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1070 Ocean Blvd FNCE19-0144 rS",T.k. FENCE WALL OR BARRIER PERMIT PERMIT NUMBER '` ` ') CITY OF ATLANTIC BEACH FNCE19-0144 � P\ ✓' �" ISSUED: 1/9/2020 800 SEMINOLE ROAD �eo;ti�� EXPIRES: 7/7/2020 ATLANTIC BEACH. FL 32233 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: 1070 OCEAN BLVD FENCE WALL OR BARRIER FENCE FENCE $2000.00 TYPE OF 1 REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170251 0010 ATLANTIC BEACH COMPANY: ADDRESS: CITY: STATE: ZIP: FENCEPRO, INC. 3727 Spring Park Road JACKSONVILLE FL 32207 OWNER: ADDRESS: . CITY: STATE: i ZIP: HOWARD TALMAN M 1070 OCEAN BLVD ATLANTIC BEACH FL 32233 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. I — — 'Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 1 PUBLIC WORKS ON SIIL RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 2 PUBLIC WORKS ROLL OFF CON IAINER INFORMATIONAL Notes: i Roll off container company must be on City approved list(Advanced Disposal, Realco Recycling,Shapells, Inc., Republic Services,Donovan Dumpsters, Phillips Containers,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City right-of-way. Issued Date: 1/9/2020 1 of 2 rs'�'''' _% FENCE WALL OR BARRIER PERMIT FERM�T NUMBER J' t�.. �� - '' CITY OF ATLANTIC BEACH FNCE19-0144 �� ISSUED: 1/9/2020 ,�� 800 SEMINOLE ROAD EXPIRES: 7/7/2020 i (i;ali ATLANTIC BEACH. FL 32233 3 PUBLIC WORKS I RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 4 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 5 PUBLIC WORKS FENCING REMOVED INFORMATIONAL Notes: All old fencing and debris must be removed from job site by Contractor. DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PLAN CHECK 455-0000-322-1001 0 $17.50 FENCE 455-0000-322-1000 0 $35.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $81.50 Issued Date: 1/9/2020 2 of 2 (ALA/tr City of Atlantic Beach APPLICATION NUMBER fil fc- 4 Building Department (To be assigned by the Building Department.) r )q 800 Seminole Road r NC_ _ O '/1/� j.,,, . Atlantic Beach, Florida 32233-5445 v `-'i` r Phone(904)247-5826 • Fax(904)247-5845LaiL9___ ;s �•r E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 en 0 30...ep,)61...ALD Department review required Yes No �^ in Applicant: .N__)GC— Q(LC) anning &Zoning /� ( _ I ree Administrator Project: CO f E DCL.E. P I" 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: APPLICATION STATUS Reviewing Department First Review: ❑Approved. enied. ❑Not applicable (Circle one.) Comments: L b� r / BUILDING bff-1 I ' IC,i, ;;,- -i. 1of I ii►`e PLANNING &ZONING Reviewed by: Date: / Z'.2-61—t`r TREE ADMIN. Second Review: Approved as revised. ❑Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by:_______________________ Date: /-3 - Zri2G FIRE SERVICES Third Review: I 'Approved as revised. I 'Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 Revision Request/Correction to Comments **ALL INFORMATION "` HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED, 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: c-hj(.,. _ ‘c1 - clti%. riiRevision to Issued Permit OR Corrections to Comments Date: i Project Address: A0 7a O c eat. 11/40/1 Contractor/Contact Name: !%CQ� f)I"[i 2- /G • J pt -a",-b ' Contact Phone: (3'Dy 6-3 P OL 2 7 Email: Fe/ite,06)4-,r e f' 77-:-.ye" Description of Proposed Revision/Corrections: c ham,c -rf /a ` o/:-- ,(/ii r/'h 4/erJ Cc)/4/Cr f, `-/ 1 1/ Y,ed.n, C ` /`�/'S/7 of 1"c r code l ro-4,,,...„/ .S-'/ker',44 / affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) • WiOiroposed revision/corrections add additional square footage to original submittal? No Li Yes(additional s.f. to be added: ) • WiJJ-proposed revision/corrections add additional increase in building value to original submittal? ii/iNo L_'*Yes (additional increase in building value:$ ) (contractor must sign if increase in valuation) *Signature of Contractor/Agent: az_ --"T--- � — (Office Use Only) i- I Approved i i Denied � . Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments Department Review Required: Building ,,, -; _ Planning&Zonings; Reviewed By Tree Administrator Public Works 1 � 1 - IC... Utilities S Public Safety Date Fire Services Updated 10/17/18 MAP SHOWING BOUNDARY SURVEY OF THE EAST 1/2 (HALF) OF LOTS 5 AND 6, BLOCK 39, ATLANTIC BEACH CORPORATION'S REPLAT, AS RECORDED IN PLAT BOOK 6, PAGE 1. OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CERTIFIED TO: TALMAN M. HOWARD & DIANNA L. HOWARD EVERBANK PONTE VEORA TITLE, LLC/HATHAWAY & REYNOLDS, PA OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY r. R> i 11th STREET (40'RIGHT OF WAY) C1 OND b �' 62.50' (DEED) `1: N 83106'36' E 62.50' (MEASURED) CR CORNEE R 02' 0,1' 6 .0' (OEEO) .'i -- -.— 2.64) 1 IZ■ I I 1 1 1 ■ ■•1 _` ' I I■.I. 0, 4.o EAST HALF jJ L ` I` I I POOLn 1 H OF LOT 6 \\�� ' i i BLOCK 39 44 1 1 ( i l 7 ■ ■ 7 ■ I Q . I1111 _ 1 , 1 _ 11111 Ili WEST HALF ,, I I I. I I I■`TPA ( 1'1 `1 Lit■] 2.4'- 1 OF LOT 6 Cr — gamma ' �(-1-20.7 I\ BLOCK 39 .I .■� I I...I . ■ m 14.1 �� I $ 0 ��_1__��� 1 ' I 6 W W O "ITT t2Y a _ „ W W 1 1 I �y' O ■ ■ ■ ■ H ` I `I I I 0u O •� ')('' `�v v ! , ■ `r■■ U Y PAVERS N O w a og II-.`i i .. t, ^• o Q >--- Yu: Q0 � ■ p ry CD - W.c (x W — 0 < I I I ■` 2.5' r J d O T ,- v 7 I I ■ '� i � EL 0. LOT 6 F I ■ I ■ I I ■ ry ' Oti Qvi BLOCK 2 _ �- - - i I I,.I._ • } 0 •'. I- - _, CD5 W zY 9.e• Cc 0 {:qq� Z 00 8 W U Om� WFtV W w., r x N ill P EAST HALF * 0 La Z -c• 3 111 O u I- v,, OF LOT 5 r 0 a '4. T 3 ON BLOCK 39 I- a N ; ir WEST HALF M i OF LOT 5 4.0'' 'd g u) BLOCK 39 I111 1 R I Z 1 1 . I • I ■ 1 ■ ■ o I J I ■ 11 I C .G ` ■r■`I I ■ `I I I ` ■ 3.PAVERSJ"1'1'L1 I 1 ——( I ■ I ■ I 1 • 37.5 -------25.0' J 1 0.6'of A/C Pw i.f-4----. . ( ' 1.2' ■". S 82'51'25" W H '0 0 ,111 62.68' (MEASURED) LOT 4 62.50' (DEED) BLOCK 2 LOT 4 BLOCK 39 LEGEND: O A SET 1/":NEnAR PC - PONT OF CURVATURE STAMPED P5u$8148 PT < POINT OF TANGENCY • .. FOUND 1/2' IRON PIPE NO IDENTIFICATION PRC PONT CF REVERSE (UNLESS OTHERWISE NOTED) CURVATURE ■n 4",4'CONCRETE MONUUENT PCC = POINT OF COMPOUND A/C . AR CONDI TONER /''' CURVATURE Building Permit Application Updated 10/9/18 ^�_.. ``'-; City of Atlantic Beach Building Department **ALL INFORMATION HIGHLIGHTED IN GRAY : MAP SHOWING BOUNDARY SURVEY OF THE EAST 1/2 (HALF) OF LOTS 5 AND 6, BLOCK 39, ATLANTIC BEACH CORPORATION'S REPLAT, AS RECORDED IN PLAT BOOK 6, PAGE 1. OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CERTIFIED T0: TALMAN M. HOWARD & DIANNA L. HOWARD EVERBANK PONTE VEDRA TITLE, LLC/HATHAWAY & REYNOLDS. PA OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY 11th STREET (40•RICHT OF WAY) ;i 1 % O ‘41 c� �, 62.50' (DEED) k!i N 83'06'36' E 0.. acx 62.50' (MEASURED) n,•.Z c . .1 (DEED) o. • 2.6.4 1 1 )! i i i at.... 1I 1.1 i , l 1 1 1 ' EAST HALF N- -8-1-1—r ■ 1 i i POOL. • OF LOT 6 -1 ■- r BLOCK 39 471 i i .7 a i T■ 1.7 I -0■ ■ i P Cil WEST HALF PAVFTts,__;r _�S e OF LOT 6 Cr I TI i r ■ ■ 20.7 24 g a s BLOCK 39 a --,„:::_t„,,,....:.: 1.1 m ,at' :< yTy.r. I I ■ -. ',� i, g 1J.1 W W La ■ 1 i 122' w> j.....1m O D Li Lit T1isMv Is ■ i 11 i 1 0u1- 0 O- ■ 1 U O Et • I. ■ PAVERS N cs $ �i ■i ■ . , . o Q O - O 1 1 1 ri 1 1 0 0 >} m O O L� ■ i ■ tT�� ; 7.S' ; 0) — Jt ct 3 ¢U `�' 1 ■ i ii 0c�i 1 1 a & LOT 6 — i ' i ' i ' O.- 0 ;LT awl -ir ril G' i i O 9.6' ct p Z's �N Q m IFN W w` V /�1- x• DI Q p c�'cn r'3 EAST HALF ! L} c� /S� YO � e " k") S. OFLOT5 .— O 'e IV a i Cr' * m In a I ` BLOCK 39 Q R `U, ,,, N - �' I tMp r �^! L 4.0'' (n 8llir Z 11111 11 I -k . 11 ▪ 1111117 11111 . 1 1� 11 ■ i ■ 1 ii1E 1111 W T IPAVERS,I a ,I 1 I I l I 11111111, 31.9' �--a , :.� r r 6'a A/C PAD S. �r�lr% ' 11.0, 1.2' . c ����� 13-li . . J A tea! • IF) S 82'51'25" W H I 0 ,l'1' 62.68' (MEASURED) LOT 4 62.50' (DEED) BLOCK 2 LOT 4 BLOCK 39 LEGEND: O - SET STTA1.PED �:14a Pi - Pol+T of cw1vAlUf, • .FOWL 1/2"IRON PIPE PT POINT OF TANGENCY NO Ceaw c ITION PRC = PONT CF REVEL QINIESS OTHERWISE NOTED) CURVATURE RP-4-114-CONCRETE MONUUENT POC = POINT OF COWCUND A/C • Ail CO►1011WNER CURVATURE__ ._ 6ht . rro+ras— cc) I , . . . . • . MAP SHOWING BOUNDARY SURVEY OF THE EAST 1/2 (HALF) OF LOTS 5 AND 6, BLOCK 39, ATLANTIC BEACH CORPORATION'S REPLAT. AS RECORDED IN PLAT BOOK 6, PAGE I, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY. FLORIDA. CERTIFIED TO: TALMAN M. HOWARD & DIANNA L. HOWARD EVERBANK PONTE VEDRA TITLE. LLC/HATHAWAY & REYNOLDS, PA OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY I I 1 11th STREET DRY RIGHT if CAT) 62.50' (DEED) N 83'06'36" E „•,.,:.. 62.50' (MEASURED) .,...,....,t(.:., -5-2..50176110) tile--- . fi'''Ij• :- ".`" — -ri r1" 14 9-0 E AST HAL r 4.-1 7 ."--11 po'.4. -171 Ol'LOT 6 -1--ri ,rai i ei. 'alii-r 1-1 1 I Er-r-r,1 --- ,--, I, !•.-.1:-........i..1.-.1.3:113-.r...t:.1.:Li...x.:.i.j, WEET HALF uj i .teems IMO MN II P',,ER,.a.moo ma• ! or ILI T 6 EC • F-.. T.:I.. ... .NINE WWII IOW.-4--'•..--Y.--cY BLCal'a 33 D Id '1.1 I'LIXTIT..r -Jr ss /1. ..-c w I'• i Eir„.....-.1„.,:.:.,.....„,„:.,.., ,:•--: .,.. .,i;-!m- s----- 36- .•.7.-,....- -,s,.;; . c. 0 6 7 ',- ...... ,•I."t...: , \ - FAvEAY ,I.. , .-' I. 1.--, < O>'7: >, s d ,,i °IR..„.5.4-,L4.„,..,,,, -Fin 0) O.. , •r Os ,..,....,, -i 1 . 0...a . r:::21: 11 i D-, ,.. Loi 6 ...I i..1.i.x..z..1......x ' 1 ,'I;4.- • CS 4,1 BLOCK 2 ' ,,,...F.1 L.I.,,c1.7 .,:, S , 1 i :,. '7'-; 2' g 1 9 h -.. Cr'• 0 •-,L3'-;.'.' .L.7— : i Qp..) w z <, 0',5 I pfA EAST ii,,,, . i.L.I rz t 1 0Ii-;: 2(4' • `, EiL..x.x •:,,, ; • ai,L - 0 , 0) ta.. T.) , , , 0 wEST HALF F')i . a N oF LOT 5 ID 9 0.• BLOCK 39 0 . — , t4-. ,,,:r.„11,1:::,„:........, •,.. Z ; . , 1 ,•, ---,- ,11 ,14.i. ,... .:. , ih. -r•-.E:•.-i....1.-...1:..:r.:..t- i9 3, : .:.:...,.1 1 r.._,Jef ..;114-9- : eoei'; t7,fr'z . ..,.._.-...., •- i A/C.PAO LI..31. amie , 4.• "-- S 82'51'25" W • • . 62.68' (MEASURED) : : •:...,;.k,,,, .••• : LOT 4 i j/76,/ BLOCK 2 • %V • LOT ,,- e Del, .,,.., • I os, , • .4,f/ ve‘opi,f LEGEND: 0 .BE,1/2"iaRAN 4e;$ 414 pc - KANT Of CURVATUPE StAtift.0,S106,46 .1 4 PaN1 OF TANC4.14C, .f•fe4.4,0 il2.WON PPE • ,40 YAW-4104110w PPC ...., POPO OF REVERS/ fo,o_ESS OOtE414SE NOTEO) CORVARItif N..r..1-OOW/W.If tf014.WZN1 FTC - nth/C"OMPOOND MN a...111701E0 Y - FENCE '..,.:.. ,..., ,. ,,,, —( Ray Thompson , . SURVEYING, inc. [Going the DISTANCE for Yogi 4613 Philips Highway,Suite 210 Jacksonville,Florida 32207 (Phone)904-448-S125 _ (Fax) 904,448-5178 PONTEYEDR TITLE, L.L.C. , j'74.3 ii 22850 I DAIE CS HELD SURVEY: 6.-- 8-2013 I SCALE' ' - 20' NOTES: CERTIFICATE J. i. 1, BEARINGS ARE BASED,314 for 0551)0)71 805001 TO--V-QQ217,:Z4•*-1'--- ,HEARS,I:(RHES 7051 00'..;',. 1 Rai, L.k,,,,Htal,S r RESPONSBLE C.HARCE 51.0810 R1E: WESTERLY DWI:DART UNE Of St.:EL£C1 PAII•Xl. ARO ffEt..,5 NE tio4141u . '."..t 51010',..:'....,.:SET FIVIH IV BA,tv.4.to BOARD CA PP0F ES&-EN A -. ,,E,ow&,H66,IPS.6,-;et:ONAPTLP fot,7.-1. Ilsorse. GRAPH1C PLO T7ING M.Y 114E CaFTC+433 LANDS LIE 611501 FLOW 2,24,E XO 7, totwo,,r.“A•tto/T, Ataw,STRA II ,..',ANT TsEene A 11 . . ...AS 511004f 014 THE NAPLXIAL P1000 iteSuRatiCE map, YE 037.0: AmC 3.2013,COMMUNI Ty tiumBEP 120078 PANEL Q4.0.9 h :171_ 3: ri‹..508001 BEREFT'S mi.EASEMENTS 8 R1,811 o WAY AS POI RtC:fLO/(. — 4101 B/OR 07LE COMm,NEN t Br SuPPUEO.UNLESS OTHERWISE STATEV.NO ,..,. - 011-01 111.6 OERIFICATiON HAS BEEN PERFORMED BY Dff UNDERSKA40. _.__ .. AVM/We/CB fLIP' 4; THIS SuRBEY IS NOT ACID WITHOBT AN AUTiONTIOATED F.....0.01177,,,0 5,00113, €E0310513)7..;1.11WE•'.. VMal 0 P.11r.••.. 810 SIM E Or •Ii.:4(1,34 'NO AffiiENTO.:Af.T.ft OtIPON ..A. O: A,.. LW,'• -• 4 3,,,,-)3. 746,, LAND SURVEYS 0 CONSTRUCTION SURVEYS 0 •if.::.!- 4-: SUBDIVISIONS City of Atlantic Beach APPLICATION NUMBER 411,-",..06 Building Department (To be assigned by the Building Department.) i- ,40.- 800 Seminole Road I" NC� l� - �/ �`-14 .! Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 Fax(904)247-5845 ` r, > ,;,19re E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I 0-7L-1)°-E,AN-1 ,k;D Department review required Yes No _�ding� Applicant: �N ,C Q�� ming &Zonings /� I ree Administrator Project: l� ( F pC , u�►'c�l1t -"ark�_� 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: APPLICATION STATUS Reviewing Department First Review: Approved. I f Denied. ['Not applicable (Circle one.) Comments: nen ; BUILDIN PLANNING &ZONING Reviewed by: fl 1 Date:/a a 3-19 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 OFFICE COPY Updated 10/9/18 if-- City of Atlantic Beach Building Department **ALL INFORMATION ' %,.r � 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY m).c IS REQUIRED. Phone: (904) 247-5826 Email: Building-DeptPcoab.us / Job Address: I 0`iC) (-)CAS 13`vd / +d►-Yj� 3 12-33 Permit Number: 1 ��Ce 19- 0I �'4 Legal Description ( b% � -XS -2...c1c1 �$ \ IZ. 11.01-. 5/6 ILS RE# [ 10 2....5 iv —oo 1 O Valuation of Work(Replacement Cost)$1Q 0(2 Heated/Cooled SF Non- Heated/Cooled • Class of Work: *Jew ❑Addition ❑Alteration ORepair ❑Move ODemo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial ❑Residential • If an existing structure, is a fire sprinkler system installed?: DYes ONo • Will tree(s) be removed in association with proposed project? ❑Yes (must submit separate Tree Removal Permit) ❑No Describe in detail the type of work to be performed: j�,4-‘S Itc.\\ > 1` L O r1S G 1 5 (k,UAQ Florida Product Approval# for multiple products use product approval form Property Owner Information Name _fa 0 l 1ala Address t 010 0cfrr' Tjl /j City c}*"kk,--j(-- 13(i.kAn State Zip 32233, Phone 1i.') T(,,;, 5 2-1-2....- E-Mail -HA k 4tn r h \ 4Artk C- }V`G " Laws. Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) Contractor Information -� Name of Company . .-12:N/1 LQQ ('� Qualifying Agent'�(W r S� J e r Address '>`1 S 11, r c,f,L Cit o , �C 7 Lk • �jc_�S hJ ��Sfate �r Zip ?» � Office Phone_ oy 53 o�ua-\ Job Site C tact Number_CSO�- 1-� S— -11 q State Certification/Registration# -�p�LlV'1 E-Mail Q EN�,�p-NO ‘n C l ) L, ls.Y, C r Architect Name& Phone# ` W t M Engineer's Name& Phone# -S1e 31 a t�� Z N c4 Workers Compensation Insure S ,a�x"T,,,�s` OR Exempt ❑ Expiration Date a I J © c' Application is hereby made to obtain a perri'f(Yto do the work and installations as indicated. I certify that no work or instatti�gag commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws rIlLinp a construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, Gfa,6 p Q WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS, etc. NOTICE: In addition to the requiremor tflfg,i5' 0 permit,there may be additional restrictions applicable to this property that may be found in the public records of this coatiaoci 2 there may be additional permits required from other governmental entities such as water management districts,state a cs&ra federal agencies. FJ- 0 H CC Q = Z OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance\ I ,il !.-1 applicable laws regulating construction and zoning. Q 0 LU 003 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAtC w w w RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IIiEN� ¢ w TO OBTAIN Fl ANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE cc RECORDING Y0UR NOTICE OF COMMENCEMENT. Signature of Owner or Agent) (Signature of Contractor) /t Signed and sworn to or affirme ) before me this day of �Siinne�dd and sworn to(or affirmed) before me this l 6 day of /PreAlthb(, d't/Iti , b � I I _ me7e (C\ , by 6C'\ . a 51W- I. - - • • nature •71!C•1• . mer'4'. Notary Public State of Florida .i Jennifer Creamer ¶Ta aidno11d1 y4f: • My Commiss on GG 229181 * Ib Oonn�lon Expires 01/08/2023 ersonally Known OR ? d�' Expires 06/17/2022 [ I Pers ally Known OR Comraluice No.03 I PProduced Identification [ oduced Identification Type of Identification: Type of Identification: 1) l City of Atlantic Beach APPLICATION NUMBER .41 `,, Building Department (To be assigned by the Building Department.) 800 eaRoad Atlantic Beach, Florida 32233-5445 ^ v\cF A4 Phone(904)247-5826 • Fax(904)247-584®EC 1 9 2019 s): z_j___LE4L9_ ' E-mail: building-dept@coab.us Date routed: I City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I O70 30...E.AND6LVD Department review required Yes No Applicant: �(uCC (z© arming &Zonin� I ree Administrator Project: 6.7 ( FE,IDCc... 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: APPLICATION STATUS Reviewing Department First Review: Approved. ['Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING � l2 /f Reviewed b � ,1����..�Date: /7j�/J 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. I 'Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 •f Jr, City of Atlantic Beach APPLICATION NUMBER r; lik r '�� Building Department (To be assigned by the Building Department.) J, - - �� r 800 Seminole Road 9 - /� /t/� s' Atlantic Beach, Florida 32233-5445ulor I^ NC. — bel-%1- . Phone(904)247-5826 Fax(904)247-5845 7 on 9.-. Z E-mail: building-dept@coab.us Date routed: ' City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: f en° 30...E.A,DE,LA Department review required Yes No t---- m � q Applicant: PNCC- QR_C) anning &Zonin I ree Administrator Project: 6 ( \ DCc rri _ 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: APPLICATION STATUS Reviewing Department First Review: ❑Approved. Denied. of applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by. Date:/Z'ZO— 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