5420 Capella Ct RES19-0366 Repair Sunroom, 6 Win/1 Door RESIDENTIAL PERMIT PERMIT NUMBER
' RES19-0366
CITY OF ATLANTIC BEACH
wt 800 SEMINOLE ROAD ISSUED: 12/20/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 6/17/2020
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:
5420 CAPELLA CT RESIDENTIAL ALTERATION REPAIR SUNROOM, 6 $1300.00
RESIDENTIAL WINDOWS AND ONE DOOR
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169397 0200 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
NORTH RIVER BUILDING
SOLUTIONS P.O. Box 840277 St. Augustine FL 32080
OWNER: ADDRESS: CITY: STATE: ZIP:
NAVAL CONTINUING CARE
RETIREMENT 1 FLEET LANDING BLVD ATLANTIC BEACH FL 32233-4599
FOUNDATION INC
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.
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 $60.00
BUILDING PLAN CHECK 455-0000-322-1001 $30.00
STATE DBPR SURCHARGE 455-0000-208-0700 $2.00
Issued Date 12/20/2019 1 of 2
S1''fr, RESIDENTIAL PERMIT PERMIT NUMBER
t CITY OF ATLANTIC BEACH RES19-0366
s,
\,gyp ISSUED: 12/20/2019
\ 800 SEMINOLE ROAD
`''i �` ATLANTIC BEACH. FL 32233 EXPIRES: 6/17/2020
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date: 12/20/2019 2 of 2
'� �;. City of Atlantic Beach APPLICATION NUMBER
i'+ Building Department (To be assigned by the Building Department.)
- i 1 800 Seminole Road _p �E, Atlantic Beach, Florida 32233-5445RE3t ���
Phone(904)247-5826 • Fax(904)247-5845 t Z t
%:r);,19''' E-mail: building-dept@coab.us Date routed: Z.
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: S4 ZO ( R heLLAc Dem..rtment review required Ye No
Buildin
Applicant: N O R-`C Ef R IVG--z. 12)0 1upto anning &Zoning
Tree Administrator
RE-...
P RS000m, Public Works
Project:
.` Public Utilities
W t flO�S `l' ��C 000 Q-- Public Safety
Fire Services
Review fee $ Dept Signature
I
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: proved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING 11 la -11-,�
Reviewed by: /' _ Date: 9
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
OFFICE COPY
S!''',:„„ Building Permit Application Updated 10/9/18
.�� sil
1 City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233
HIGHLIGHTED IN GRAY
o;tw� IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: SWO CRpe//K Cam R
Permit Number: ESL 9 - O3
66,
Legal Description /3gr aESec 5.fe, Tow.7.4ip 2 5oc.T/, Fa.�i290 /41 /E# '164 3Q7""0200
Valuation of Work(Replacement Cost)$ 4300 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition IkAlteration Lepair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial leResidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes 111.11-o
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) k<0
Describe in detail the type of work to be performed:
Apw>y fe=4'1r0Ir17: Re.yove // 4
let,op$, /�CP W.n ✓sw. l,C9E>t/,Usroi”
40944,340(27 )440,7 •txs?in •/J 1� -$1-erwor,-, 0
CI
Florida Product Approval# ce2 -/52/0.1 for multiple products use product approvj form 1
Property Owner Information Z
Name F/ee/,L.r/7tli, Address are F/tef.44)."../,,....i 4#1 ,Q co
City 0441..,74 c er<.c� v State A Zip .19233 Phone 964! 2+' .WA, i V Z O f
E-Mail ihaliAr^fe7/4rr.li.; •cowl Q' tt d H ~
ZJIJJ •
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) .0a....7 rt /r// O m !-- 0 f
Contractor Information U O
e /� Uov
Name of Company 00o* �L � BJDLDJ() Qualifying A ent . A 'f'9 A Ui z ‹ Z
Address -77 StateZ Z
P� ao� 8Z1o1y9 City Sr-5T y � Zip azo o '` \
Office Phone qa`l• 624. $31�, Job Site Contact Number l � N
State Certification/Registration# C44.15-19, E-Mail ,I1)1E04 p 0(2-4u17i DTni , Co4', pf' I— 0 I--
Architect Name&Phone# 0 LI. 5 W
Engineer's Name&Phone# 0 uuj
Workers Compensation Insurer gu;laeis Inria4ict. 4(alap OR Exempt 0 Expiration Date y 9 20 4. CC u
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or instal la r dsu 'O u
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulifinY N CC ii
W
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SITS, 5
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS, etc. NOTICE: In addition to the requirementrof this a
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.
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.
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
RECORDIN 2 ' OTICE OF COMMENCEMENT.
nature of Owner or Agent) kSignature of Contractor)
Signed and sworn to(or affirmed)before me this I S day of Signed and sworn to(or affirmed)before me this (1 day of
VP Gir16 ii 14)1 ,by
4*,, yat•. 1 ,�2 f Florida .*2 i i�
o SigFlgl�lr ". )° „ > •! i_- •N#GG057579
S;�an ownse d - .-20-.
,, ,.;._ < My Commission GG 147833 ?'; EXPIRES January 22,2021
? "} ne Expires 11/04/2021
j Personally Known OR?,,,,.a,,F,,.."0=w • . • . [ ]Personally Known OR
[ ]Produced Identification ()Produced Identific on
Type of Identification: Type of Identification: Lot__Jt__