1330 Ocean Boulevard RES20-0003 Int Remodel/New Contractor _._
e,J,,., RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES20-0003
v" ISSUED: 1/9/2020
`�.��3 >� 800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 7/7/2020
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 APMLY, 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: I VALUE OF WORK:
RESIDENTIAL ALTERATION INTERIOR REMODEL-TOOK
1330 OCEAN BLVD $0.00
RESIDENTIAL OVER RES19-0142
TYPE OF ,REAL ESTATE 1
''..0.•-.
, BUILDING USE
CONSTRUCTION: NUMBER: ZONIN '; SUBDIVISION:
;:' ,T t � GROUP:
171847 0000 MANDALAY
COMPANY: ADDRESS: CITY: , STATE: y ZIP:
DUVAL CONSTRUCTION 13221 Mendenhall PI JACKSONVILLE FL 32224
INC
OWNER: ADDRESS: kti, CITY: STATE:e ZIP:
ROBERT EBENER 1330 OCEAN BLVD ATLANTIC BEACH FL 32233-5744
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.
5Lat , ,.,, C ... i"o'Fi?4.w., � .:.k �'. : .
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455 0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455 0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $59.00
Issued Date: 1/9/2020 1 of 2
,.,,y,,,, RESIDENTIAL PERMIT PERMIT NUMBER
(J 3, -� CITY OF ATLANTIC BEACH
R ES20-0003
800 SEMINOLE ROAD ISSUED: 1/9/2020
,;i�� EXPIRES: 7/7/2020
ATLANTIC BEACH, FL 32233
Issued Date: 1/9/2020 2 of 2
01.A'1 Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
—4,13'
AllIr 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
01119 IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 1330 Oce (3 '3 Ali .*t tachFI�3P-33 Permit Number: '.1 RL-"") 0003
)
Legal Description 1\&t\ I\3 KJ-AY Lo-i- z. , a(_v, c-,4 RE# l 1 e:,47 - nov6
Valuation of Work(Replacement Cost)$ 1(c D, GGOO Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition 14ration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial residential -4-a ,r
• If an existing structure, is a fire sprinkler system installed?: ❑Yes ,JJo
• 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:, OYe'( Pry Ow( ce frost
-\fYieicx. rto ciAe ISS VA -0\L
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name WA-R ;a-4-,6u10 L'‘,P QX Address 9S9 Mr'-"CX
DR Gay Pr •
City 1aC(CStT(1�1 �te State F Zip 3aa5� Phone cfD`1'11D'3i b]
E-Mail IMA't ,iffC ir4,661, GOm
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) I.Gt,& ?l• `f BD ' e-loehtt(
Contractor Information nn
Name of Company IN OA COM-t(�tr Qualifying Agent eet v u'
Address 13a.a` MeA1a0A Va-kl ?t&Ge City St�(A6s blvtA lie- State FL- Zip 3?"?, -(1
Office Phone 010 4- n-7--?"031 Job Site Contact Number 104- - a-031
State Certification/Registration# CGC.i ') M I a'0 E-Mail 6Auv0-d& sirtnc 4O n e 1vrket.►( • (AbM
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer ).61,. --t11"7"-- OR Exempt.( Expiration Date
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 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 all4. A
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 LEN c , ' AN ATTORNEY , - • 'E
RECORDING YOUR NOTICE OF COMMENCEMENT /4-7A-AitAcki - 1 / -
(Signature of Owner or Agent) (Signature of Contractor) 5�
Signed and sworn to(or a irm� d)before me this g day of Signed and sworn to(or a ••d before me his CJ day of
pun. , ?-tixo . LA ..4. • . ' .. , • . 0.N ,2.07U, . :..1A fa. 1 -(is4
..:,', TONI GINDLES 'r s(Si . I -o' lo • _�!!� •f _�
_. , MY COMMISSION#GG 353178 1 '
..a• EXPIRES:October 6,2023riks'6""------------I'.4iv.ti , TONT GINDLESPERGER
°'�^{'f�er$@9f14A�11KIht BgWe Undenrtitets kyPING4 0410SION#GG 353178
ro use I eication ``� Id fllE o lober6,2023CcC ��_Type of Identification: (SCo `J a i -7 t'0__,,S5'D $enl liTh I' ®t OC)-74 -1. 6-7- 0