2328 BEACHCOMBER TR RES NEW FAM RES RESIDENTIAL PERMIT PERMIT NUMBER
RES19-0009
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 2/5/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 8/4/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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 federa I agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
2328 BEACHCOMBER TR RESIDENTIAL NEW SINGLE GARAGE DOOR $2468.00
FAMILY RESIDENCE
TYPE OF REALESTATE BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
1694630072 OCEANWALK U NIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
PRECISION DOOR SERVICE 11323 Business Park BLVD JACKSONVILLE FL 32256
OF N FL JASO
OWNER: ADDRESS: CITY: STATE: ZIP:
ALLIGOOD CHARLES 2328 BEACHCOMBER TRL ATLANTIC BEACH FL 32233-6607
EDWARD
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.
LIST OF CONDITIONS
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 4S5-0000-322-1000 0 $6S.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4SS-0000-208-0600 $2.00
Issued Date: 2/5/2019 1 of 2
RESIDENTIAL PERMIT PERMIT NUMBER
ISSUED: 2/5/2019
800 SEMINOLE ROAD
tilt 9 EXPIRES: 8/4/2019
2- 1,
RES19-0009
CITY OF ATLANTIC BEACH
ATLANTIC BEACH. FL 32233
TOTAL: $101.50
Issued Date:2/5/2019 2 of 2
F'\ City of Atlantic Beach
/12 1 APPLICATION NUMBER
Building Department (To be assigned by the Building Department)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 00
Phone(904) 247-5826 - Fax(904)247-5845
'A' E-mail: building-dept@coab.us H Date routed: 9
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �k onrn QjePa#n4qnt review required Ye ;�;_No
Applicant: PE r- 0 Q0q_ C_f Qju�i�l ning
Tree Administrator
Project: (ac-- tz— Public Works
Public Utilities
Public Safety
Fire 3ervices
Review fee $ Dept Signature
Review or Receipt
Other Agency Review or Permit Required f P rif Date
I
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: MApproved. F]Denied.
(Circle one.) Comments:
(E5)
PLANNING &ZONING Reviewed by: Date: 7-/9
TREE ADMIN.
Second Review: [-]Approved as revised. RDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [JApproved as revised. nDenied.
Comments:
Reviewed by.- Date:
Revised 07/27/10
OFFICE COPY
Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FIL 32233
Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: Permit Number: (9 oc)C)C�
Legal Description T
C)Ctany,�WV_ �M.�A :a- RE# 2
Valuation of Work(Replacement Cost)$ 2A I(De. 0 0 Heated/Cooled SF Non-Heated/Cooled
LLJ
Class of Work(Circle one): New Addition Alteration Repair Move Der-no Pool 0
(�� Z
Use of existing/proposed structure(s)(Circle one): Commercial (R:es;ident�iial W
t I _J Z
In 1 :3 u < o
s
If an existing structure, is a fire sprinkler system installed?(Circle one): es NoC�,A) Z
Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal :5 0
Describe in detail the type of work to be performed: F- LU
Z
00
��,P\Xt (�afa�t LL1 13
Florida Product Approval# for multiple products use product appn—oa
Property Owner Information _J
N a m e: V--13\1�(�rIA Z\,)0\T\tS A\M)c)o6 Address: �ISaB Q)taOncornbtt" �<- ctl=) 'Z
city Alrmn��P_ bitac), State P�_ Zip Phone QK)4-1�12(o- 009q! i2r W2 J
a UJI W >.
E-Mail '�)tQ\0`1�cx) C-c)vn co�si. nci - n
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Owner or Agent(If Ag'ent, Power of Attorney or Agency Letter Required) 11-- LU M 10
— LU (3 W
Contractor Information L) U) W ?r
Name of Company:lPf ZUSkQ)n 'OOOr ()�14-R-Qualifying Agent: JQSQn CJV)It PQ II1A X
Address Z lit LU
()�u ff)U 0� POf�- Or S City State V p_
Office Phone C1 CIA- (C S%-2�1'20 Job Site/Contact Number P L k
State Certificati on/Regist ration# E-Mail MC��fCkY\ Q\M �0 En c,1 1
Architect Name&Phone#
Engineer's Name&Phone# I
Workers Compensation (�)te! C_'t'(VkCaAt v,IC-EA D--0C)-;f;-ZZ-7- Z 0 C�? t 11
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 LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
(Signature o(fiwner or Agent including Contractor) ignature of Contractor)
Sig d and sworn to(or affirmed)before me this C46 day of Signed and sworn tuir affirmed)before me this (6 day of
by P-d A\WoP6 J, (�V) by 1015 0 n
LSIgnature of Notary) (Signature of Notary)
MICHELLE VAN VUREN MICHELLE VAN VUREN
Pu
Notary Public-State of Florida Notary Public-State of Florida
Commission GG 203567
s
Commis lion#GG 203567
my
Personally Known My Comm.Expires Jul 29,2022 Personally Known OR W Comm.Expires Jul 29,2022
OE ..."F -.1
Bonded through National Notary Assn, yy
Produced Identifica Produced Identification Bonded through National Notary Assn.
Type of Identification: Type of Identification: I I— I