1856 TIERRA VERDE DR GARAGE DOOR PERM RESIDENTIAL PERMIT PERMIT NUMBER
'$ RES19-0052
CITY OF ATLANTIC BEACH
~, 800 SEMINOLE ROAD ISSUED: 3/1/2019
<=
ATLANTIC BEACH. FL 32233 EXPIRES: 8/28/2019
MUST CALL INSPECTION PHONE914 ' BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, OF BEACH CODEOF • '
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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1856 TIERRA VERDE DR RESIDENTIAL ALTERATION GARAGE DOOR $1843.00
RESIDENTIAL
TYPE OF
• • GROUP:
169542 5064 SELVA TIERRA
• ADDRESS:
GEORGE'S GARAGE DOOR 870 MAIN ST ATLANTIC BEACH FL 32233
SERVICE, INC
• ADDRESS: '
KREIDL OLIVIER PATRICK 1856 TIERRA VERDE DR ATLANTIC BEACH FL 32233
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 • .
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 $60.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $30.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4SS-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date: 3/1/2019 1 of 2
Ly- City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 0C) S Z
Phone(904)247-5826 - Fax(904)247-5845 1
•,�% E-mail: building-dept@coab.us Date routed: z S l
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I C)S(O I C=(Z(Z(-� U epartment review required Yes No
uildin
Applicant: (�C O(Z CZ E,11 piC& �Oc�(� P anning Zoning
Tree Administrator
Project: L' oc) (Z 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 V��
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:
�IN
PLANNING &ZONING
Reviewed by: Date: Z o
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
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
``Ji_ I IS REQUIRED.
Phone: (904)) 247-5826 Email: Building-Dept@coab.us
Job Address: �'S(a 1 F—g.p—f1 VE)e L-) D/Z Permit Number: Rs ((� — C—,-OS-Z
Legal Description RE# Z6 ( S ST 6 y
Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New []Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Po ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial
• If an existing structure,is a fire sprinkler system installed}: ❑Yes ❑No
• Will trees be removed in association with proposed ro'ect? ❑Yes must submit separate Tree Removal Permit ❑No
Describe in detail the type of work t �bbeperfo�rmecdl:
Florida Product Approv # / /Z ' for multiple products use product approval form
PropertyOwner Inform n
Name 0 VIE Address �SCo T/El�/2f� V-20 b2
City AZZ-Ani T7 L 9AA61{ State rL Zip 33 Phone c10 Z/ 6c2K) /105-
E-Mail
905E-Mail f�lky"KICIG, K/ /AL G�L>Ni�o ED1J
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company 6ED44E 'S GA A446G DW4 .�PV 46Mualifying Agent 4?E0AC C R6FA(�AAA
Address -7D MA IN ST city 41z— 9,_I-I State FL Zip 3iW,233
Office Phone qd 4 S3 4 /491 Job Site Contact Number `)0d�7 y U N
State Certification/Registration# 67 D 3 aZ E-Mail A X 2A6 ED s I I/E U) �
Architect Name&Phone#
Engineer's Name&Phone# d Z
Workers Compensation Insurer O xempt❑ Expiration Date LL) y 0 Vj
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or ins I .ri. Q
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws ru i�
U
a
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBIN I Z
WELLS, POOLS,FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the require r�n Jodh�
permit,there may be additional restrictions applicable to this property that may be found in the public records of this c&nay,rdP
there may be additional permits required from other governmental entities such as water management districts,state wrfg-esoyg
federal agencies. Q O W W
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OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliancEWitot m
applicable laws regulating construction and zoning. w p W
LU V N w
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT @AY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU MTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR Aly ATTORNEY BEFORE
RECO DIN Y U NOTICE OF MMENCEMENT.
v -
o m N (Signature of Owner or Agent) (Signature of Contractor)
i' a and sw rn t (qr affir d)before me this day of Si d and sworn to or affi m d)before me thi day of
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E o ' a :'rg`"Y r - ONI GI L tory)
U 92'
c � a 5 .: ,r. MY
Z + �P EXPIRES:October 6,2019
.�. Pe Wally Known OR [ ]Pers naE{�r�(}$OWrBQ FdThNNotary Public Underwriters
` 2
uced Identification �('�1 I�� � [ ]Produce
Identification: (•L� Q Type of Identification: (S Z—C:�Q^-3 ( J—S( --4