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341 11TH ST - RES18-0190 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,IT,32233 INSPECTION PHONE LINE 247-5814 RESIDENTIAL -ALTERATION RESIDENTIAL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RES18-0190 Description: REMOVE&REPLACE WINDOW AND DOOR JAME AND HEADER Estimated Value: 1000 Issue Date: 6/4/2018 Expiration DOW: 12/1/2018 PROPERTY ADDRESS: Add�: 341 1 1TH ST RENumber: 1701050000 PROPERTY OWNER: Name: STEIN DEBRA A Add�: 341 1 1TH ST ATLANTIC BEACH, FL 32233-5531 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: BOSCO BUILDING CONTRACTORS Address: 2158 MAYPORT RD 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 my 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 amencies. *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 IIVAC work exceeds and estimated value of$7,500. City of Atlantic Beach APPLICATION NUMBER Building Department (To be as d by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826- Fax(904)247-5845 E-mail: building-dept@wab.us Daterouted: city web-site: hftp:/Avww.Wab.us APPLICATION REVIEW AND TRACKING FORM Property Address: b4l ment review reg ired Yes—,5N70 Bmuilding Applicant: E9L)(2>'SC0 60*ACNW1 Zoning Tree Administrator Project: aem6i)-e 41106 Public Works Public Utilities Public Safety Fire Services Review fee Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified Y Florida Dept.WEnvironme.tal Protection Florida Dept.of Transportation r Management District hirmy Corps of Engineers D Ment review a Zonmg Tree Adm'n"tratr 4L P , 'bl'_Works Public Utilities Public Safety Fue Services Division of Hotels and Restaurants ivision of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: &Ap'Proved. [–]Denied. ONotapplicable (Circle one.) Comments: PLANNING &ZONING Reviewed by: /71 5!L-- Date: TREEADMIN. Second Review: [JApproved as revised. bDensed"' DNtappficble PUBLICWORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. ElDenied. E]Not applic,able Comments: Reviewed by: Date:— Revised OW1912017 Building Permit Application City of Atlantic Beach OFFICE COPY 800 Seminole Road,Atlantic Beach,FL 32233 0 Phone:(904)247-5826 Fax:(904)247-5945 Job Address: -!5;gz Wre*t-//c�A/// cy- permit mber Legal Description ?__5 - zf,- 'd lfta�4 W �y _721 Valuation of Work(Replacement Cost)$ le" Heated/CoolecISIF 1'70-yW Non-Heated/Cooled Re ove Demo Pool Window/Door • Class of Work(Circle one): New Addition Afteration6�� • Use of existing/proposed structure(s)(Circle one): Commercial 6e7ldenQ) • If an existing structure,is afire sprinkler system installed?(Circle one): Yes Z!55 N/A • Submit a Tree Removal Permit Application ifanytrees areto be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: A-_~ Amw_ -I*t,& or 4 hbgvr* / *//~ A-11 /--V4- /&�'Z XA;r�' e� Florida Product Approval# Jqor_� for multiple products use product approval form Property Owner Information iii % Name: 61c"Or Address: city CL m,*%c_ State=Zip Phone 6cZq E-Mail] lie�, , *e.��0 49'L. tD Owner or Agent(if Agent,Power of Attorney or Agency Letter Required) Contractor Information Name of Company: Cc� lifyipVAgent: fAldl A!ii;49 — e -33 Address 96rX, M"ORP-9--r lkrr+_e—i State�C� zip Office Phone :/*X�/- IP37,a? —jobSite/. tact Number — 991100 State Certification/ReRls,tration# 12,�Vtgl f, E-Mail Architect Name&Phone# Engineer's Name&Phone# e_�� Inik9olt U11 1115&1� Workers Compensal 2DW,&4� 60�� We—PC—cr4VC004ilV—00 f E.�rnpt/losure,fue.se Ernpl.yai,�/E.Piration Nte Application is hereby made to obtain a permit to do the work and installations as ind"' t lat on has .d to- JR commenced prior to the issuance of a permit and that all work will be performe or fiod L' a r ulationg I construction in this jurisdiction.I understand that a separate permit must be secured or I L L I ,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 wilkWdopEgn 9"liance with all applicable laws regulating construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE CffMW CKMIE4 �,TtMAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YQ" 8RQffCkT_YLJf�Yqii , ATEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y OT CE OF COMMENCEMENT. - R7 olj_� (Signature of Owne�or Agent including contractor) (Signature of Contractor) sw;n to(or affir day of Signed and sworn to(or affirmedj_before me this Z!L day of 1`13 ,by by _G42_T CO W%—)�(Sto&tur.of�N.Ir,�' Denift A.Err" Denise X Erft NOTARY PUBLIC NOTARY PUBLIC S TE TA E OF FLORIDA Personall, STATE OF FLORIDA �M Personally Known OR V Known OR Ccimo*FF996M I I Produced Identification Comirrill FF986426 I Produced Idenfificirtion E)Vras 3/1/2020 Type of Identification: Explm 3/l/2020 Type of Identification:— TREE & VEGETATION AFFIDAVIT City of Atlantic Beach OFFICE COPY Department of community Development Planning&Zoning Division 800 Seminole Road Atlantic Beach,FL 32233 w� (P)904 247-5800 (F)904 247-5845 PERMIT# SECTION I -APPLICANT INFORMATION P'Ownerfs) F- Legal Authorized Agent- NAMEOFAPPLICANT NAMEOFCOMPANY ADDRES50F COMPANY ZISS, 0A ?Oa-r (2d , Gre 6; , PHONE %qy/-0) CELL EMAIL C)Pc"-- CONTRACTOR CERTIFICATION NUMBER ATUBCH BUSINESS TAX RECEIPT NUMBER SECTION 11-SITE INFORMATION STREET ADDRESS OF PROPERTY -; q I 14-k siv-Ec-+ ffan addmshas ncx�,,uqnmwthispro�m6�toatheABBuifding D.Vam�tat(�)247-5826 tonximton�ddm� LEGAL DESCRIPTION !!;-6f Ap -?5- Z%e-- OrC Ael.� LOT IZ-0 BLOCK /5,4 SUBDIVISION REAL ESTATE NUMBER 1'7010,!5--4W LOT OR PARCEL SIZE: SO FT AC RESIDENTIAL V-� COMMERCIAL OTHER(SPECIFY) I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation"of the Municipal Code of Ordinances for the City of Atlantic Beach,FL andlor I have participated in a pre-application meeting with the Administrator of those regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed andlor removed from the akovedescribed or o4acent qmperties in conjunction with this project. SIGNATURE OF OWNER SIGNATURE OF OWNER Signed and sworn before me on this-,?JAday of by State of F1 0�i4ick, County of r��yAL_ Identification verified: K-nowy-) Oath sworn: r- Yes f�4 No D�A.Enra NOTARY PUBLIC STATE OF FLORIDA Notary Signature AW Expim 31112020 My Commission expires: