2233 Seminole Rd Unit 34 DEMO20-0010 Soffit DEMO PERMIT PERMIT NUMBER
.•
. _. CITY OF ATLANTIC BEACH DEMO20-0010
0 ISSUED: 3/5/2020
800 SEMINOLE ROAD
r v~ ATLANTIC BEACH. FL 32233 EXPIRES: 9/1/2020
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:
SOFFIT DEMO FOR
2233 SEMINOLE RD UNIT 34 DEMO PARTIAL ENGINEERING UNITS 34 & $2000.00
35
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169519 0166 OCEAN VILLAGE ONE
CONDO
COMPANY: ADDRESS: CITY: STATE: ZIP:
JBL CORPORATION INC 1949 JERSEY ST JACKSONVILLE FL 32210
OWNER: ADDRESS: CITY: STATE: ZIP:
LASETER W SCOTT ET AL 2233 SEMINOLE RD 34 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
DEMOLITION 455-0000-322-1000 0 $100.00
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
Issued Date:3/5/2020 1 of 2
I1..A,r DEMO PERMIT PERMIT NUMBER
t l+'
'. .. '; DEM020-0010
,� CITY OF ATLANTIC BEACH
_.).1",.. ISSUED: 3/5/2020
� try 800 SEMINOLE ROAD EXPIRES: 9/1/2020
Orin ATLANTIC BEACH, FL 32233
TOTAL:$129.00
Issued Date:3/5/2020 2 of 2
1''`--'//, Building Permit Application Updated l0/9/18
-, City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
�V;
"4o,stp' viCi L T �' IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us • . J�
Job Address: ZZ33 ')en+:Hole Rd �hn}i� �1.. PI. 522.33 Permit Number: _L v\azo -L) ( 0
Legal Description (A-23- 2,R_& Uttan V;ilbse - car,dow.:ni,,,r. t' ,ash t(„RE# WI 511 -0134 13S-
Valuation of Work(Replacement Cost)$__SA3S.�.
Heated/Cooled SF Non-Heated/Cooled
-Z x c:.) - l- e:11 o C).-1(..,L(
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): IiCommercial ❑Residential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes 116No
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) kJo
Describe in detail the type of work to be performed: C/-Y-\0 ;-'CL-(
Se cf i+s I ± 0-1644k .a*C4e4 E k '14,6/114- P )01W1.
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Uctwn V;Ila c Gogo .4atac;•1iin Address 2233 Sow:mile Itirai
City M14n1+•c Sao State S'L. Zip 322 33 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information ^- / 7
Name of Company V'et �-ffl120• -,� Qualifyin Agent CAA/ "1". el /�-�.�
Address / I'3 G21-St-v 'ST. City VD Jer-A/(L State ci Zip 3?-246
Office Phone Soy /361- oo')y Job Site Contrt Numbcjr 10 1.141 t0q•?I 7 63$U
State Certification/Registration# C. C. /520 T .--0E-Mail V� a C�9( (OI C.-Car.
Architect Name&Phone# L V
Engineer's Name&Phone# A ( a / 144i 'S , R.1 _ Y OM Al ' Q 1:7 0 ' 0 0 I
Workers Compensation Insurer c4 (�, "(,d . o OR Exempt❑ Expiration Date 01 JOY1')-0
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 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 A ^ •RNEY BEFORE
RECORDING YOUR NgTI E OF COMMENCEMENT.
i•Cei,--- — if( '/
Signature of Own or A�ent) . 1 .f
(Signature of Contractor)
Signed and sworn to(or affirmed)before me his .ay of Signed and sworn to(or affirmed) before me this ,')rd day of
k't tiktti , 2D Le,by 4'C X IR i' (YIO,YaI , b , .•• • a, a
1.w - 1.1-?_k I-k-
(Signature
�ignature of Notary) (Signature of Notary)
.0,,,,r°• Kacey L.McKenzie 1
•° State of Florida ,4O_`Y,",,,,, BRIANNA M.CUEVAS
[ ]Personally Known OR • ,My Commission Expires 01/10/2021 NdPersonally Known OR '=o I Notary Public-State of Florida
, ,
Produced Identification - roe. Commission No.GG 280808 [ ]Produced Identification ,''3, ; Commission # FF 998598
Type of Identification: V(, (.) Type of Identification: '';N46 —1Vty Comm.Expires Jun 2,1020