Untitled e n
CITY OF ATLANTIC BEACH
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: RES18-0303
Description: install new vanities, fixtures, flooring, paint, &the
Estimated value: 19500
Issue Date: 9/19/2018
Expiration Date: 3/18/2019
PROPERTY ADDRESS:
Address: 654 SELVA LAKES CIR
RE Number: 172027 5806
PROPERTY OWNER:
Name: WILSON JAMES III
Address: 654 Salva Lakes Circle
Atlantic Beach, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: JEP CONTRACTORS INC
Address: 1416 FOREST AVE QA JOHN EWEL PEARSON. III
NEPTUNE BEACH, FL 32266
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$7,500.
. cu�.rri City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 322335445
` Phone(904)247-5826 Fax(904)247-5845 1,
'moi ;slq? E-mail: building-dept@coab.us Date routed: 9 l II
City web-site: hap:/M .wab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �Q.S`"�S-Q-��r1 LktQ, 6 / . D ntreview required Yes No
'f Building
Applicant: v t.(�/�{,(ft_(.'�1 S � L arming &Zoning
Tree Administrator
Project: JcC(lti�.lS k�i X14(0$ Public Works
n� ` Public Utilities
F l° ^J ( �°` Public Safety
Fire Services
Dept Signature•
Other Agency Review or Permit Required Review or Receipt Data
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: Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
SYt.,.�C."rv�A� C7R (_s10.�1c�� k .t
BUILDING �oa7—�A.Hr Utz e__'4-rwnz.nF_
PLANNING&ZONING Reviewed by: _tph� Date: 9 [p 1
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 0919/2017
Building Permit Application Updated 12/8/17
0 City of Atlantic Beach AUG 31 2018
800 Seminole Road,Atlantic Beach,FL 32233
// /
Phone:(904)2477-5826 Fax:(904)247-5645 n
Job Address: F� 3T JC/✓R /�,K Kf3 (/1 rC�P� Permit Number. ILGSI_d - D3a
Legal Description bb RE#
Valuation of Work(Replacement Cost)$ / i.J GtJ Heated/Cooled SF Non-Heated/Cooled
• Class of Work[Circle one): New Addition eratipn -pair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial esidenti
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes N0 N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or A I avitpf No Tree Removal
Descri a In detail the type of work to be pe -ormed: S ,%U B YYJ'dL ies/ U rpf�
t� //
Florida Product Approval M fo``r''multiple products7use product approval farm
Property Owner Information �9cJ�
Name: l $ Address:
,City State PL Zip Z72M Phone C
E-Mail V' Pn "' o
Owner or t If Agent,Power Attorney or Agency Letter Required) cr�
Contractor Information �. —�/ c�J
Nameof C !9pany:.A rtfF'rtc IOYS 4L _ Quail Ing ent rd0/pA TBa rsng
Address Y r�_5 ✓e.. City N vtc � Zip
Office Phone —Z - Job Site/Contact umbgi 2 z"q - 6$3 z
State Certification/Registration AIC6e d 877 E-Mail .Tk.P<o h Ti'1* rGONLaS 1 11
Architect Name&Phone a /'
Engineers Name&Phone#
Workers Compensation
Insurer/lease Employees/Expiration Date
Application is hereby made to obtain a permit to do Xe and installations as indicated.I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.NOTICE:In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT: I certity that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTOR EY BEFORE
RECORDIN OUROTICE�COMMENCEMENT. -
(Signature of Owner or Agent) (Signature of Contrattor)
(including contractor)
ned and sworn to(or affirmed)before me Ois33P' day of Signed and sworn to(or affirmed)before me this _day of
.)fM1C5 . W I 1'%;oVL t r.1,$:1 Aj t)a by-JL n c4 'TR
Simature.;+of Nota (Njimiribre of Notary)
{�I Personally Known OR .+P`�tfi '�g'��I II'ers ally Known OR :'M'..'. JENNIFER JOHNSTON
Persored ldentinrOR MY AMISSIMa FF .Y y; MYCOMMISaION ttGG 0419a4
T1 ' EXPIRES:November i8 d ed identification EXPIREa:Odaber2],2020
Type of Identification: c `ri pf entinration:
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