762 Aquatic Dr 15-RAAR-2712 J �
CITY OF ATLANTIC BEACH
uF 800 SEMINOLE ROAD
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-2
Job Type: RESIDENTIAL ALTERATION
Description: FLOOD REPAIR - FIRE WALL
Estimated Value:
Issue Date: 11/19/2015
Expiration Date: 5/17/2016
PROPERTY ADDRESS:
Address: 762 AQUATIC DR
RE Number: 171818-5254
PROPERTY OWNER:
Name: CHIN, XINGPING
Address: 762 AQUATIC DR 9t-7 Cv — U
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
1031PEcT � t zo l5
OA vie o k
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
B C Z_ L /,Vs aCrib
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH '
800 Seminole Road, Atlantic Beach, FL 32233 r �r 'J"S9
Office (904) 247-5826 Fax (904)247-5845
Job Address: ;H4 m. Dl/ bc/Ifw ISo rR ).233 Permit Number:
Legal Description Parcel#
oor ea o q. t. t
Valuation of Work$ Proposed Work heated/cooled non- heated/cooled
Class of Work(circle one): Ne Addition Alteration Repair Mov emolition pool/spa window/door
Use of existing/proposed structures)(circle one): Commercial en
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes N N/A
Florida Product Approval#
For multiple products use product approvaorm
Describe in detail the type of work to be performed:_ /_'/,e 6 06 /l �41 S
Property Owner Information•
Name: Address: d T Q
City G State ip (l� phone q j
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 commenced prior 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 if work is not commenced within six(6)months, or if construction or work is suspended or tibandoned 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, ells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Condifioner%etc t
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 YOUi NOTICE OF
COMMENCEMENT.
I hereb cert6 that I have read and examined this application and know the same to be true and correct. rill provisions of laws and ordinances governing this
type o,Pwork 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
provisions of arty other federal,state, or local lmv regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Print Name
Before me Before me
:his Day of 20 this Day
gotary Public Notaiy Public
Revised 01.26.10