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967 ATLANTIC BLVD TENT19-0001 TENT PERM rf' TENT PERMIT PERMIT NUMBER 1TENT19-0001 v� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 3/14/2019 ATLANTIC BEACH, FL 32233 EXPIRES: 9/10/2019 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + 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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK- 967 ATLANTIC BLVD TENT temporary 40-ft. x 70-ft. tent $0.00 TYPE OF • • GROUP: 177602 0040 SECTION LAND COMPANY: ADDRESS: • ADDRESS: EQUITY ONE ATLANTIC 1600 NE MIAMI GARDENS DR NORTH MIAMI FL 33179 VILLAGE INC BEACH 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 455-0000-322-1000 0 $31.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$35.00 Issued Date: 3/14/2019 1 of 1 SrS!:L'1�� City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) r� 800 Seminole Road _r� —� ILC — 0001 �r Atlantic Beach, Florida 32233-5445 "l V Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: GC W� k� �- Bku review required Yes No Buildin Applicant: �� l Q \ Planning &Zoning Tree Administrator Project: I(Y��( L�l`I 'I,V �C _W1)4_ 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 B 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: A roved as revised. ❑ pp ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable j Comments: Reviewed by: Date: Revised 05/19/2017 Building Permit Application Updoted10/9/18 J S. City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED. Job Address: �( A-j k- dud . Permit Number: Legal Description RE# Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteera�tion ❑Repair []Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): mercial ❑Residential • If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No • Will trees be removed in association with proposedproject? ❑Yes must submit separate Tree Removal Permit L1Nio Describe in detail the type of work to be performed: Florida Product Approval# for multiple products use product approval form Property Owner Information /� Name C. t'1 "" �id�ess ah I t l/�,�"dr) C L_V P City 81 L, T �— atte Zip S' Z_ Phone ITO� E-Mail rte' l /18 AA i eL',_ALA_�lIic ��•�"t Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Qualifying Agent Address City State Zip Office Phone Job Site Contact Number State Certification/Registration# E-Mail 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 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO N ICE OF COM EN ENT. (Signature of Owner or Agent) (Signature of Contractor) Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this day of by by (Signature of Notary) (Signature of Notary) [ ]Personally Known OR [ ]Personally Known OR [ ]Produced Identification [ ]Produced Identification Type of Identification: Type of Identification: Page 1 of 1 IMPORTANT DOCUMENT ECONCEN"thirate of}tame Resistance Issued by ktiT��CVtJd'fN� INPLAST CORPORATION Registration Number F-01101 MANUFACTURERS OF THE FINISHED PRODUCTS DESCRIBED HEREIN This is to certify that the materials described are inherently flame retardant and we supplied to: PRI Production 1819 Kings Ave. Jacksonville,FL 32207 �j15TEQ ',f plRE►40� RE"fPt; Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with the California Fire Marshall Code. Ail fabric has been tested and passes NFPA 701-04. Invoice Date:10/04/16 Number:96575 Description of item certified: 40'X60' TRADITIONAL COVER ONLY WHITE Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric INPLAST CORPORATION NAME OF APPLICATOR FLAME RESISTANT FINISH SIGNED. ECONOMY TENT INTERNATIONAL about:blank 3/11/2019 4t� � ..... '�, - d- IL r Pk ALI fro 46�1 ;r. r :• ass ?'4 Olt '' 4r aw �,�+�!�- +!'' if ''� is � .`Y ` t'�'a1�- A" �},� � � �,,,�, 1" �`� � �2- t.' ',Z4 •- � �.er?xr'r �` — ;, im Tr fp. ilp ►• � a �_ �" Tom' ^ tL ti- y t .AIII CA . 10i I - 0 1353 1307 #` 1223 111 , / � Yr✓a/� IBI—I—I—I—I_I—I—I—I—I—I—I—I WlacHb"L "' CITY OF JACKSONVILLE, FLORIDA Permit Number BUILDING INSPECTION DIVISION BUILDING PERMIT APPLICATION Application MUM be yvard or printed legi In Ink.Cmdm WI reasons Below REAL ESTATE NUMBER DATE ISSUED JJ OFFICIAL STREET NUMBER STREET NAME USE TYPE_DIRECTION_UNITISUITE ZONING ZONING APPROVAL ONLY ZONING NOTES FINAL APPROVAL TOTAL PERMIT FEE$ NOTICE OF COMMENCEMENT REQUIRED? YES 0 NO❑ FIRE PLAN REVIEW FEE$ PROJECT IDENTIFICATION PROPERTY OWNERSHIP DETAILS PROJECT NAME TYPE: INDIVIDUAL❑ GOVERNMENT AGENCY[I BUSINESS[] PROJECT CONTACT FULL LEGAL NAME,AGENCY,OR BUSINESS PROJECT CONTACT PHONE PERMITASSOCIATIONS? NO C YES[] If ties nM permit dam: MAILING ADDR{F�(S�./S'j G YIL st..Iy.O [I BASE PERMIT IBLIJ—LTJ--LI—LI.JJ 0 SITEITREE PERMIT I I I I I 1 1-1 1 —L_—L---I OWNER CONTACT PHONE(7�)_-Z—C — `T J i TEMPORARY TAG NUMBER OWNER E-MAIL ADDRESS C' `G^Q Midi C9 W BUILIDI G'/ G k PERMIT ADDRESS trNeewl+rrdr.I.mr.dw.ewwxMMrlmJ STREET NUMBER STREET NAME f ( n1 c r—✓.O TYPE w� � Wl DIRECTION UNIT/SUITE - ZIP CODE 322331NTERSECTING STREETS AND LOT NO. BLOCK SUBDIVISION CITY DEVELOPMENT NUMBER COMPANY NAME LICENSED CONTRACTOR FLORIDA DESIGN PROFESSIONAL COMPANY NAME NPAIE LICENSE WJAE VE�LADDRFSS CITY to NUMBER - LICENSE NUMBER P➢ORESS FA% PHONE FAX EMAILADDRESS EHOLDER eF OTH.A ...W . BONDING COMPANY MORTGAGE LENDER NAME- - pCDRE59 AppRE99 TYPE OF PLANS JOB COST PAYMENT METHOD BRIEF DESCRIPTION OF WORK ❑Rolletl ❑Smell Total cost s to include O Cash D Escrow Acct ❑Folded ❑Other MEP work. D Credit D Exempt `-!,'L( tI .2 C) Miler Plane' a CA I .l OIS Application is hereby made m obtain a permit W do Me work aM insWitati es indicated I certify Mat ro work or installation has commenced prior to Me issuance of a permk aM Mat all work will be performed to meat the standards of all laws regulating construction in thisjuriediction. I understand that a cepamte permit must be secured far ELECTRICAL WORK.PLUMBING,SIGNS,WELLS,POOL$FURNACES,BOILERS,HEATERS,TANKS,AND AIR CONDITIONERS, to OWNER'S AFFIDAVIT-1 pertly Mat all M¢foregoing information is errurele and fled all work will be tion in compliance with all applicable laws regulating construction and zonil will not occupy or use the referenced building or any part thereof until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official.as required by law. 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. WORKER'S COMPENSATION CONTRACTOR AFFIRMATION 0 EXEMPT Ioumleeroruyl O INSURER I atrest the Worker's Compensation information provided on this permit application is true and correct and that the applicant is in full compliance with El LEASE EMPLOYEES the State of Florida Worker's Compensation laws. EXPIRATION DATE OWNER or AGENT Signed. -Date:___J----j_ (a Aperrr,PoaarMAnomay or Agarrvry LNW Wqu4Ml Before me this day of Signed: Date:_/J— in the County of Duval,Stale of Florida,has personally appeared Before me this tlay of herein by himself/herself and in the County of Duval,Slate of Florida,has personally appeared affirrns all statements and declarations herein are true and accurate. herein by himselfRrereelf and Bell all stefemenm and declarations herein are true and accurate. Notary Public et Large,State of ,Courtly of Notary Public at La rg 9�oe --- __ _ -- -- gUlEtl90 pea!AeB