54 Oceanside Dr RES19-0098 Siding/Fascia RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0098
800 SEMINOLE ROAD
ISSUED: 6/10/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 12/7/2019
MUST CALL INSPECTION • • • 1 i i PM FOR • •
ALL WORK MUST CONFORMTO THE CURRENT • 1 OF • DA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE
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:
54 OCEANSIDE DR RESIDENTIAL ALTERATION SIDING AND FASCIA $2800.00
RESIDENTIAL
TYPE OFBUILDING USE
• :D •
• • GROUP:
168846 5150 OCEAN SIDE
COMPANY: ADDRESS:
MERRITT ROOFING &
GENERAL CONTRACTOR 1704 GIRVIN ROAD JACKSONVILLE Fl_ 32225
INC
• ADDRESS:
LEVIN SIMON 54 OCEANSIDE DR ATLANTIC BEACH FI_ 32233-5927
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 $65.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 6/10/2019 1 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 W
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: t
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: S4 00-0 an C t (A'e— Department review required Ye No
I ding
Applicant: / \/A e-F rl OCA arming &Zoning
1 e Tree Administrator
Project: 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 J
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. El Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Y•y-aQ/�
Reviewed by: Date:
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
Building Permit Application OFFICE COPY
Updated 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
Olt S, 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
[[..Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address:_ J^ / ��L.Q S (? � � Permit Number. &--�-_,i
Legal Description L� / ' 3 y 3 7'.;15 .3 o C ? RE#
Valuation of Work(Replacement Cost)$ ? Z�� Heated/Cooled SF Non-Heated/Cooled
• Class of Work: []New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo []Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial 'V2esidential
• 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 ❑No
`Describe in detail the type of work to be performed: cb
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pp a`- for multiple products use product appr3 \ Tfirn�
Property Owner Information1 J t rnC�n U1 p
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City f State = zip Phone s�C, > Z-1 J ) U ❑U O
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Owner or Agent(If Agent, Power o Attorney or Agency Letter Required) p 0 Q
Contractor Information _ —,
Name of Company Z ail t G ��f�i �.'r-�„�ivali ingAgent IJ«'�� 2'r'-rt( cc f-_ z
Address D ✓L City �0I State P zip G f
Office Phone c{[) -�f i , y Job Site Contact Number La x m
State Certification/Registration# 0 5 E-Mail j_ teI l G (G,� 7 (' Lu :3 In
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Architect Name&Phone# U ui
Engineer's Name& Phone# w
Workers Compensation Insurer ` C D S OR Exempt❑ Expiration Date ( Z
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 O ' N ATT"OR -FORE
RECORDI G YOUR NOT) F COMMENCEMENT. ; klal
(Signature of Owner or Agent)
(Signature of Contractor)
ir
Signe d s orn to(or affirmed!)before me this`'S"day of Signed nd sworn to(or affirmed)before me this Z5 day of
wl of by LCf-t.LrZr7 ACV. YG4- zo by
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No tar N +'; Commission # GG 040126
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[ ]Personally Known OR %;Foa F`oa`O, MY Comm, #GG 040126 Personally Known O Bonded through Napo a! ,
Produced Identification "... Bonded th ou Exprfes Oct 19, [f:]Produced Identificat on
9h National Notar 2020Type of Identification:
Type of Identification: ssc