2317 Barefoot Tr RES19-0172 Int Remodel RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0172
800 SEMINOLE ROAD ISSUED: 6/17/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 12/14/2019
MUST CALL INSPECTION • • • 1 PM FOR NEXT DAY • •
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, ' OF BEACH CODEOF 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:
2317 BAREFOOT TRACE RESIDENTIAL ALTERATION INTERIOR REMODEL $28000.00
RESIDENTIAL
TYPE OF
• • GROUP:
169463 0622 OCEANWALK UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
OSBORN BUILDERS LLC 2157 POINCIANA RD NEPTUNE BEACH FL 32266
• ADDRESS:
ABRASS STEVEN J 2317 BAREFOOT TRICE ATLANTIC BEACH FL 32233-6604
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 • It •
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 $195.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $97.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.39
STATE DCA SURCHARGE 455-0000-208-0600 1 0 $2.93
TOTAL: $299.82
Issued Date:6/17/2019 1 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
s� 800 Seminole Road 1\ �; ::� _ ' '-7 Z
Atlantic Beach, Florida 32233-5445 1\ /
Phone(904)247-5826 Fax(904)247-5845 /
fit �r E-mail: building-dept@coab.us Date routed: �/� I Q 1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
` r A
Property Address: j ( Q -e_�.' (/— Department review required Ye No
uildin
( &Zoning
Applicant: �� Y>a:�[`rl � � P /�S
Trace Administrator
Project: 1 T e 1 t C2(— ��O C�1 Cj_ I 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 r
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: Ipproved. ❑Denied. ❑Not applicable
(Circle one.) Comments: //
BUI DI �� V
PLANNING &ZONING 6- -1
Reviewed by: lin 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
ate:Revised 05/19/2017
Building PermitApplication
OFFICE COPS
Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (9n04) 2477.-.5826 Email: Building-DePt@coab.us Q IS REQUIRED.
Job Address; oZ317 171 rvvT7i Permit Number: '���1 { - �) `-
LegalDescription 2-/3 09.25-A-7E 37-Z5- 2.1 �r,4%*, sex w -Z. RE# /69�jG3�-0�22
O
Valuation of Work(Replacement Cost)$cQ9 -M.0'0 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 &Residential
• If an existing structure,is a fire sprinkler system Installed?: ❑Yes $No
• Will trees be removed in association with proposed roiect? ❑Yes must submit separate Tree Removal Permit o
Describe in detail the type of work to be performed: 4eoml
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Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name STFYE V_14*40'T76 ioWw595,5 Address 17E�D'e7 77 9CE .4 /c J3,04eH
City State R Zip 3Z-Z-39 Phone e100_567- 22-96
E-Mail�VZ��}e ►I.V}' <�8�/G G�q 6,
E-Mail nz*
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company 0 BU/L!?e126 41-Z Qualifying Agent L7�✓/.D Or.,$s10^�
Address 2157 P MCtA. City/V6'PTWVE 136WN State of-7— Zip 32266
Office Phone O'! �y9-473Z Job Site Contact Number4'l9-40 -/737
State Certification/Registration# C49C1ZSSSa E-Mail A�wD a�b5�r�$vtcnGpJS.GOi'-t
Architect Name&Phone#
Engineer's Name&Phone# ,gxl[w ii WG7141 aF,gG6J�
Workers Compensation Insurer [/ON VlL4,d(FCpMP'My!l OR Exempt Expiration Date s ZOZI
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
RECORDI YOUR NOT E OF COMMENCEMENT.
.5 1Z1 A'q
( ignatur of Owner r Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this17 day of ned and sworn to(or a r d)before rrIe this day of
/� Ol b zp b ti
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CHERYL JEAN BARBER MY iMISSION#FF 924951
:; Notary Public-State of Florida �=
Personal) Known OR _•. Commission#GG 128679
EXPIRES:October 6,2019
Y =">'r r o M Comm.Ex fres JUI26,2021 [ )Personally C�RBondod Thru Notery Public Underwriters
[ )Produced Identification "� W,: BondedcnroagnNalfonalNoraryAssn. [ 1 Produced-ld" i 07-1
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REVI CITY O ED oiRTLANTIC BEACH R CODE COMPLIANCE OFFICE
COPY
SEE PERMITS FOR ADDITIONAL
REQUIREMENTS AND CONDITIONS
REVIEWED BY:—62k—
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All dimensions size designations This is an original design gn and must Designed:5/10/2019
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job site and adjustment to fit job not be released as copied unless Printed 6/5/2019
conditions. �y applicable fee has been paid or job
g � order placed.
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