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319 Ahern Street RES17-0274 oyavr , City of Atlantic Beach APPLICATION NUMBER ril i �4 Building Department (To be assigned by the Building Department.) A • - 800 Seminole Road n L S 1 1 — GQ 1-LI �: sl Atlantic Beach, Florida 32233-5445 i� l� Phone(904)247-5826 • Fax(904)247-5845 J:il�? E-mail: building-dept@coab.us Date routed: (L ' IS ' t1 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 C -Aii14 n Department review required Yes No I :u. . .. n - Applicant: `-�-( ban ki-v�-{S C ns-} t Li_uklbr) I Planning &Zoning , Tree Administrator Project: i\Q) A-D I-3 n‘4V0eA L 0_3N5t I L C r I -ublic Works 4 Public Utilitie, . Publi - - ire 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. JWDenied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:.4.15., e...----l------ Date: 5/11/1 p G TREE ADMIN. Second Review: ['Approved as revised. XDenied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: , ...."{+l/i----- Date: VIA e FIRE SERVICES Third Review: Approved as revised. ❑Denied. ['Not applicable Comments: Reviewed by: •*••••l e,-<" Date: 671/1II Revised 05/19/2017 ' ,o!,, j jr, City of Atlantic Beach APPLICATION NUMBER ti PP a Building Department 1 (To be assigned by the Building Department.) r.• _ _•-• 800 Seminole Road Nov 6 2017 n LS, 1 — GQ 4 LI iiii j�,„ �,- Atlantic Beach, Florida 32233-5445 i�--l� Phone(904)247-5826 • Fax(904) 247-5845 '1\\L___/ 19:' E-mail: building-dept@coab.us Date routed: it I is 111 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ` C kN\Q_j (1 6-k . Department review required Yes No Applicant: ` t be n Cck Ij \J{-S ��nS-k- Ltar' %,Plann_ing &Zoning Tree Administrator Project: 0 ti,3 1\V1.OML e-ok5 1 Ltcfitn 'public orks Public Utilities Publi - - ire 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. fNot applicable (Circle one.) Comments: BUILDING ?tans —oo 6i92 PLANNING & ZONING A Las/461 Q/ �1.�,8'.rl Reviewed � Date: TREE ADMIN. Second Review: IveVproved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES �J /� r PUBLIC SAFETY Reviewed b�.,..ee -/se4ay1„. Date: fr2 FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 01.A,,. City of Atlantic Beach APPLICATION NUMBER 5_-; i � Building Department (To be assigned by the Building Department.) r. y 800 Seminole Road n-L S`1 _ GQ 1 L' e Atlantic Beach, Florida 32233-5445 i� l� Phone(904)247-5826 • Fax(904)247-5845 x o;3 q? E-mail: building-dept@coab.us Date routed: I \ ISt.1 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 CA k'\o_/ n Si . Department review required Yes No �1 u Applicant: U-( ban �G.i'�Yv_f s C,onS* _Planning &Zoning Tree Administrator Project: 0 ti.-3 4-0 n VOpit Q. Cb -k I Llublic Works Public Utili Publi ire 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 i.a�y;J,, City of Atlantic Beach APPLICATION NUMBER �Sl Building Department (To be assigned by the Building Department.) 800 Seminole Road NOV 16 2011 Q-eS _ GSI `i -: - , Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 A2,01.09 E-mail: building-dept@coab.us Date routed: (l \ (s- I t1 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: , .• n Department review required Yes No R nSkt i !� • I. Applicant: \1 ban '1'G1-I-\'r1[ l �nlA-1,1%j\ '_Plann_ing &Zoning Tree Administrator Project: 0 4 4---DL,- n kilo ivk L ei k I L Ln I 'ublic Works 4 Public Utiliti- Publi - - ire Services Review fee $ 9.-D 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: APPL - ATION STATUS Reviewing Department First Review: Approved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING 't Mans -In (Ov3 PLANNING &ZONING 4t AAs Ocie 6✓, Reviewed by: Date: 2-1-51(% TREE ADMIN. Second Review: Approved as revised. Denied. ❑Not applicable P ::ille WOR S Comments: 'UBLIC UTJLITIE 2- S— i PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ['Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 S ~ t, �I' CITY OF ATLANTIC BEACH 1 ' , f PUBLIC UTILITIES 1200 Sandpiper Lane ATLANTIC BEACH, FL 32233 1-Dit1-' (904) 270-2535 or(904)247-5874 NEW WATER/SEWER TAP REQUEST Date: 2/05/18 Project Address: 319 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 X Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# RES 17-0274 Water System Development Charge $ 1140.00 Sewer System Development Charge $ 4,050.00 /Ort c l S(2d C Water Meter Only $_ 185.00 Reclaim Meter Only $ Water Meter Tap $ Sewer Tap $ Cross Connection $ 50.00 Other $ TOTAL $ 5,425.00 APPROVED: Kayle Moore, PEVA (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 %'w-v-t., Building Permit Application r �3` r, City of Atlantic Beach f 800 Seminole Road,Atlantic Beach, FL 32233 '#' tin o} Phone: (904)247-5826 Fax: (904)247-5845 3�o. 3 LS i -- o q-I-[ Job Address: 3i C) ,,e ..1.-+2rr7 4-.,G...HGn}+G f cGI7, 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 FINANCING, CONSULT WITH YOUR LEN 0 .R O' AN ATTORNEY B FORE RECOR I YOOTICE F CO MENCEMENT ,i" /itL/i�L� . (Signature o ner Agent including tractor) _V (Signa Ife of Co, ractor) Signed and sworn to(or affirmed)before me this 1. ay of Sig ed and sworn to(or . med) before me this lx, day of ) I ,- 0)--),by /2'G...4.. ,/c.I )r -+c,1 I t ,Qo .y Ecirr-h--.►--do G-amv-,z.....1Ie-Z ----,. ---- ------t I r"----_,.__ (Signature of Notary) (Signature of Notary) Personally •,:�;P'� ;•; TALL DAHLKE Personally Known OR ?o;A"•°s ,: TALIADAHLKE Proed Identificatio MY COMMISSION#GG 094490 [ ]Produced Identificatio °.e MY COMMISSION#GG 094490 Al Type of Identification: i EXPIRES:April 16,2021 Type of Identification: y;,,'�`- EXPIRES:April 16.2021 ,, r Bonded Thru Notary Public Underwrites •'.,p,,,,4 bonded Thru Notary Public Underwriters ..I.sm..IMM•.., �r.s.�.....iww...a.rs