15-RAAR-2773 684 AQUATIC DR �-
�t, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
!� X 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-2773
Job Type: RESIDENTIAL ALTERATION
Description: REPAIRS FOR FLOOD DAMAGE
Estimated Value:
Issue Date: 12/1/2015
Expiration Date: 5/29/2016
PROPERTY ADDRESS:
Address: 684 AQUATIC DR
RE Number: 171818-5228
PROPERTY OWNER:
Name: HUFFMAN. ADAM S
Address: 684 AQUATIC DR
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
C L L 11Vs � cry
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH "
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address:_(p$�� A&L iPermit Number:
Legal Description Area of Parcel#
Valuation of Work$ Proposed os d Work heated/cooled t
p non-heated/cooled
Class of Work(circle one): New Addition AlterationRepair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial Residenti
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes N/A
Florida Product Approval#
For multiple products use product approva orm
Describe in detail the type of work to be performed: ,_e 4� 117;e S
Property Owner Information• //yy
Name: Nc'm Sc .i 4J�.(.yV1(,n Address:_ �p /q ✓t ajeA I L lbU
City ) ►�'11{_tr Kslectch State f l_Zip 3 2_ Z33 Phone—e/0 til (off – (�7
E-Mail or Fax#(Optional)_ �,v V o iL iO PU n, j
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 commenced prior to the
issuance o,f 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 after
work is commenced. I understand that separate permits must be secured or Electrical Work,Plumbing,Signs, Wells,Pools, irnaces,Boilers,Heaters,
Tanks andAir Conditioner.,etc f
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 YOVIT NOTICE OF
COMMENCEMENT.
I hereb cert that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type ofYwork will be complied wit whether sppeci led h ein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of arty other feder ,st t, or local Iew r hg construction or the performance of construction.
Signature of Owner ,` Signature of Contractor
Print Name
.SG............ ............... Print Name
............................................_..................._............__........................_........
__._....
Befor Before me �`''� `,.�.•�
his 1 o f L 20 1 this Day
Jotaiy FLiblic
( a ( ^ (f Revised 01.26.10