15-RAAR-2836 666 AQUATIC DR S!r>>`l
CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
j ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2836
Job Type: RESIDENTIAL ALTERATION
Description: FLOOD REPAIR - FIRE WALL
Estimated Value:
Issue Date: 12/8/2015
Expiration Date: 6/5/2016
PROPERTY ADDRESS:
Address: 666 AQUATIC DR
RE Number: 171818-5222
PROPERTY OWNER:
Name: GONZALES, CARLOS
Address: 3304 A ST
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: y n �:4 i—ct e C Permit Number:
Legal Description Parcel#
Valuation of Work$ F oor Area o q. t. t
Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Additionterati Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed: ( s
0. N
Property Owner Information•
Name: _� oc S2 a-r-0,I e_ Address:
City State_Zip Phone
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS: p) h O nC.
Company Name:
Address: Qualifying Agent:Office Phone Job Site/Contact Number City State Zip
State Certification/Registration# Fax#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Addr
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 laws regulating construction in this jurisdiction. This permit becomes null
and void f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a_period of six_(6)months at any time ajter
work is commenced. I understand that separate permits must be secured for Electrics!Work,Plumbing,Signs, Wells,Pools, Furnaces,Boilers,Healers,
Tanks and Air Conditioners,etc.
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 YO'UR NOTICE OF
COMMENCEMENT.
I herebcertify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
ape of work will be complied with whether specs:ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
7rovisions of any other federal,state, or local law regulating construction or the performance of construction.
signature of Owner Signature of Contractor
'rint Name Print Name
...............................................................
. ..........................
le ore me Before me
,is Day of 20 this Day of
20
lotary Public Notary Public
I
Revised 01.26.10