1057 Beach Ave 2005 Misc Items JN
RECEIVED
CITY OF ATI.AWIC SEACM
81,11L'DW7 k �nNiNC
CITY OF ATLANTIC BEACH
BUILDING PERMIT APPLICATION W09 N
(ALTERATIONS/ADDITIONS)
Date:
3Y4
Job Address: lOS-? 3�c--q z4y
Owner of Property: POUlAneD k 1/
Address: /os 7 6Y.iliH I/, Telephone:
Legal Description: Block Number: Lot Number: Zoning District:
Contractor: 1'A54A14FZ C i DaYriye/`9Bwr State License Number:
Contractor's Address: 7f2 Sf� StAy, LG
.3 22-2_S
Telephone: fog- 6/y— 1 f 9`Jl Fax: 9oy- ,2 2.3- 30 7 S
Describe proposed use and work to be done: H aJ%fiO✓ To �A'�ST/.✓y S/t1 rr�d
15; '!/LY A/O.tiE
Present use of land or building(s): 3,"46-6b �Arr• /
Valuation of proposed construction: X,3.50 000
What are the dimensions of the added svace: feet x feet 2.
Will the added area be heated and cooled? YG'S POatioo New electrical or increase in service? X25F15
New plumbing fixtures? y-� New fireplace?_�6S New heating/air conditioning? y�S
Is approval of Homeowner's Association or other private entity required? VO If yes,please submit with this application.
Willthis project involve changes in elevation,site grade or any use of fill material or the removal of any trees?
NO. Applicant certifies that no change in site grade or fill material will be used on this project.
❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building
Permit.
❑ NO. Applicant certifies that no trees will be removed for this project.
❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree
Removal Permits to be reviewed b the Tree Conservation Board,which meets two times each month.
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Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate.
Incomplete applications may result in delay in issuance of permit.
STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please
contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have
Property Appraiser's Real Estate Number available.
STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction
topographical survey or grading plan is required. (If not required, written verification must be provided with this application.)
The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834
STEP 3. Submit Tree Removal Application if trees are to be removed or relocated.
STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if
owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic
Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826
800 Seminole Road •Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 • Fax: (904)247-5845 • http://www.ei.atlantic-beach.fl.us
Page 1 Revised 1/14/03
In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being
performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner.
1. Current survey showing the property boundary with bearings and distances and the legal description.
2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify
any existing structures and uses.
3. If required by the Department of Public Works,a pre-construction topographical survey.
4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies.
5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools
may be excluded from total Impervious Surface.
6. Other information as may be appropriate for individual applications.
I hereby certify that all information provided with this plica' s correct.
Signature of owner: C� Date:
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and
ordinances governing this type of work 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 any federal,state or local rules,regulations,ordinances,or laws in any manner,including the
governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the
above information being true and correct and that the plans and supporting data have been or shall be provided as required.
i�2LSignature of Contractor. c E Date: 5/%/O
Address and contact information of person to receive all correspondence regarding this application (please print).
Name:
Mailing Address:
Telephone: Fax: E-Mail:
AS TO OWNER:
Sworn to and subscribed before me this 3day of 6AI
State of Florida,County of Duval
NOTARY PLBLIC SIAIE OF FLORA
_U,k DeFREITAS Notary's Signature: /
COD�QSSIOv= DD398157 V
VU RES: FEB. 20, 2000
Thsn Adantic Bor.dmg co.,1nG ❑ Personally known
Bon ❑ Produced identification
Type of identification produced
AS TO CONTRACTOR:
Sworn to and subscribed before me this L� day of -,200S.
State of Florida,County of Duval N
�k
_TA4�,'-. F g205p9 Notary's Signature: G Or
�oti� 5, 4� �g ❑ Personally known
F-1Producedidentification
BDa��b=° Type of identification produced
800 Seminole Road • Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 • Fax: (904)247-5845 • http://www.ci.atiantic-beach.fl.us
Page 2 Revised 1114/03
CITY OF ATLANTIC BEACH C
BUILDING / ZONING DEPARTMENT
800 Seminole Road oerr
Atlantic Beach,Florida 32233
(904)247-5800 ___ —
(904)247-5845 Fax R E C EIV E U
www.coab.us CITY OF ATLANTIC BEACH
BUILDING � ZONING
PLAN REVIEW COMMENTS MAY 09 2005
Permit Application # C-,,5 - -�3o Z S-9 BY:
Property Address: [ O S-7 13E�cr� E '
Applicant: 5���r_�I ! ✓EL[�P 1`-e Ei��'
Project: f— DTA 1 Ti 01�
This permit application has been:
Approved
Reviewed and the following items need attention:
Please re-submit your pplication when these items have been completed.
Reviewed By: 91 - C '� Date:
Date Contractor Notified:
CITY OF ATLANTIC BEACH cc,
BUILDING / ZONING DEPARTMENT L Hen
'ns
4 �r 800 Seminole Road S. Doe
Atlantic Beach,Florida 32233
(904)247-5800
(904)247-5845 Fax RE C E I VE D
www.coab.us CITY OF ATI.QNTIr. BEACH
R (,
PLAN REVIEW COMMENTS MAY 0 9 2005
Permit Application # Z IR-*7
Property Address: 'I C)S-7 6EAC+4
Applicant: t5 ►.��ll-( I�JEV� t-Q�►JT
Project: D 1 C)L L
This permit application has been:
Approved
Reviewed and the following items need attention:
Please re-submit yo application en these items have been completed. /
Reviewed By: Date:
Date Contractor Notified:
CITY OF ATLANTIC BEACH
s PUBLIC UTILITIES DEPARTMENT R E C E I V E ID
1200 Sandpiper Lane
J CITY OF ATLANTIC BEACH I{
Atlantic Beach,Florida 32233
(904)247-5834
BUILDING F, 7.ON NG
(904)247-5843 Fax �/
www.coab.us MAY ® 9 2005 1
. i
PLAN REVIEW COMMENTS BY:
Permit Application # c.)S ' E3c)Z 6
Property Address: �Ep'cf+ Ave:-.
Applicant: t'fk5�.( �✓E L�t�1`-QT'
Project: Dt� o
Your application is approved as noted by the Public Works Department.
Final application approval must come from the Building Department.
❑ Your permit application has been reviewed by the Public Utilities Department
and the following items need attention:
At — oLix AVOibc�,J e
Please submit these requirements to the Public Utilities Department, 1200 Sandpiper Lane,
Atlantic Beach, FL 32233 in order that we can approve your application. If you have any
questions, please call (904) 247-5834.
Revi ed by Donna Ka Public tilities Director
Date
Signature
Contractor Notified Date 1��.2513
C�ta3-3o�r
CITY OF ATLANTIC BEACH
r s PUBLIC WORKS DEPARTMENT
r � RECElVEC7
1r 1200 Sandpiper Lane CITY OF ATLANTIC BEACH
J s Atlantic Beach,Florida 32233 B1,l1 (J1nir, 7n�i''nir
(904)247-5834 MAY
(904)247-5843 Fax MAY U 9 2005
www.coab.us
PLAN REVIEW COMMENTS BY'
Permit Application # OS
Property Address: I Q S-7 Ave-.
Applicant:
Project: SER_
❑ Your application is approved as noted by the Public Works Department.
Final application approval must come from the Building Department.
Your permit application has been reviewed by the Public Works Department
and the following items need attention:
Drainage plans, including on-site storage, as required by
Land Development Regulations 24-66 (b) , are required.
Provide construction detail for silt fence.
Please submit these requirements to the Public Works Department, 1200 Sandpiper Lane,
Atlantic Beach, FL 32233 in order that we can approve your application. If you have any
questions,please call(904)247-5834.
Rev ie k Carper, P.E., Public Works Director
Date
Signature p
Contractor Notified Dateiyc 611
�a3 � 3 a7s
- ?tyLvfJJ, CITY OF ATLANTIC BEACH
r SSS
,
PERMIT CALCULATION SHEET
J
Date: 6-- 2 0 -O,-
Address /Q� 7 /3/-c,4 C M t4c/F_ - ,W/j�0 A) 7-D
Heated Square Footage 2 @ $ per sq ft= $
Garage/ Shed @ $/ per sq ft= $
Carport/Porch @ 0/el,lO F' per sq ft = $
Deck 'U S @ $t� r . per sq ft = $
D�
Patio @ $ per sq ft = $
TOTAL VALUATION: $ 1,000
Total Valuation
1st $
Remaining Value $ . per thousand
or portion thereof
CONSTRUCTION TYPE: TOTAL BUILDING FEE $
ZONING: a G-3 - + 1/Z Filing Fee $
FLOOD ZONE: - (1) Fireplaces @$35.00 $ 33-
IMPERVIOUS SURFACE:
BUILDING PERMIT FEE $
WATER IMPACT FEE $ Y 0 0
SEWER IMPACT FEE $ O
WATER METER/TAP $
CAPITAL IMPROVEMENT$
SEWER TAP $
VVC (y6/) RADON HRS .0050 $
SECTION H PAVING ( ) $ - O
VCROSS CONNECTION $ 3s`
VVST(288�) SURCHARGE $
OTHER $
GRAND TOTAL DUE: $
1/13/03