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1026 BIG PINE KEY RES19-0082 WATER DAM REPAIR ''`% RESIDENTIAL PERMIT PERMIT NUMBER r CITY OF ATLANTIC BEACH RES19-0082 800 SEMINOLE ROAD ISSUED: 3/26/2019 EXPIRES: 9/22/2019 ATLANTIC BEACH. FL 32233 MUST CALL INSPECTION . • • . , BY . PM FOR . INSPECTION. CODE,ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING OF ATLANTIC BEACHi1 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: 1026 BIG PINE KEY RESIDENTIAL ALTERATION repair water damage $40000.00 RESIDENTIAL TYPE OF • • GROUP: 172027 5060 SELVA LAKES COMPANY: ADDRESS: STOCKTON 2223 ASTOR ST STE POR4 ORANGE PARK FL 32073 CONSTRUCTION • ADDRESS: MAHARREY TIMOTHY 1026 Big Pine Key Atlantic Beach FL 32233 JAMES 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. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $255.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $127.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $5.74 STATE DCA SURCHARGE 455-0000-208-0600 0 $3.83 Issued Date: 3/26/2019 1 of 2 r RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH RES19-0082 800 SEMINOLE ROAD ISSUED: 3/26/2019 EXPIRES: 9/22/2019 ATLANTIC BEACH. FL 32233 TOTAL: $392A7 Issued Date:3/26/2019 2 of 2 % City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us L Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: bc� bi(/1 �1 ;�_ L/ Dpja24ment review required Ye No n Builc1 Applicant: �fiDL�'�n C��S� �uL�'n anning &Zoning Tree Administrator Project: t CL", At4 Cla (n( 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: QApproved. ❑Denied. ❑Not applicable (Circle one.) Comments: P06, BUILDING PLANNING &ZONINGa Reviewed by: Date: V1 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 JSrS'"L''� �5 Building Permit Application OFFICE COPY 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 Email: Building-Dept@coab.us IS REQUIRED. Job Address: 1026 Big Pine Key, Atlantic Beach, Florida 32233 Permit Number: o_srl` c'OOG c) Legal Description 41-55 17-25-29E Selva Lakes Lot 29 RE# 172027.0000 Valuation of Work(Replacement Cost)$40,000 Heated/Cooled SF 1437 Non-Heated/Cooled 417 • Class of Work: ❑New ❑Addition ❑Alteration XRepair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial MResidential • If an existing structure,is a fire sprinkler system installed?: ❑Yes KNo • Will trees be removed in association with Proposed ro'ect? ❑Yes must submit separate Tree Removal Permit KNo Describe in detail the type of work to be performed: Repair water damage from a broken pipe and roof leak. NON-STRUCTURAL O U1 Florida Product Approval# for multiple products use productKpproval fwmt-I _ J _ Property Owner Information a V go Name Timothy Maharrey Address 1026 Big Pine Key City Atlantic Beach State FL Zip 32233 Phone 615-945-6212 or 615-93 t E-Mail timandtammymaharrey@gmail.com V G Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) �' < Contractor Information La Z;32 —<Name of Company Stockton Construction Qualifying Agent Heather Stockton Address 2223 Astor Street,Portofino#4 City Orange Park State FI Zip _ Office Phone 904-772-5262 Job Site Contact Number 904-772-5262 Ll. ir � State Certification/Registration# CBC 057006 E-Mail crysalis97@aol.com IO _nm Architect Name&Phone# LUW p Engineer's Name&Phone# (� H Workers Compensation Insurer OR Exempt V Expiration Date 12/03/20E 5 Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or irtmallation has w commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating CC 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 YOUR NOTICE OF COMMENCEMENT. 01 _ 4- 117 n rei� r (Signature of Contractor) Signed and sworn or affirmed)bef e thi.Qtk day of ned and sworn to(or aff m d_ )before me this day of 4d by Vq c C�1 • , b L cl� "(1 ELLEN R.THIGPEN ignature of tary) �y y, ignatu a � ,- MY COMMISSION if GG 144796 MY >: TONI GlPvDLESPER a a COMMISSION#FF 924951 -.;;,fE �o` EXPIRES:October 23,2021 ��= EXPIRES:October 6,2019 OFFS,YD (�,wF1wINi1D ^'' Pers 'MWICfI'6W`6RUndery0- Wroduced Identification 1 � Lu 17 ro Ze ti Type of Identification: ` 'v � Type of Identification: l Cash Register Receipt Receipt NumberCity of DESCRIPTION • QTY PAID PermitTRAK $392.07 RES19-0082 Address: 1026 BIG PINE KEY APN: 172027 5060 $392.07 BUILDING $255.00 BUILDING PERMIT 455-0000-322-1000 0 $255.00 BUILDING PLAN REVIEW $127.50 BUILDING PLAN CHECK 455-0000-322-1001 0 $127.50 STATE SURCHARGES $9.57 STATE DBPR SURCHARGE 455-0000-208-0700 0 $5.74 STATE DCA SURCHARGE 455-0000-208-0600 0 $3.83 i�- TOTAL FEES PAID BY , $392.07 CITY OF ATLANTIC BEACH 800 SE%NJLL P,, ATLANTIC BEAC,FL 32233 03 26,2019 08:40:53 CREDIT CARD VISA SALE Card XXXXXXXXXXXX6757 Chip Card: CAPITAL ONE VISA AID: AOOOO000031010 ATC: OOD2 ARQC: 305E66E44956C3B7 SEQ#: I Batch#: 1009 INVOICE 1 Approval Code: 01607G Entry Method: Cho Read Mode: Issuer Tax Amount: $0.00 SALE AMOUNT $392.07 CUSTOMER COPY Date Paid:Tuesday, March 26, 20' Paid By: STOCKTON CONSTRUCTION Cashier: CT Pay Method: CREDIT CARD 01607G Printed:Tuesday, March 26,2019 8:41 AM 1 of 1 mNcr S yCash s) Register City�r of 1 41 DESCRIPTION • CITY PAID PermitTRAK $110.00 RES19-0082 Address: 1026 BIG PINE KEY APN: 172027 5060 $110.00 BUILDING INSULATION WALLS 05/30/2019 RBE $110.00 BUILDING INSULATION CEILING 05/30/2019 45500003221002 0 $55.00 RBE BUILDING INSULATION WALLS 05/30/2019 45500003221002 0 $55.00 RBE TOTALR10240 $110.00 Date Paid: Friday, September 13, 2019 Paid By: STOCKTON CONSTRUCTION Cashier: CT Pay Method: CREDIT CARD 08654g od Printed: Friday,September 13,2019 11:46 AM 1 of 1