195 Beach Ave #5 RES19-0129 Remodel Bathrooms N RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0129
800 SEMINOLE ROAD ISSUED: 5/1/2019
EXPIRES: 10/28/2019
ATLANTIC BEACH. FL 32233
MUST CALL
Y 4 PM FOR NEXT DAY INSPECTION,
ALL • . INSPECTION• • . • • • • r OF • • L • BUILDING
CODE, AND CITY OF • • 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
It 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:
RESIDENTIAL ALTERATION remodel bathrooms $2280.00
195 BEACH AVE 5 RESIDENTIAL
TYPE OF ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP: —
SHORECREST
1703141010 CONDOMINIUM
COMPANY: ADDRESS:
PIJ Builders LLC 10736 Majuro Dr Jacksonville FL 32246
• ADDRESS:
HOFFMAN LARA M 1644 SEA OATS 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 CONDITIONS
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-WOO S22-1000 O $6500
BUILDING PIAN CHECK 455-0000-322-1001 0 $32.50
STATE DEER SURCHARGE 455-0000208-0700 0 $300
STATE DCA SURCHARGE 455-0000-208-06M O $2W
TOTAL:$101.50
Issued Date:5/1/2019 1 of 2
6t City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
G800 Seminole Road
Mantic Beach, S
Florida 32233-5445 /
\J // Phone(904)247-5826 Fax(904)247-5845 a I
E-mail: building-dept@mab.us Date routed:
City web site http:ltw coati us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1aS ff.(1(, A\)_L merit review requi YesT No
-7Building
P'Z V QIA� dy.�S (SLC -PTEn—ning&Zoning
Applicant: C Tree Administrator
Project: '( L,In OA LA b AAA i 0(nJ Public Works
Public Utilities
Public Safety
Fire Services
Ij,@view fee $
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified
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 9r
Reviewing Department First Review: pproved. ❑Denied. [-]Not applicable
(Circle one.) Comments:
BUILDI
PLANNING &ZONING Reviewed by: Date: s
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:
Revlaed 06/19/2017
Building Permit Application OFFICE COPY Updated 10/9/18
City Of Atlantic Beach Building Department 'ALL INFORMATION
HIGHLIGHTED IN GRAY
' 800 Seminole Road, Atlantic Beach, FL 32233 IS REQUIRED.
n,r
Phone: (904) 247-5826 Email: Building-Dept@cclab.us 'i
Legal
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Job Address: Permit Number:
Legal Description it,225ELHoRF/:Ra55TCONDOMa3nIM3DwEU.M()DMT5C 55116-3133 RE#
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Valuation of Work(Replacement Cost)$ ` V Heated/Cooled SF I /
• Classof Work: ONew OAddition XAReration ❑Repair OMove DDemo ❑Pool OWindow/Door
• Use of existing/proposedstructure(s): DCommerclal :Residential APR 26 2019
• If an existing structure,is a fire sprinkler system installed?: Oyes "MNo
• Will tre s be remove in a oci ionwithj2ro ed ro'e s u b 't re Tr e R ov Pe mit ON
!' ing epa men
Describe In detail the type of work to be performed: )1 each, F
'Zi! del -)0VUML5/ Flour NIM (f ht *I s EGy e �B,HbI� � x1 r'e
Florida Product Approval# for multiple products use product p=vol Z 1
Q O I
Property Owner Information 0. C) z —
Name Address JWOA'r5DRA3L5nTtCBEALHFL3=13 O ~
Statera Zip •tz33 Phone 9p 53110 n m �• z G
City U Uo
E-Mail W
Owner or Agent(If Agent,Power D Attorney or Agency Letter Required) O O G
Contractor Information
Name of Company PDBtm msec Qualifying Agent Jonaiae'a vSt sv BUBnERs
Address 10t3b CitY,_-J —,. s em State ZiP
-• _ Job Site Contact Number 0 _ m
Office Phone
State Certification/Registration# CGC 1-556 E-Mail veph311@wilco
F w � o
Architect Name&Phone# W V in 111—
Engineers Name&Phone# W
Bwsms o#aArvwnoN, OR Exempt❑ Expiration Dale
Workers Compensation Insurer ..9911Pw
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that nowork or irntallation 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 entitles 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 NANCING, CONSULT WITH YOUR LENDER A TTORNEY BEFORE
RECO I YOUR IC F MMENCEMENT.
R
(Signature of can o e ��II (Signature of Contractor)
ned and sworn to(or.affirmed)bef r me this{�yQ day of SI ned nd sworn to(or affumed)before rm�his day of
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