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1 OCEAN BLVD COMM18-0037 BATHROOM REMODEL PERMIT 1 Vj COMMERCIAL PERMIT PERMIT NUMBER }, CITY OF ATLANTIC BEACH COMM18-0037 ISSUED: 1/8/2019 800 SEMINOLE ROAD °'t'�~ ATLANTIC BEACH. FL 32233 EXPIRES: 7/7/2019 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE 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: 1 OCEAN BLVD COMMERCIAL ALTERATION WOMEN'S BATHROOM $161000.00 COMMERCIAL REMODEL TYPE OF CONSTRUCTION: NUMBER: GROUP: 170229 0000 ATLANTIC BEACH COMPANY: ADDRESS: CITY: STATE: ZIP: WESTLAKE CONSTRUCTION 231 RIVER PARK DR N WOOD SERVICES LLC • ADDRESS: ASHFORD ATLANTIC C/O EASLEY MCCALEB & ASSOCIATES MAITLAND FL 32751 BEACH LLP 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. CONDITIONSLIST OF Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 4SS-0000-322-1000 0 $663.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $331.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $14.92 STATE DCA SURCHARGE 455-0000-208-0600 0 $9.95 Issued Date: 1/8/2019 1 of 2 COMMERCIAL PERMIT PERMIT NUMBER COMM 18-0037 CITY OF ATLANTIC BEACH ISSUED: 1/8/2019 800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 7/7/2019 TOTAL: $1,019.37 Issued Date: 1/8/2019 2 of 2 City of Atlantic Beach APPLICATION NUMBER js ri� Building Department (To be assigned by the Building Department.) s� 800 Seminole Road Lo) Melt � L9^ 000 Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 - Fax(904) 247-5845 RR E-mail: building-dept@coab.us Date routed: l '2'0�� C J City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM 11 Property Address: 0 &VID ent review required Yes No Buildin Applicant: poR'� `�C�N Tc C Planning &Zoning Tree Administrator Public Works Project: Vy 0 i1(1C-/��� �-7 (f-IZC`�C� (1/�. Public Utilities Public Safety ire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept. of Environmental Protection p ]� Florida Dept. of Transportation � ( �l" �` St. Johns River Water Management District uo/ Army Corps of Engineers �O L::'re'P Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. V�Benied. ❑Not applicable (Circle one.) Comments: VA o t//�v ►-t�Ik L'rrC9"� 1A O L BUILDING PLANNING &ZONING Reviewed by. Date: ►Z Z( ° c.� TREE ADMIN. Second Review: 104proved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: �► oto ' FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road,Atlantic Beach,FL 32233 HIGHLIGHTED IN GRAY Phone:(904)247-5826 Fax:(904)247-5845 Email: Building-Dept@ ab.us 15 REQUIRED. 1 Ocean Blvd.Atlantic Beach,FL 32233 C� Job Address: Permit Number: O�'v�M ��—O �� Legal Description 5-69 21-2S-29E 2.350 ATLANTIC BEACH PT BLK 36,ALLEYS LYING WITHIN RE# 176229-6006 Valuation of Work(Replacement Cost)5 161,000.00 Heated/Cooled SF _Non-Heated/Cooled • Class of Work: inNew CAddition ❑Alteration ❑Repair OMove ❑Demo ❑Pool OWindow/Door • Use of existing/proposed structure(s): QCommercial aesidential • If an existing structure,is afire sprinkler system installed?: MYes t_Irvo • Will tree(s)be removed in association with proposed proiect?2yes imust submit separate Tree Removal Permit 17No Describe in detail the type of work to be performed: Florida Product Approval# for multiple products use product approval form Property Owner Information Name Ashford Atlantic Beach LP C/O Easley McCaleb Assoc Address 431 E Horatio Ave.Suite 120 City Maitland State FL zip 32751 Phone E-mail elaina@alliancepennitting.com Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) n/a Contractor Information Name of Company Westlake Construction Srvs LLC Qualifying Agent Charles Terry Finch Address 231 River Park North Dr City Woodstock State GA Zip 301$$ Office Phone (904)579-7122 lob Site Contact Number State Certification/Registration# CGC1506847 E-Mail elainac@alliancepermitting.com Architect Name&Phone# Craig A.Sommers Engineer's Name&Phone# DSAE Workers Compensation Insurer 'VV L 4 I (C" `t 'x>C�C� [ OR Exempt o Expiration Date i Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installs ion has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating 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 INTEND TO OBTAIN FIN C?NG, CONSULT WITH YOUR LENDER OR N TTORNEY BEFORE RECORptiVJ R NOTICE OF COMMENCEMENT. (Signature of Owner or Agent) (SiQti+at ofat•• Signed and sworn to(or affirmed)before me this /4 day of Si-gree and sworn to(fir ed4otpreday of December 2018 Christo her Peckham c C, (Signature of Nota r 0 ti74(Signatyl An W uth Shumway F•�°»G•`,G f PersonallyKnown ORw�nmiun M�1909 v6 Personally Known OR zr,�OKE,,`�.� 1"r [ ]Produced Identificaticnpires.04/21/2020 [ I Produced Identificatinn L Type of Identification: Type of Identification:T +" City of Atlantic Beach APPLICATION NUMBER �s s Building Department (To be assigned by the Building Department.) r 800 Seminole Road i 8IIJJ _ /�O3 j Atlantic Beach, Florida 32233-5445 C_(a)N\1\1\.JN\1\1\. U Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.usDate routed: 1�30J t City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM I� Property Address: I 0 C�� K-) LVOent review required Yes No Buildin Applicant: 5{-f �O�(� �N�c e I5 anniiTg &Zoning Tree Administrator Project: V v�i1(\C � �-7 {-��QQ f V� Public Works Public Utilities R, I �I�,d� Public Safety ire Services C©t,3 yP,RC�o(Z u � D �ScDE� 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 NE.�D S S10Ce, tL) t-,\.LCAZ OCA (P—C— CA Sc� r(C-& OCD/y, inC PLANNING &ZONINGReviewed 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 Dipierri, Miguel WOMAN Bathroom Remodel Comm18-0037 ( 1 0 CeC1r1 � 'Vf 1. My modifications or alterations to the sprinkler system or fire alarm system requires a separate fire permit. MIGUEL Di PIERRI Fire Safety Inspector/ CDN Reviewer JFRD PREVENTION OFFICE 515 N.Julia St.,Jacksonville, Florida 32202 Office: 904-255-8561 cell: 904-763-1290—Email: DIPIERRI@COJ.NET SCANNED Date: ( Z I C) 1 Printing :: CR486648 Page 1 of 1 Duval County,City Of Jacksonville Jim Overton ,Tax Collector 231 E.Forsyth Street Jacksonville,FL 32202 General Collection Receipt Account No:CR486648 Date: 12/7/2018 User:Prevention,Fire Email:FirePrev@coj.net FIRE MARSHALL FEE FOR SERVICES PROVIDED Name:Ashford Address: 1 Ocean By Description:Plan review Fee Comm 18-0037 woman bathroom remodel TranCode Inde:Code ( SubObject GLAcct SubsidNo UserCode Project ProjectDtl Grant GrantDtl DocNo Amount 701 ( FRFP159FI I 34222 1 1I ( ( 150.00 Total Due:$150.00 Jim Overton ,Tax Collector General Collections Receipt City of Jacksonville,Duval County Account No:CR486648 Date: 12/7/2018 FIRE MARSHALL FEE FOR SERVICES PROVIDED Name:Ashford Address:I Ocean By Description:Plan review Fee Comm 18-0037 woman bathroom remodel Total Due:$150.00 http://financeweb.coj.net/TCCR/printing.aspx?cI=CR486648 12/7/2018 Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY H 1, Phone: (904) 247-5826 Fax: (904)247-5845 Email: Building-Dept@coab.us IS REQUIRED. Job Address: 1 Ocean Blvd.Atlantic Beach, FL 32233 Permit Number: Legal Description 5-69 21-2S-29E 2.350 ATLANTIC BEACH PT BLK 36,ALLEYS LYING WITHIN RE# 170229-0000 Valuation of Work(Replacement Cost)$ 161,000.00 Heated/Cooled SF Non-Heated/Cooled • Class of Work: 41New ❑Addition []Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): QCommercial ❑Residential • If an existing structure, is afire sprinkler system installed?: MYes []No • Will trees be removed in association with proposed ro'ect? es must submit separate Tree Removal Permit []No De scribe in detail the type of work to be performed: -RA-6, 0FJMIC>e_5 f S'f'2pIM Ul% t GtNb &j kt Work fePl4ct,wtcv.� ih Wolue.L' er door - Florida Product Approval# or multiple product se product approval form Property Owner Information Name Ashford Atlantic Beach LP C/O Easley McCaleb Assoc Address 431_ Horati ve. Suite 120 City Maitland State FL i 32751 one E-Mail elaina@alliancepermitting.com Owner or Agent(If Agent, Power of Attorney Agency L tter Require ) n Contractor Information 2 Name of Company TQ P alifying Agent Address ity State Zip Office Phone 10 ' e Contact Number State Certification/Registration# E-Mail elaina@alliancepermitting.com Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer OR Exempt❑ 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 regulating 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 maybe additional restrictions applicable to this property that maybe 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 P YING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN F NCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDG UR NOTICE OF MENCEMENT. (Signatur o Owner or Agent) (Signature of Contractor) i Signed and sworn to(or affirmed)before me this u�day of Signed and sworn to(or affirmed)before me this day of November 2018 Christopher Peckham,VP by (Signature of No ) (Signature of Notary) Personally Known 0 �y POW Sweorlesm [ ]Personally Known OR [ ]Produced Identificat Ruth Shumway C•. a 19"M [ ]Produced Identification Type of Identification: EaII 04/21/2020 Type of Identification: