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307 AHERN ST RES17-0266 (2) p.Ad , City of Atlantic Beach APPLICATION NUMBER �j�r Building Department (To be assigned by the Building Department.) 800 Seminole Road NOV 1 6 2017 est-f- _ C3 t � - s. Atlantic Beach, Florida 32233-5445 Jv v Phone(904)247-5826 • Fax(904)247-5845 E-mail: _ j;t>>% building-dept@coab.us 4". ` Date routed: I. t LS- 1./ City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 02- A \\-2-i c • Department review required Yes No iBuilddiin. Applicant: Ui ban i)Q(�cv S ebf\s- i.L * r tanning &Zonin4 Tree Administrator Project: y\jw AD,„,) f\ \ \kk (I.fi .,..:___.lic Wor- kY s-71s 1 -a •sUt S J Public Safety ire' ervices 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. nied. Not applicable (Circle one.) Comments: BUILDING Plains --1-bo Iav9Q/ 4-6tcoPArtige • PLANNING &ZONING lD -2 p-11 Reviewed by� a� Date: TREE ADMIN. Second Review: IVrApproved as revised. I 'Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES /7 e- PUBLIC SAFETY Reviewed by' 4 );_ _ Date: /-'4,2?-13 - FIRE SERVICES Third Review: Approved as revised. ❑Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ,1 `Pf,J,_ City of Atlantic Beach APPLICATION NUMBER r� , Building Department (To be assigned by the Building Department.) • 800 Seminole Road St-} _ a ij IF �. v Atlantic Beach, Florida 32233-5445 cc Phone (904)247-5826 Fax(904)247 5845 `` i':-.013)9'? E-mail: building-dept@coab.us Date routed: t l l�J ll City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 O2 A \Lj (1 Sk • Department review required Yes No Buildin. j Applicant: U-i 6 a iQ4--1-(4,-(S C-o(1S1fi,l(%')I' 4 . •.1. : Zoning _., Tree Administrator Project: '(l .Q,,-J ,.)Aknoi L e_ockSkc1,L,t •Iic Works ' -. • ACM Public Safety ire' ervices 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. I!enied. Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:„. �T l/ - Date: 7'1L//f TREE ADMIN. Second Review: Approved as revised. Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES , / PUBLIC SAFETY Reviewed by;�,�r,�,tv1/v A_____----- Date: 47/1//" FIRE SERVICES Third Review: YiApproved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: ,�i.Ktei L.---<V4- //L - Date: .f/,J//i tT Revised 05/19/2017 r!.ivi;yr„, City of Atlantic Beach APPLICATION NUMBER 8� Building Department (To be assigned by the Building Department.) 800 Seminole Road _ ca le f j v; r� Atlantic Beach, Florida 32233-5445 co Phone(904)247-5826 • Fax(904)247-5845` tt oitI9'' E-mail: building-dept@coab.us Date routed: Ill ` l� City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 309-- A1\124 n S4 . Department review required Yes No Build i;Th Applicant: \II ban •PQ iS r AL-$ ):-) ' -'. '. : Zonin• Tree Administrator Project: '(l It-N.) ADv3 d1\c\oN t CZ di flic works Pun irUtilities Public Safety ire- ervices 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 o..J. City of Atlantic Beach APPLICATION NUMBER �S Building Department NOV 6 2017 (To be assigned by the Building Department.) 800 Seminole Road �S`-� _ (�a �u "� Atlantic Beach, Florida 32233-5445 1G Phone(904)247-5826 • Fax(904)247-5845 t ,il9r E-mail: building-dept@coab.us Date routed: ( l�� ` (l City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 D2 A \L \ Sk • Department review required Yes No Building Applicant: �i ban S)O -A-N2_{S ezi-,sk bu.-k r _Rianning & ZoninT Tree Administrator Project: 0 tk-,) v,); \lOpAk l,OINS'\cl.la6,/, C •licwor-�R m • • Utilities Public Safety ir ' ervices Review fee $ 54' Dept Signature 5C 14.1 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: APP CCATION STATUS Reviewing Department First Review: Approved. I 'Denied. Not applicable (Circle one.) Comments: BUILDING ): Plats -bo Icty , PLANNING &ZONING 46 Lantr- 16'VQi Reviewed by: /"/- _ Date: 2/31 TREE ADMIN. Second Review: Approved as revised. ❑Denied. Not applicable P _WORKS omments: ELIC UTILITIE PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 r4CITY OF ATLANTIC BEACH PUBLIC UTILITIES 1200 Sandpiper Lane ATLANTIC BEACH,FL 32233 01319''' (904) 270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: 2/05/18 Project Address: 307 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 17-0266 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 $ /✓v SDC S gi.QP Sewer Tap $ Cross Connection $ 50.00 Other $ TOTAL $ 50.00 APPROVED: Kayle Moore, PE (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 .,,..v' Building Permit Application City of Atlantic Beach 800 Seminole Road,Atlantic Beach, FL 32233 •"..:,ti ar Phone: (904) 247-5826 Fax: (904) 247-5845 ..3 3 Job Address: 3c.)-1 .none-•-+ 54- �1—). it }-iC. Fl Permit Number: �e-S 1^ 1-— 0:(a b 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 :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 OBTA , FINANCIN CO ULT WITH YOUR LENDE• O' A N ATTORNEY : FORE RECO',/' 'G Y R ,, • I r OF COMMENCEMENT. ' /_ . . , <«4.-Wa i (Signature• Owner or Agen • ding Contractor) — (Si: - A re of Con,actor) Signed and sworn to(or affirmed)before me this day of Sig,ed and sworn to(• . irmed)before me this l.a day of I 1 • ii ,by R,' „)czf-,r7. 4- 'r, I 1 , o70.1111 byC.dm....,r,do Crt:)nZJo,Ie- . - .-- / (Signature of Notary) (Signature of Notary) ,,,/// PYP. TALIADAHLKE Personally Known OR 11) Personally Known OR rq'"'`4:: TALIA DAHLKE 90 �� MY COMMISSION#GG 094490 "• :,; MY COMMISSION#GG [ Produced Identification a; �M { Produced Identification ; 0944 Type of Identification: %.^o:� . ,,, APril• ..,1. Mme of Identification: .-;;:,•r;...:4 ,47.: EXPIRES: ,• 'I . 121 Lit,,_„,' ; N'otary Publtc Underwriters