identific 1 Produced Identifica ;i' ',:: MY COMMISSION#FF 1; Type of Identification. l� ype of Identificati EXPIRES:August 30, Yp u Notary Public Un