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331 7th Street (Summer Kitchen) 2014BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH F l L E COPY 800 Seminole Road, Atlantic Beach, FL 3223 - �w-:,�. .�..�,•..;....-�..° Office (904) 247-5826 Fax (904) 247-584( Job Address: 33/ `?-r" Sr , R7Z4ArW 8,CAe H 3 2z3 -1 Permit N t�r r z r� rr P`4r t-� Legal Description-rr4r, _ 4 c w t U Y �i A YVLl 6'kL%1" vlva.A.i •. --I-- Valuation of Work S I *& k Proposed Work heatedlcooled non-heated/cooled Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/pro u sed structure(s) ((circle one):Commercial esidenti If an existing structure, is a fire sprinkler system installed? (Circle one): es N /A Florida Product Approval # /jdia r ,6 9�Id v "dy-' For multiple products use product approve form {, Describe in detail the type of work to be performed: Ae-k-YRAb inD�w, T Ivo irz o-ar wets bf -'hj 1,,6&1 Name: -�Ybdtu C>S aa( --r Address: 331 7r" S'7r' A City ._ ATt W✓,'Wt r3'6+4 t'! Stated Zip _3 a3_Phone E -Mail or Fax # (Optional) Contractor Information: Company Name: Hr�+" 13vLLbLyZ5 Tice - Qualifying Agent: 6-iAle4CS HOa44 Address: ti215- sr��#n+s ac_st-� �+� City encs �icc' State FL, Zip 3 ��1 (6, Office Phone (2y" 2y7� y Job Site/ Contact Number snv V 3 ax # - State Certification/Registration # C <11 C -c) ::� Architect Name & Phone # rJ FLt�+ ttQca r�r�c� ZA: VEIL" � 94Y y Engineer's Name & Phone Fee Simple Title Holder Name and Address Bonding Company Name and Address w Mortgage lender Name and Address C" (,a Application is hereby made to obtain a permit to do the work and instaffations as i'ndicateaR t certify that no work or installation has commenced prior to the issuance of a permi! and that elf work wily be performed to meet the standards of all Laws regulutfng construction in this jurisdiction. This permit becomes Huff and Void tf work is not commenced within six (b} months, or if construrtian or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. f understand that separate permits must be secured far Electrical Work, Plumbing, Slgns, We!!s, Pools, Fkrnaces,nllers, Healers, Tanks crud Air Conrfitloners, eta 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. I here b certify that ! have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the pravtsrons of any other federal, state, or local law regulatr' g construction or the performance of construction. 44c,� Signature of Owner Signature of Contractor Print Name Print Name ©,H N.........t7S�a�4GT.............................-.............. [ter ..�.............._ ....... ........... ....�........ Sworn to and subscribed before me thisz3 Day of 7 ^' , 20 l5/ Notary Public PATRKK RICH * ICY Comm iSSION # FF 054475 EXPIRES September '15,2017 Sworn to and subscribed before me this m3 Day of ---SmA i— F 20 /y Notary ' PATFOCKRICH Revised 01.26.10 My COMMISSION # FF 054075 EXPIRES-. September 15,2917