374 MAGNOLIA ST RES20-0285 �a? RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES20-0285
15-4/0"
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800 SEMINOLE ROAD ISSUED: 10/19/2020
v'j ATLANTIC BEACH. FL 32233 EXPIRES: 4/17/2021
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:
374 MAGNOLIA ST RESIDENTIAL ALTERATION WOOD TRIM AND METAL $1836.00
RESIDENTIAL FLASHING
TYPE OF REAL ESTATE BUILDING USE
ZONING: I SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170441 0000 SALTAIR SEC 02
COMPANY: ( ADDRESS: CITY: STATE: ZIP:
SUNSHINE COAST 513 VIKINGS LN ATLANTIC BEACH FL 32233
CONSTRUCTION
OWNER: ADDRESS: l CITY: STATE: ZIP:
PISCITELLI STEPHEN V 374 MAGNOLIA ST ATLANTIC BEACH FL 32233-4028
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II`
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 $60.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $30.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$94.00
Issued Date:10/19/2020 1 of 2
Building Permit Application Updated 10/9/18
:....f.a. City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 7"-" 371 'i./A 944+ S TIt&Er Permit Number: E..-- ZCD` C) 8,5
Legal Description /t) -i6- (6 -2.5 -214 S EL. :. :A+f Ihe L.f 2 'j b RE# t 7 0 yi,-- 00t'0
Valuation of Work(Replacement Cost)$ I i 3c, •L"' Heated/Cooled SF Iv/ft Non-Heated/Cooled 11//,4
• Class of Work: ❑New ❑Addition ❑Alteration Lepair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ElCommercial I Kesidential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes Pilo
• Will trees)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) L to
Describe in detail the type of work to be performed: Rt..m v✓E a /(6 PL%f LE R o;r f it, (.. .,0,41: T R In 4 2J vNO
Tit P.EE 1v1.4.0,.w3 ( 2 d,v /li.tii y,,�s a. i ,iv w15, $soli) ti No ilhPlai.i +v 1114 1.1k "11f2,40".
iA/)14C Ak.vnin.u,+1 2. - f1-451.11AG ,a(3.✓f h.i..vAcL.,,, , s'IAia,L,SS STF_oL f'iji(,t.FR) .
Florida Product Approval# N/}a for multiple products use product approval form
Property Owner Information
Name 3(E vi PtSCi7ELi- j Address 3?y frill 61.104-i.1 57ftE r
City ftTI.A"'''TrC i3Egi 'i State jt. Zip 32233 Phone 90y. ' /o , 6 /yz
E-Mail ) rev: t Sieve p:iSci to/!i _ tush
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) A/J;q
Contractor Information
Name of Company y u N;H,...E CoA'j .U.yi t2v:.lrr..v,i�Qualifying Agent -:165 E PAi /n R l.,^7A 4'/k
Address 13 V1K/K/1, $ QA'dE City Ait4A_fIt. 13e4,"State A Zip 3223/
Office Phone i0.I . Z i. Z , /0 3'/ Job Site Contact Number /0 %. iv t. i6 ' f
State Certification/Registration# C/3C TZ C6 31r E-Mail j4-:'!.el Sii4$/LiteI ct 57iI . t vM
Architect Name&Phone# /v/A- _
Engineer's Name&Phone# /✓/4
Workers Compensation Insurer L Liv v6/Z 6444: 4* OR Exempt n Expiration Date /U/U/ 02 I
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 eo
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR ' ' • :TY. IF YOU INTEN ' M N
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A g'•�Y BEFORE w 0
RECORD! NOTICE OF COMMENCEMENT. Lu z
• nature of Owner or Agent) (Si, .tur Contractor) '/ ',- a 2�.
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