1965 Brista De Mar RES18-0334 RESIDENTIAL PERMIT PERMIT NUMBER
n RES18-0334 CITY OF ATLANTIC BEACH
.0 ISSUED: 10/11/2018
ATLANTIC
SON ROAD EXPIRES:4/9/2019
C BEACH.
EAFL 32233
INSPECTIONMUST CALL • • t • FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1965 BRISTA DE MAR CIR RESIDENTIAL ALTERATION New Garage Door $1925.00
RESIDENTIAL
TYPE OF . SUBDIVISION:BUILDING USE
CONSTRUCTION: NUMBER: GROUP:
1695061668 SELVA NORTE UNIT02
COMPANY: ADDRESS:
HOM SPACE 11613TH AVE N ATLANTIC BEACH FL 32233
ADDRESS:
Valerie Steece 1965 BRISTA DE MAR CIR ATLANTIC BEACH FL 32233-4525
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must been City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-321-1000 0 $6000
BUILDING PIAN CHECK 455-0000-322-1001 0 $3000
STATE DBPR SURCHARGE 455-0000-2080200 0 $200
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$94.00
Issued Date: 10/11/2018 1 of
?c-�>.v;• City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
ri 800 Seminole Road
Atlantic Beach, Florida 322335445
i Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@wab.us Daterouted: '7/2-
City web-site: http://v .mab.us
APPLICATIONQ REVIEW AND TRACKING FORM
C
Property Address: I t(PS SJr j$ .UL 1 ► IQ De ent review required Yes o
ll Buildin
Applicant: +ib m spa-C a Planning &Zoning
(l Tree Administrator
Project: v�rQQe �bbr - Public Works
VT Public Utilities
Public Safety
Fire Services
Review fee $ 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:
BUILDI
PLANNING&ZONING Reviewed by: Date: 10'9'—
49
TREEADMIN. Second Review:
❑Approved as revised. ❑Denied. V ❑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
OFFICE COPY
Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
1- ('�
Phone:(904)247-5826 Fax:(9N)247-5845
Job Address: I I�tb/t� Rrl�5'r , De M (j;,je L Permit Number:
Legal Description 40-37 VI—2 5— 4E SPI 1 �tY7 L6� O 1 REq 16;�5� I�D
Valuation of Work(Replacement Cost)$ 0/—'5.01111' Heated/Coaled SF Non-Heated Cooled a Z__
Z
J
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window car d < i—
• Use ofexisting/proposed structure(s)(Circle one): Commercia Residentla 0 m O Z 12
• If an existing structure,is a fire sprinkler system installed](Circle one : yes
• Submit aTree Removal Permit Application if any trees are to be removed or Affi avit of No Tree Removal W F R O
Describe in detail the type of work to be perforate 0 0
Rale CKl S over I ePfar� g F
a -
FloridaProductAppro Iq 22 for multiple products use product a}lar Igbr,
ProertOwner Inform / q� } a ¢ m
Name: h Lay%l) S ee—e Address: 1`16 S Br15� ✓e_ -mow A� w
city Irg&k , State_' Zip S z ZR Phone 16 7RZZ 30CUI W w
E-Mail
4111-
city
S
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required) LIJ
K m
Contractor Information pp --7'(''� ! T�
Nameof Company: 7 tiC2 INC- Qualifying Agen{:, :Aj&QS W 14I PSIP
Address }ly cityy1fQT S� �V(11� tState F4L Zp-- -Z C,0
Office Phone lob Site/Contact Number
State Certification/Registratipng E-Mailhn(v S�C-e n ® �ryyvtl , 1.6 w�
Architect Name&Phone a
Engineers Name&Phone 4
Workers Compensation Opp
Exempt/Insurer/Leau Employees/Evpiadon pate
Application is hereby made to obtain a permit to do the work and installations as indicated.l certify that no work or instal lation 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 TO YOUR PROPERTY. IF YOU I
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER 9R AN ATTORNEY BEFORE
RECORDINOUR 0 C COMMENCEMENT. � e
�LL
ffijh
iZ= (5ignature of Owner or Agent) ( ure of Co y 4
(including contractor) 9//q 8 w€
0-0 reds swan to( affirrpedl befor a his, ay '`S ed and worn to(or atr m )befo e t 's aj
C 11/1
(Signature of Np ary) (Signature of N ry)
fy ersonally Known OR
p ( p [ I Personally Known OR
rof Id ed Idcatia tbn R I j Produced Identification
[ian Z�qq 0� T
e of Identification: Type of Identification: W 4`t's/ -4-59 — �-247—V