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64 Lewis St Bldg S9 RES19-0289 Window/Siding ,,,,:s = '' ��� . RESIDENTIAL PERMIT PERMIT NUMBER ` �. ''� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD RES19-0289 J �'f :ai`' )V ISSUED: 10/10/2019 � ° r ATLANTIC BEACH. FL 32233 EXPIRES: 4/7/2020 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies,or federal agencies. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 64 LEWIS ST#A RESIDENTIAL ALTERATION WINDOW AND SIDING - $8000.00 RESIDENTIAL BLDG S-9 TYPE OF I REAL ESTATE ZONING: { BUILDING USE I CONSTRUCTION: NUMBER: GROUP: SUBDIVISION: 172229 0050 DONNERS R/P COMPANY: i ADDRESS: CITY: STATE: ZIP: KBT CONTRACTING CORP 5105 BLANDING BLVD JACKSONVILLE FL 32210 OWNER: ADDRESS: CITY: STATE: ZIP: JACKSONVILLE HOUSING AUTHORITY 1300 BROAD ST JACKSONVILLE FL 32202-3996 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. LIST OF CONDITIONS .,, ,- Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $95.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $47.50 STATE DBPR SURCHARGE 455 0000-208-0700 0 $2.14 STATE DCA SURCHARGE 455 0000-208-0600 0 $2.00 TOTAL: $146.64 Issued Date: 10/10/2019 1 of 2 v.Aiv,. City of Atlantic Beach APPLICATION NUMBER , Building Department (To be assigned by ffthe Building Department.) ,04 PP:441- 1 800 Seminole Road R l S ,.---(3z••`:�� Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 Z S '�;t >% E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: CA LEJ o I _Department review required Yes o _ Building K B. f g Zoning Applicant: ` ©(v� � l � Tree Administrator \AZQ Public Works /Project: I I�©01,� S (I 11DC- Public Utilities Public Safety 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: APPLIC TION STATUS Reviewing Department First Review: pproved. ❑Denied. ['Not applicable (Circle one.) Comments: BUILDIN PLANNING &ZONING Reviewed by: fil /�l Date:A— l 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 „,,.,:' ''' 7,:., , Building Permit Application Updated 10/9/18 OFFICE COPY °=�r City of Atlantic Beach Building Department **ALL INFORMATION �, 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY fi wow- IS REQUIRED. o� `y Phone: (904) 247-5826 Email: Building-Dept@coab.us f Q V p $ Ct _l.t_ll1 �_-bfl-'1iAf4L RSG B 32233 Permit Number: RES 1c1 C�Zv1 ob Address:0_1-94. , 02 Legal Description'A-lli ii-/4-2.4g.. Vormkai t1Q A 1444 t.$ t3, 14 ILL., RE# LItVli9 i.v G5-6 Valuation of Work(Replacement Cost) $ % ,OOO Heated/Cooled SF l36 Non-Heated/Cooled Q • Class of Work: ONew ❑Addition E7Alteration Repair ❑Move ❑Demo ❑Pool '6lWindow/Door W „� • Use of existing/proposed structure(s): ❑Commercial 1Residential - (/) (•� I Z • If an existing structure, is a fire sprinkler system installed?: ❑Yes No 1..' ,-L'' O N • Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Perritli) oCI- Describe in detail the type of work to be performed: lh ilt2Cv/ t, sips 0r�-t 0 EL p Zl 8 a la o N Q � D • Ci -•; rr 9. Florida Product Approval# F L I b% a°1 - R3 \ci...tS a/ S, S for multiple products use product gpr 2fcin Property Owner Information CC O Q W Name �Q[,1Zf�pAJtLLriG �J.atj ►!4 L4v-r1„+p11�� Address L one a. 6L�pq c��tftj.� Lt,. 2 Ou� w City p,tJVlLl.k State �(,. Zip 14,441 4,,e- Phone . t�G- (,0-1Li 0%.) a cC La E-Mail �yliVC' , Ja)C4• at/ yy Owner or Agent (If Agent, Power of Attorne�or Agency Letter Required) 041012._ VH w D w LL., —01--m Contractor Information • ^� j cc w Name of Company i -g f Gov 1IfJ& Qualifying Agent Kurt ), 1 ti mrpoj1i1"w tu Address 5-1.06--QLD`/pr ag I.4J4 Q A City State Zip 3/`t2(,fl CC Office Phone 4104 ,(4)41 - Q seri Job Site Contact Number o -4,r, - State Certification/Registration # C•'(C- Cs,5` E-Mail j K eo 0 .V.47-t-tanrF.' Architect Name& Phone# 14jict Engineer's Name& Phone# i,/4, Workers Compensation Insurer ` g/.IQ/6. ► 'IitAW OR Exempt o Expiration Date g (4.0 f'Z Zo 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 fort I AL o ,d:il ,IGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. No I h re', -=. :' frits of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts,state agencies, or federal agencies. SEP 2 5 2019 OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Building Department WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICECwycgi g,NcE 1ENT rin6Y RESULT IN Y U AYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINA CING, CONSULT WITH YOUR LENDER OR ORNEY BEFORE RECORDIN , CIUe .„E OF COMMENCEMENT. (Signature of Owner or Agent) (Signature of Contractor) Signed and sworn to(or affirmed) before m this P1 day of Signed and sworn to(or affirm:d) b-fore m- this day of e5.pr ,2Ol , byb v i,e Al idiZ/'r cam . 2.01�b �• .� - TR vyn 0 5 4 ,, . ” 11lkN _(SjEnatUre of W43t��y�. 4 ;r.�.t(3igrl�tuyfuDfcN6lg�gf)=1ad ( _ 1....):.,. '• Commission t GG 106242 r r.. C GINA SHOOK ,� �� v• My Comm.Expires tun 25,2021 ;•���,,, Notary Public-State of Florida .F of F� •: h� Bonded through National Notary Assn. ;A..3.7,1... CommissionN GG 199162Personally Known ORo_ _ _ _ _ _ _ _ _ _ _ 4 [ ] Personally Known OR1 r�,: MyComm.ExpiresApr6,2022Produced Identification uced Identificatio _Notary ] � 9 for u h Nati nal Assn, Type of Identification: Type of Identification: �► � ——•