708 SELVA LAKES CIR - PERMIT RES18-0142 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
r, y ATLANTIC BEACH,FL 32233
X13>> INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0142
Description: replace hardie-board siding
Estimated Value: 16000
Issue Date: 5/10/2018
Expiration Date: 11/6/2018
PROPERTY ADDRESS:
Address: 708 SELVA LAKES CIR
RE Number: 172027 5836
PROPERTY OWNER:
Name: BELLOIT WHITNEY E
Address: 708 SELVA LAKES CIR
ATLANTIC BEACH, FL 32233-4350
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: SUPER SIDERS AND TRIM, INC
Address: 65 W. 9th Street
Atlantic Beach, FL 32233
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 AP.PLICATIQN NUMBER
Building Department (To tie assigned by'the`Building Department:)- -'
800 Seminole Road p
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 ` r•
E-mail: building-dept@coab.us Daterouted
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: O g Sz�U ct Lc k Cc r. De artm_ent review required Yes No
,,II
Applicant: �i.l, s� ( �; / an Gl tri M �� &Zoning
I Tree Administrator
Project: ( Q--D la Ct \(g di b t7c��S l�t(}(I Public Works
Public Utilities
Public Safety
Fire Services
Review fee $``' Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: FL-Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments: /V'
BU 148ilt 0� J�/
P.
PLANNING &ZONING Reviewed by: Date: /2 y
TREE ADMIN. Second Review: ]Approved❑ pp as revised. ❑Denied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [-]Approved as revised. [-]Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
a 0"I BICE COPS : I i
Building Permit Application Updated 12/8,1
2/8 '
R City of Atlantic Beach s APR 1 6 2018 ''''
800 Seminole Road,Atlantic Beach,FL 32233 i
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: Lx Cure, —Permit Number:
Legal Description 1'
Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled34
• Class of Work(Circle one): New Additioerab Repair Move Demo 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 No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in deta'I the type of work to be performed:
��-�sl�
Z �
Florida Product Approval# w%i -PQ t. (fovdy Nb U7-oft Di rmultiple products use product apalr qyn 1
Property''Owner Informati M 4 O H
Name: C�IJ� �hG Address: ®Q ( ~ Z
City / State_EL , Phone G -
E-MailQmd� ' H'L IJI
Owner or Agent(If A9 nt, Power o ttorney or Agency Letter Required)
.Contractor Information E9 U
Name of Company: ✓ Qualifyi Agen Fr
Address ,S City It i� State Zip Z9
Office Phone - 3 Job Site/Contact Number XVt, W m
State Certification/Registration# E-Mail 141
a IO
Architect Name&Phone# r W Q
Engineer's Name&Phone# -� W
Workers Compensation Tin,
gL,mi,Lee_
Exempt/Insurer/I-Efase Eoyees/ExpirgtigA 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 et NOTICE"Ingaddition to the requirements of this
Ymit,there ma be additional restnctlons a 'lleable,-to this ro`ert that mabae found in the ubllc r ards of thi3 count ,and
YLL� pp _. p P Y . `Y E� Y ap sus Y
here maybe add tlonali fits_requlred from other governrnenfal enti`t-ies such as water rnana ement districts,state a envies,
ederal a enc�es6
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 LENDERORNEY BEFORE
RE YOUR NOTICE OF COMMENCEMENT. o a
o CA
it
(Signature of Owner or Agent) -(Signature of Contractor) ,L LIU*(including contractor) .�4 11�
Si ed swo n to or affirmed) bef e me th' da of Signed and sworn to(or affirmed)before me this O day o
by 6L, , DDI
by 0-fn
`s
401
A �`� ig re otary) mture of Notary)LP
� rso�r �ofFl0rld8 [ ]Personally Known OR
� d �es�t�l3 ) ]Produced Identification p
n: 9. !/ems Type of Identification: jFL