15-RAAR-2809 846 CAVALLA RD `s, CITY OF ATLANTIC BEACH
_ f 800 SEMINOLE ROAD
j ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2809
Job Type: RESIDENTIAL ALTERATION
Description: FLOOD REPAIR - FIRE WALL
Estimated Value:
Issue Date: 12/3/2015
Expiration Date: 5/31/2016
PROPERTY ADDRESS:
Address: 846 CAVALLA RD
RE Number: 171717-0330
PROPERTY OWNER:
Name: CALDERAN, LOURDES M
Address: 711 S 15TH AVE
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILD C �. L. 1AIS1 1 Citi
ING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845 Z_Z��
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Job Address: LI(P ,►VCL 1 . Qd Permit Number:
3V -tka 1-1 2 -aq ,o s
V4q-�.4� �- OF t' lot--'Legal Description gjf of Pk of ►3tta�P
Parcel#
Floor Area of" q N't. Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration �Repaiiove D molition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial >
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:_ /,e N,6 /l ,tf_ 4/t ,e s
Property Owner Information•
Name:L_4:S1-1,iCLtS 1A1�kx C Address: 0 V(A.
CityAbun;A , 11eacr State C- Zip_3AD_5Phone 9p!- . aa• ?, a a
E-Mail or Fax#(Optional) --
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: ifying Agent:
Address: ity State Zip
Office Phone Job Site/Contact N er Fax#
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commencedprior to the
issuance ofa 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 fwork is not commenced within six(6)months, or if construction work is suspended or&bandoned for a__period ofsix j6)months at any time after
work is commenced. I understand that separate permits must be secured or Electrical Work,Plumbing,Signs, Wells,Pools, irnaces,Boilers,Heaters,
Tanks and Air Conditioner.,etc
. r
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 hereb cert 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
type o1work will be complied with whether sppeci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the
Provisions of arty other fe al,state, or local lary regulating construction or the performance of construction.
� i Q9�6�
Signature of Owner Signature of Contractor
Print Name �(� if�/$t,�, Print Name
................................................................................__...................__......__-._._.
Before me Before me t
:his a Day of y�b
cylt✓ 20 15- this Day o: �&
/l. YPGp�Y Brynn A. Mccauley
J blic + :: _„ 3 Notary Public
J-
07,2017
1V1":W.�RON`NOTt+R'cot9
Revised 01.26.10