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5810 FLEET LANDING BLVD RES19-0091 WIND PERM RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH RES19-0091 ISSUED: 3/26/2019 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 EXPIRES: 9/22/2019 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: 5810 FLEET LANDING BLVD RESIDENTIAL ALTERATION REPLACE WINDOWS $890.00 RESIDENTIAL TYPE OF REALESTATE BUILDING USE ZONING: SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: COMPANY: ADDRESS: CITY: STATE: ZIP: NORTH RIVER BUILDING 6771 SHINDLER DR JACKSONVILLE FL 32222 SOLUTIONS OWNER: ADDRESS: RETIREMENT 1 FLEET LANDING BLVD JACKSONVILLE FL 32233 FOUNDATION INC 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 $SS.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $27.50, STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 Issued Date: 3/26/2019 1 of 2 RESIDENTIAL PERMIT PERMIT NUMBER RES19-0091 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 3/26/2019 ATLANTIC BEACH, FIL 32233 EXPIRES: 9/22/2019 TOTAL:$86.501 Issued Date:3/26/2019 2 of 2 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) I P 800 Seminole Road Atlantic Beach, Florida 32233-5445 IR E's I n 0 9 1 Phone(904)247-5826 - Fax(904)247-5845 zjt E-mail: building-dept@coab.us L_Date routed: City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: c�—e)10 �artment review required Yes �No d� ,�uiL Applicant: Rkve-r LiICLI lu —PTmming &Zoning Tree Administrator Project: Re �)Iac' _C_ 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 X,�"er cz" 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: EgApproved. DDenied. [—]Not applicable (Circle one.) Comments: PLANNING &ZONING Reviewed by.- Date: 151zlb?�I_ TREE ADMIN. Second Review: U ]Approved as revised. ElDenied. F]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. F]Denied. F]Not applicable Comments: Reviewed by.- Date: Revised 05/19/2017 Building Permit Application OFFICE COV Updoted 1019118 City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Email: B_1Jildir19-n_ e0t@coab.us IS REQUIRED. Job Address: Permit Number: P.�;� 0 'L�� 4, t.4clt. -- Legal Description 0 tts &-4L4f, 5%r- DA 1 k�J SC4�/151 2. SOKA f DAuq cs-L,,� OR A 2A RE# Valuation of Work(Replacement Cost) Aqt) Heated/Cooled SF Non-Heated/Cooled • Class of Work: DNew DAddition ElAlteration EIRepair OMove []Demo E]Pool VWindow/Door • Use of existi ng/p ro posed structure(s): []Commercial XResidential • If an existing structure, is a fire sprinkler system installed?: 11Yes XNo 41 Will tree(s) be removed in association with Proposed Proiect? E]Yes (must submit separate Tree Removal Permit) )ZNo Describe in detail the type of work to be performed: N. Florida Product Approval#_ FL RIS 12— Iri for multiple products use product apprbval form Property Owner Information Name--.,. NCC-RF- Address 0AR- nee City Ch r,6 V,It he State Zip 372-33 Phone 0 E-Mail_ 73 ope _� Owner or Agent(if Agent, Power of Att&?ney or Agency Letter Required) ,ne 0�_A Contractor Information C.) U U 0 NameofCompanyl AIZ�Jqrl < 90!4�45 =V. Qualifying Agent I-- �State��Zip 54 Address ?t> X city 54 St t qo^ zip Office Phone qq Job Site Contact Numb r L_ State Certification/Registration# C&r iSl gi I B E-Mail T\55 Co tA Architect Name& Phone# V_ Engineer's Name&Phone# %a L)J LU Workers Compensation Insurer kd\tp- C1.1 IrLv,� OR Exempt Li Expiration Date I- L2j :3 % 61-0 W Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work'or installation 21SE 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, UJ WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS, etc. NOTICE: In addition to the requirements of this cc 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 YPU, r( E OF COMMENCEMENT. (Signature 6f Owner or Agent) U (Signature of Contractor) Signed and sworn to(or affirmed) before me this day of Signed and sworn to(or affirmed) before me this W dayof by (Signa'ture f Notary) (Signatu re of Notary) P Notarl Public State:)f Flond�a pa%,� i otari Public:StN.t.of Fl.,,dl- Shari R Townsen, % Personally Known OR, Personally Known OR P I<1, .1 %A Shari R Townsend ti4 s,% w My Commission GG 147833 Produced Identifica Produced Identification "A,2v my Commission GG 147833 ,diF E.-p,res 11 10A12021 Type of Identification: :1�, 0" VJ Expires 11/04/2021 Type of Identification: