303 AHERN ST RES17-0270 s=Al ri,, City of Atlantic Beach APPLICATION NUMBER
,-51r , BuildingDepartment (To be assigned bythe BuildingDepartment.)
p NOV 1g p )
800 Seminole Road 6 2017
jv`-� _' 2 Atlantic Beach, Florida 32233-5445 1-ti 5 —O -o
Phone (904)247 5826 Fax(904)247 5845 _ E
*0,319'' E-mail: building-dept@coab.us Date routed: I t t J (-I
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 0 A hEt sl S* • Department review required Yes No
uilding_.)
Applicant: �y6an VII(-\4\1-1,... (t?ivSt(�LCkii?1) nrr g-TZoin
Tree Administrator
Project: 0 LL.,) v3 VIC.)An.L CC sA (d l(k v� Public-Works
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 Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. ViDenied. Not applicable
(Circle one.) Comments:p
BUILDING ,*T [ayu--It° 61
PLANNING &ZONING 40 [.a-w- ollg, Reviewed by. Date: 11-2F 11
TREE ADMIN. Second Review: OApproved as revised. El Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed b : i�,4 4.4 • .t Date: _
FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
r= �r City of Atlantic Beach APPLICATION NUMBER
\ Building Department (To be assigned by the Building Department.)
• -_ 2 800 Seminole Road pLS
� t �O
w'~ � Atlantic Beach, Florida 32233-5445 h
Phone(904)247-5826 • Fax(904)247-5845
P!ortiE i• E-mail: building-dept@coab.us Date routed: l l
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 30 A hQt \ St • Department review required Yes No
Building J
Applicant: Uy b c1 n O Dr n g onin
Tree Administrator
Project: (lL - X(1VtO( t-CASA(�.lL�c} lic_orks )
ublic Utilities
Public Safety
Fire Serviceses j
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: ❑Approved. Denied. Not applicable
(Circle one.) Comments:
BUILDING /
PLANNING &ZONING Reviewed by: � (/ie.-----' Date:_____t ,�
TREE ADMIN. Second Review: I (Approved as revised. J.Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: v / v Date: ii/2/le
FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: `!".-^-'•" C/ ` ate: "2i/4
Revised 05/19/2017
r
o,m-,-,J, City of Atlantic Beach APPLICATION NUMBER
JS • A Building Department (To be assigned by the Building Department.)
800 Seminole Road p LS I-} -Oa
Atlantic Beach, Florida 32233-5445 t'�
• Phone (904)247-5826 • Fax(904) 247-5845
'-�J 31T'' E-mail: building-dept@coab.us Date routed: t,t.k-t (1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 30 3 A c S-4 • Department review required Yes No
uilding
Applicant: Uy bu.n Pa ( rs OmStrvu-klOf) nig onin
Tree Administrator
Project: (1 Q,t ;) ).n hc`U k L%NSt(i-1(;{� P lic _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 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:
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
rS1,:Ly;.�J, City of Atlantic Beach APPLICATION NUMBER
6s ; , Building Department (To be assigned by the Building Department.)
� 800 Seminole Road NOV 16 2017 S i-� _n a 1-0
J "�W s) Atlantic Beach, Florida 32233-5445
\�� Phone (904)247 5826 • Fax(904)247-'584N5OV
01119.- E-mail: building-dept@coab.us Date routed: t t t J WA-
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 30 A hE( r'\ S-- . Department review required Yes No
'uildin
Applicant: Uy 6 Gln V t__Ck4q_43 ((Dd\st(iLC=-ki m I nrritrgThrn
Tree Administrator
Project: Q�t ,; �C �Crn . t.�`rSt(Ll(s>(.7),,) Public" rks
ublic Utilities
Public Safety
Fire Services j
Review fee $ Pi 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:
APPyCATION STATUS
Reviewing Department First Review: Approved. Denied. ['Not applicable
(Circle one.) Comments:II'_
BUILDING p1,05-[00 I�Ol✓5Q.'
PLANNING &ZONING "f° Reviewed by:/ r 22'lr''-- Date: 4-r(ICC
TREE ADMIN. Second Review: ❑Approved as revised. Denied. ❑Not applicable
PU:410,ORKS I Comments:
BLIC UTILEi r/
PUBLIC SAFETY I Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
(---
ej V ''',:,A CITY OF ATLANTIC BEACH
�� - ��yr
ri PUBLIC UTILITIES
\\ 1200 Sandpiper Lane
ATLANTIC 1,f ATLANTIC BEACH,FL 32233
(904)270-2535 or(904)247-5874
NEW WATER/SEWER TAP REQUEST
Date: 2/05/18 Project Address: 303 Ahern Street
No. of Units: 1 Commercial Residential 1 Multi-Family
New Water Tap(s)&Meter(s) Meter Size(s) 3/4"
New Irrigation Meter Upgrade Existing Meter from to (size)
New Reclaim Water Meter Size New Connection to City Sewer
Name:
Applicant Address:
City: State: Zip _
Phone Number: Cell Number:
Email Address Fax:
Signature:
(Applicant)
CITY STAFF USE ONLY
Application# RES 17-0270
Water System Development Charge $ PROPERTY CREDITED FOR SIX
Sewer System Development Charge $ EXISTING WATER AND SEWER
Water Meter Only $ SERVICES.
Reclaim Meter Only $
Water Meter Tap $ /Jo I'DC $ ilr t 6
Sewer Tap $
Cross Connection $ 50.00
Other $
TOTAL $ 50.00
APPROVED: Kavle Moore,PE X-110'--
(Deputy PW Director or Authorized Signature)
ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES
CAN BE ASSESSED
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
ri';t`';4/3. Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904)247-5845
3... -.. .3 Q
Job Address:3a3 Ahne--n .4-• A-1-kap-14-i_Beep- f Permit Number: '" �, a �
Legal Description See Attached RE# 169742-000, 169737-0000, 169737-0010
Valuation of Work(Replacement Cost)$ 200,000.00 Heated/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 ' 'O AN ATTO' is : FORE
RECO: i, 1 G OUR + ICE F COMMENCEMENT
/✓� (�ja
(Signature • Owner or Agent including CSrtcactor) (Sign. e of Contra 3 or)
Signed and sworn is •r affirmed)before me this l�day of Si; ed and sworn to(or• med) before me this S. day of
I I ,mo t'-i, by R:'UG ..lv1-ir-+,54-t'ii I I , acs i •y Edrn-+r->'cia G"oriZ. Ie--z-
(Signature of Notary) (Signature of Notary)
?�°;$;!., TALIADAHLKE
'' TALIADAHLKE ersonall Known OR ?'.. - •, i COMMISSION
,Personally Known OR :Wig• ��: [/1`Y Y , .� :,; MY #GG 094490
[ ]Produced Identificatio , = *e MY COMMISSION#GG 0944�b [ ]Produced Identification y� �`.; EXPIRES:April 16.2021
,;,r �` EXPIRES:April 18,20 1 Type of Identification: .',,p� ;°' Bonded Thru Notary Public Underwr,ters
Type of Identification: ._ Yp
411
. I'
BuildingPermit Application
lication
t` ')
City of Atlantic Beach
w 800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904)247-5826 Fax: (904) 247-5845
3 R Esq —e a. -0
Job Address:30l,414-,42,-,-,414-,,414-,42,-,-,i- •54- .- lc-1n.f-,LC3ecici1 F Permit Number:
Legal Description See Attached RE# 169742-000, 169737-0000, 169737-0010
Valuation of Work(Replacement Cost)$ 200,000.00 Heated/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): i ommerc :1 Residential
• If an existing structure,is a fire sprinkler system installe.? 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 if CGC 1518379 E-mail eg@urbanpartnersgroup.com
Architect Name& Phone it 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 LENDERT OW N ATTO' : FORE
RECO: 9, l ,OUR ICE F COMMENCEMENT
/,:iiiiiiiiiiiiiafillr'"/Ait /
(Signature Owner or Agent including ctor) (Sign. e of Contra;or)
Signed and sworn ( r affirmed)before me this t... day of Si;, ed and sworn to(or . med)before me this 1p day of
1 I ,. a,-7,by /Q,. K Jvh,r7,3-I'n t I , o7ai .y 1, ci .+r—,tic, Cn'7_c,ie-Z
-,_ r r ------r
(Signature of Notary) (Signature of Notary)
VeigaSEMIMMIYA'.�a ,\// :.2j:a.°:i; TALIADAHLKE
,{Personally Known OR �q ''`% TALIADAHLKE [�jsPersonally Known OR 4, '•,? MY COMMISSION#GG 094490
+�,- MY COMMISSION#GG 0944 0 [ ]Produced Identification ,, -.,,r EXPIRES:April 16.2021
%[ ]Produced Identificatio �::
�`-,,o; EXPIRES.April 18,2021 Type of Identification: '' 66°•` 3aided Thi Notary Public Ur derwr.ters
Type of Identification: YP ..•