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303 AHERN ST RES17-0270 APP RVW /yL��f, City of Atlantic Beach APPLICATION NUMBER /Js~ \ Building Department (To be assigned by the Building Department.) 800 Seminole Road V_E S 1 -Oaf -r Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 • Fax(904)247-5845 I I 1: J;ilr'" E-mail: building-dept@coab.us Date routed: t t 1, S ` (l City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 0 A hat n Sk • Department review required Yes No uilding Applicant: Uy b Cl in ,Q S C Oi1St 1*c i 6/) nritrircromm Tree Administrator Project: (l L,;; )c\.I(VC &k_ LC: SA 1 c,tici!1Public orks ) ublic 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' ,,ps 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: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: ['Approved as revised. ❑Denied. ❑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 y(1et____. 4 Building Permit Application , 51ti City of Atlantic Beach 800 Seminole Road,Atlantic Beach, FL 32233 ';ur Phone: (904) 247-5826 Fax: (904)247-5845 Job Address:303 , €'r .4-• ..A.4-h:=1,-,4-.e....j3 c i-7 f ) Permit Number: Legal Description See Attached RE# 169742-000, 169737-0000,169737-0010 Valuation of Work(Replacement Cost)$ 200,000.00Heated/Cooled SF 1823 Non-Heated/Cooled 639 • Class of Work(Circle one : New ddition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): r ommerc :I 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: New Townhome Construction Florida Product Approval# See Attached for multiple products use product approval form Property Owner Information Name: Ahern Project TH LLC Address: 830-13 A1A North#170 City Ponte Vedra Beach State FL Zip 32082 Phone (904)219-5003 E-Mail rjohnston.mec@gmail.com Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Contractor Information Name of Company: Urban Partners Construction .Qualifying Agent: Edmundo Gonzalez Address 3236 Beach Blvd. City Jacksonville State FL Zip 32207 Office Phone (904)270-2225 Job Site/Contact Number (904)591-7929 State Certification/Registration# CGC 1518379 E-Mail eg©urbanpartnersgroup.com Architect Name&Phone# Mark Macco(904)249-2724 Engineer's Name&Phone# Bradford Davis(904)739-3655 Workers Compensation Builder Mutual Insurance Co.WCP 104191601 Exempt/Insurer/Lease Employees/Expiration 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,etc. 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 INANCING, CO SULT WITH YOUR LEND • 'OR/N ATTO• : FORE RECO: ID, 1G OUR d ICE F COMMENCEMENT , /Liiii6iiiiawy 4Ait (Signature . Owner or Agent including ctor) (Sign. e of Contra;or) Signed and sworn r. •r affirmed)before me this l., day of Si;: ed and sworn to(or med)before me this 1p day of 1 I ,. oi1, by gi'UC „Jv1-7n.34 711 1 I , aai •y ecirr+urncia Go,-)7...c,'e_Z- (Signature of Notary) (Signature of Notary) �::. TALIA DAHLK6 ?�:."•°:;• TALIADAHLKE I Personally Known OR ;zg' [ ersonally Known OR : ,\ MY COMMISSION#GG 094490 Produced Identificatio = MYCOh1MISSION#GG 094486 [ ]Produced Identification ,. ....14,...v EXPIRES:Apri116.2021 • .'..no; EXPIRES.April 18,2021 Type of Identification: o'F v;4�•' Bonded Thru Notary Public Underwriters Type of Identification: _ . . .. _ •• •• YP Legal Description: A Replat of Lots 2, 4, 6, 8, 10 and 12, Block 2, Plat No. 1 Subdivision "A" Atlantic Beach, as Recorded in Plat. Book 5, Page 69 of the Current Public Records of the City of Jacksonville, City of Atlantic Beach, Duval County, Florida. Address RE#: 542 EAST COAST DR RE# 169742-0000 329 AHERN STREET RE# 169737-0000 331 AHERN STREET RE# 169737-0010 AHE A Replat of Lots 2. 40 Atlantic Beach, as Recarce(. the City of ,Jackson PLAT BOOK PAGE N T 0 WT%ZH ss:. ss SHEET 2 2 S4iEETS g: 10 and 19, Block 29 Plait Noy i Subdivision, � '�E'lff�f 1 FifR OEIM�li1.1101F� L Plat Book 5, Page 69 of the Current i'ub►iic �ecc�rds cif , .«sir te, City of Atlantic Beach, Duval County, Florida. i ,t-+ 4 P_ ,_F.4C%r�vf i 'q.JdfY NEf s i r5 t� .-•.2'' Asa-VG�j'"�, �c,5 & � " r �'y�\�q ,•.rpt ; :. � 3 {��,µys� e _ SIT- '� r z�+�T 1 "'•tix° F,+ 4 t r71 -f ..: F4a as�s.s.; '`'". fc ^�, � rA :. 3 itOi &P . -i '. � ' �'y 3.,30fi S.F. �'�� y ,,�� ", t . .fit � +ss�.'. •s _ 4� . +� . 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