367 7TH ST RES ALT PERM RESIDENTIAL PERMIT PERMIT NUMBER
RES19-0020
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 2/4/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 8/3/2019
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 federal agencies.
JOB ADDRESS:- PERMITTYPE: DESCRIPTION: VALUE OF WORK:
367 7TH ST RESIDENTIAL ALTERATION replace exterior door $360.00
RESIDENTIAL
TYPE OF REALESTATE BUILDING USE
T-
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
1699370000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: I STATE: I ZIP:
Mr. Handyman 1107 Park Avenue Orange Park FL 32073
OWNER: ADDRESS: CITY:
SMITH LINDA SAYRE 367 7TH ST ATLANTIC BEACH FIL 32233-5433
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 455-0000-322-1000 0 $55.00
BUILDING PLAN CHECK 4SS-0000-322-1001 0 $27.SO
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$86.50
issued Date: 2/4/2019 1 of 2
PERMIT NUMBER
RESIDENTIAL PERMIT
RES19-0020
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 2/4/2019
I vi ATLANTIC BEACH, FL 32233 EXPIRES: 8/3/2019
Issued Date:2/4/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road 0 0
Atlantic Beach, Florida 32233-5445 ILs k 4q
Phone(904)247-5826 - Fax(904)247-5845
-mail: building-dept@coab.us lei
E Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Si
Property Address: Dawrtmen review required Y -No
(-Building' _i)
Applicant: Wf , Planning &Zoning
Tree Ad m i n istrator
r
Project: Lg(_Q_ txy_� lu' ' 'Ooi Public Works
Public 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: [B/Approved. FIDenied. [:]Not applicable
(Circle one.) Comments:
(E�P
PLANNING &ZONING Reviewed by: N�r_ Date:
TREE ADMIN. Second Review: ElApproved as revised. F]Denied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. ODenied. DNot applicable
Comments:
Reviewed by: Date:
Revised 05119/2017
OFFICE COPY
Building Permit Application Updated 1019118
City of Atlantic Beach Building Department
"ALL INFORMATION
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Buflding-Qept@coab.us IS REQUIRED.
Job Address:Aic,'l Permit Number:
!22f r-'r�n q
Legal Description RE#
Valuation of Work(Replacement Cost)S-9 HeatedlCooled SF Non-Heated/Cooled
a ClassofWork: ONew ClAddition DAlteration DRepair OMove E]Demo OPool )�Window/Door
• Use of existing/proposed structure(s): OCommercial
• If an existing structure,is a fire sprinkler system installed?: Dyes ONo
• Will tree(sl be removed in association with Proi)osed Rrolect?Byes(must submit separate Tree Removal Permit) XNo
Describe In detail the type of work to be performed:
,!3 v3, �4
Florida Product Appr�l for multiple products use product approval form
va I#
Property Owner Inf\o-r
Name Address
city Csaksc-, Slbf�Q�_State zip Phone -0A 46 �;S
E-Mail-1�.krlv-1� - I-Vn (-_1 &ft*.nck
Owner or A�gent'(If Agent,Power of Attorney or Agency Letter Req-uired)
Contractor Information 7;;2�,A(�Otx.Aq i
Name of Company tA
6--�tkZt'! G�jj� Qualiflting Agent
Address\S iY-1 �tate �-Z:_ zip.
Office Phone C
I Job Site Contact Numb&
5tateCertification/Registration#��",c E-Mail- _i.CAq,_rCv -n--,V40c�,M, _X,--)f.,n
Architect Name&Phone# _\ - \) '_
Engineer's Name&Phone#
Workers Compensation Insurer �k OT'�M OR Exempt 0 Expiration Date_C�) J
installation has
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or* I !�
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulatimg, (N
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 44ils
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,�nd -J .0
there may be additional permits required from other governmental entities such as water management di�arlcts,state agenc eFjor z
federal agencies. t- 1 0 —
ZZ: Ld 0
OWNER'S AFFIDAVIT.I certify that all the foregoing information is accurate and that all work will be done in compliance with aP, 0 0
applicable laws regulating construction and zoning. 0 (�N Q o
LLJ P e� 0
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY' 19 ' -Z
0.u 0
Rb_J
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTE
TO OBT4N FINANCIVG,C�NSULT WITH YOUR LENDER OR AN ATTORNEY FORE Li- <
JEC R LL U. UJ
1 0
I OA"GY06 IYIPTI CO MENCEMENT _1;
d uc.- W 5.:
n. X
�(Signatune of Owner o-r Agent) (Signature of Conlkactor)
? U C3 W
Li 0) LLJ Z:
�ijgned and sworn to Lor affirmed)before me this tl:d!!�ay of S' d and sworn to(or affirm e4pefore me thi/V day>( cc
:�?'? 41
VULLusn.- 2�byLAAS_ / by LLJ
L
(Si��atu&04;t.ry) (Signature of Notary)
HOWARD�SALKIN
U4'ersonally Known R ELLEN R.THIGPEN I Personally Known OR C;otmAm. #2115984
Produced Identification F. 5.0 ry Pul California
MY COMMISSION#GG 144796 roduced Identification 9 - Notary Public- .
nly
Type of Identification: yp, Mann Cou
--6-21 9021 pe of Identification:11/1 4, 1 P.-niffl,
Borided Thru Notary Public Und��Iers Expa"ly 12,201M