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494 Beach Ave FNCE19-0066 Canceled via Phone since Denied City of Atlantic Beach APPLICATION NUMBER �}¢ Building Department (To be assigned by the Building Department.) 800 Seminole Road Vf Q O��/ Atlantic Beach, Florida 32233-5445 1 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date muted: City web-site: http://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: `'r - 1 ! V�, Dg9miment review required Yes No u Applicant. �i 6{' (� Q� ( US �C) S Tree Ad inistrator Project: F-e ac,-e_ Public Works Public Utilities Public Sa e y _ Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date r of Permit Verified B Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers t� Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. enied. ❑Not applicable (Circle one.) Comments:/ f &`+ BUILDING Sc► i+ erg( PLANNING &ZONING y: 60 &-1,4-[q"*DReviewed ba TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road NCS �q 0 QC Atlantic Beach, Florida 32233-5445 l� (O Phone(904)247-5826 • Fax(904)247-5845 •i —runt 9' E-mail: building-dept@coab.us Date routed: co City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 4c `4 (�)e-" � � De ent review required Yes No r J Applicant: �i b (� e� U-S Tree Administrator Project: F-e - . _ Public Works Public Utilities PublicSae y Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. []Denied. Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed bC- Date: y Lv TREE ADMIN. Second Review: ❑Approved as.revised. ❑Denied. —]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [—]Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 .5QJ'Jr- City of Atlantic Beach � 0-111, APPLICATION NUMBER Building Department assigned by the Building Department.) 800 Seminole Road 2 �'IQCU �� 0 (0/ Atlantic Beach, Florida 32233-5445 JUN 12 2019 �O Phone(904)247-5826 Fax(904)247-5845 + x�ji3 E-mail: building-dept@coab.us if. a routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: �i4 �� De ent review required Yes No �� (\ U's U� Applicant: �� - Tree Administrator Project: F-e ( c,-e Public Works Public Utilities Public Sae y Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: //Approved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING / PLANNING &ZONING Reviewed bycJ Date: TREE ADMIN. Second Review: []Approved as revised. ❑Denied. []Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) s 800 Seminole Road 1�1C �q ooh Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 + 7 E-mail: building-dept@coab.us Date routed: C� City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 4(:A De ent review required Ye No Applicant: r S 0—.C-*), �C;{ — nir,g ing (� 2l U Tree Ad inistrator Project: C_ � Public Works,) Public Utilities Public S Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date , of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: [Approved. []Denied. ❑Not applicable (Circle one.) Comments: BUILDIN PLANNING &ZONING / Reviewed by: Date: 6'�3 TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 Building Permit Application Updated 10/9/18 J` City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, VL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5326 Email- IS REQUIRED. Job Address: �4`14 9 LOCO l)V i5 Permit Number: r__11\i CC �� - 00.(Ok ' Legal Description �) -- 1=T ).o-r ey, I 5 Valuation of Work(Replacement Cost)$ '��j fV a� Heated/Cooled SF - Non-Heated/Cooled--- • Class of Work: RNev; ❑Addition ❑Alteration Pffepair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proriosed structure(s): ❑Commercial ,-Residential • If an existing stru,L-ture,is a fire sprinkler system installed?:- BYes Qt's-- • Will trees be reg iyoved in association with ro osed ro'e t?❑Yes must submit se crate Tree Removal Permit ❑No Eibndetail th type of work to be performed: �'ii`Z ►-�C �C15+1 KC (9` �(C�1 �( /�CK� Z17- Florida Product Approval# for multiple products use product approval form Property Owner Information l Name �(;Pj� -5 imyP '00 Address MA ff)U-AC0 A�j F_ City !i-1afJi1L. 'i3C-o StaterL Zip 372-3S Phonegbq,,- ?42.'-"s73l��> E-Mail LQC�n P0S'-k5 (C A6 L'C QM Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Contractor Information NameofCompany Qualifying Agent Address 2I A P rc,4' i City NDN (StateL_ Zip '?z(a� Office Phone 2A • !q`IC6 Job Site Contact Number State Certification/Registration# CE-Mail ft 6--6 ' O—CJZK L 0-5r j)6J J;7 U(T)(}LZ(/ ( Architect Name&Phone# Engineers Name&Phone# Workers Compensation Insurer OR Exempt Expiration Date (0 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 the laws regulating construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS, WELLS, POOLS,FURNACES, BOILERS,HEATERS,TANKS, and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the pu:.!ic records of this county,and there may be additional permits required from other governmental entities such as water managemen`districts,state agencies,or federal agencies. OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in comp(iaace wit;,:all applicable laws regulating construction and zoning. 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 RECO ING Y OTICE FCOMMENCEMENT. (Signature of Owner or Agent) (Signature of Con actor) gned and s rn to r affi m b for me his f Signed and sw� ffi a before me this day of ? : &,b C1,_t, �vr i 'a o a ip at re Not It TONT GINplESPE ,ER Puft�d Fbrlda M'(0owISSION N 1 Com 00 20M Personally Known OR {`�• '''- {_ f EXPIRES:October 6,2019 [ ]�r.dou'cecl ally Known OR My COl�lq MSM SipL 17.20!2 [ ]Produced Identificatio :��: No,&d Thru 4btary Public Underwrt=R [ Identification Type of Identification: �— "'" Type of Identification: MAP SHOWING SURVEY OF The North 25.00 feet of Lot 5, except the West 115.00 feet, together with Lot 6, except the West 115.00 feet, Block 22, as shown on the Plat of Atlantic Beach, as recorded in Plat Book 5, Page 64 of the Current Public Records of Duval County, Florida. For: Stanley B & Elizabeth A. Goeekel fh 3 T,4 EE T } �0 2. ti ' 6 N i o dl O.l � I AG• 6o' i x, 1 O U O � �o .J J Ne Z 7 J i ° /o.�• Q Vi O � CARFi7RT ,` OyFi6 7.T /UNOERJ E� LU ry�7 I b a Q 3l.9¢' Q L O 7 ¢ I A10 CbR t/ERS S E T LEGEND RAY, DURDEN. SNYDER & ASSOCIATES ORDERED B'f HILLEREST as•SIMN•.n+sn a+n.n tiwM spm,i; PROPERTY ADDRESS: 130 5TH STREET JACKSONVILLE,FiOMDA 32233 SURVEY tAWK-R:Ft 1611 0166 FIELD WORK DATE: REVISION DATE(Sk;+eeva r x,Jp+a tB1tor6o 80UNNRY SMEY DUVAL COUNTY h-- tYr � 3 l i f Ij/jfjj S�-.I. ■ I r h-f --- -------- t P•.♦ � t r t �• t t uT ------------ -------------------- - --- -.--------� �j — 1 1It LOT f I i• � I '------------------------------------------------ '— + _ i' i .,'•Bav�•AGtf�. 4�LlIFIC4 .. ko 393"2 Al Ct 30 3 3C '► • r 017td!tH'ER�0!'StytDt�JMvrvrY'05 eft--" e u N.- ,.4_,. Ty J n jw ptlk•!YI n0wsEA�tr&k7M+E�4,3B:r✓8d/'.UdCCW3le'l°P'E-enf314'' ---._. •"+ �,c.FarjSowpac"sdVMpfMeFioVjSaj-JVPVM50'19 GRAPHIC SCALE (In Feet} S*,p�,!�J:�►��Y.;�4,S.-''Y fV FvVJ Aa7WllSlWVr C'cde I inch = 30 i t ,:w V'1::5;✓•'•Tr+u-PWj}OSKt pth•r Inn NM,'Q i.W11WM Wr�M MM�CM+oR w�p[7a AW i/1M-5 QOM�Y50 M►t5e0#li�tYt0111f 5✓•fY01 !wLMr+yt nnton Mai be(onstftod to COW NO a(1■•R!!K5 to Awww 000 Vw Mss■tertAw FLOOC)INFOR#AATION PAINTS OF INTI:REST rPEWOOMING A S gJit H NTH THE LOCAL GOVERNING NON AURLS UL,AOC*Ajry op WWW FEMA COV,THE PROPERTY APPEARS TO BE tOr_ATIO IN ZONE X TNES PROPERTY WAS FOUND IN THE CJTY OF ATLAN')G OfA£H.COI,dMWr(NUM"R 12MM DATED(1bt0VI3 SMITH FENCE COMPANY, Inc. 1329 Marcheck Street Jacksonville, FL 32211 Smith.fenceco @yahoo.com (944) 743-7175 Serving Jacksonville for over 40 years Customer 0 i Q Date Address Phone _ -5_7 Length C Height W/Gates -- DD/Gates T-Posts ' I L-Posts T-Rail _ I K-Up 1 Barb-Up l �q viol Special Instructions Total Price Method of Payment Customer's Signature We do want and appreciate your business!