150 2nd St 2014 windows,siding and kitchen remodel CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001084 Date 7/10/14
Property Address . . . . . . 150 2ND ST
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 11300
----------------------------------------
Application desc
kitchen remodel
---------------------------------------
Owner Contractor
-
------------------------
-----------------------
WOOLVERTON, DERICK R OWNER
3761 109 AVE NW
PONTE VEDRA BEACH FL 32004
--- Structure Information 000 000 REMODEL KITCHEN / BATH
Occupancy Type . . . . . . RESIDENTIAL
-- -------------------------------------------------------------------------
Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . 55 . 00
Permit Fee 110 . 00 Plan Check Fee .
Issue Date . . . . 7/09/14 Valuation 11300
Expiration Date . . 1/05/15
------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
--------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------
--------- ----------
Permit Fee Total 110 . 00 110 . 00 . 00 . 00
Plan Check Total 55 . 00 55 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 169 . 00 169 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
• »��� - �'--� BUILDING PERMIT APPLICATION � L�
� � oa �
CITY OF ATLANTIC BEACH
JUL 0 7 2014
17L COPY 800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1502 nd street Atlantic Beach Florida 32233
Legal Description Lot 6 Block 13 Plat No. 1 Sub"A" Atlantic Beach. Florida Parcel# 170211-0000
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work S( 1i3mProposed Work heated/cooled 1,490 non-heated/cooled 1,490
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial esidentl
If an existing structure,is a fire sprinkler system installed? (Circle one). es No N/A
Florida Product Approval # 5r(Ef-
For multiple products use product approval form
�a�r-�u�� h S
Describe in detail the type of work to be performed: Remodeling Kitchen and Bathroom A
�� +--
Property Owner Information: r
Name: Derick Woolverton Address: 150 2nd
City Atlantic State Fl Zip 32233 Phone 904 509 6993
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: Qualifying Agent:
Address: City State Zip
Office Phone Job Site/Contact Number Fax#
State Certification/Registration#
Architect Name& Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address Derick Woolverton
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicate and that all work will be performed to meet the standards of c
laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6 months, or if construction or wo
is suspended or abandoned for a period of six (6� months at any time after work is commenced. 1 understand that separate permits must be secured j
Electrical Work,Plumbing,Signs, Wells,Pools,f urnaces,Boilers,Heaters, Tanks and Air Conditioners,etc.
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 BEFOR
ENTE RECORDING YOUR NOTICE OF
COMMENI hereby certify that 1 have read and examined thheris his a plication and know the same to be true and correct. All provisions of laws and ordinances governing tl
provisiwork will be ons of any other fed ral,stateworelocal laeci/ied herein or not. The w regulating construction or performance of construction.notermit does presumeto give authority to violate or cancel t
Signature of Owner Signature of Contractor
Print Name ACtACk (.✓e,�d��v .................................. Print Name ........................................................................................................................... .....
................................._......._................_...................
Sworn tt"and subscribed b\g pr�j me Sworn to and subscribed before me 20
thisZ_t'Day of -►v 20 this Day of
Nota P lic Notary Public
Revised 01.26.10
e4+'•'y JENNIFERµpIM�EP.
:
n, MY COMMISSION N FF 011480
+; '= 0124,2017
ar` Bonded Tnru�Notars
ry Public UndafWrh
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i -
1 �
1T$ � Esq
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CM03'
milli
ssu City of Atlantic Beach APPLICATION NUMBER
BuildingDepartment
g; tf p (To be assigned y t =Buiing Dep rtment.)
=• 800 Seminole Road
�r Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
*�C E-mail: building-dept@coab.us Date routed:
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ��14� �3 ent review required Yes o
Building
Applicant: �� Planning &Zoning
Tree Administrator
Project: G �4T(. Ar 72 Public Works
Public Utilities
Public Safety
Fire Ser-ices
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Rece, Date
of Permit Verifiec_ i3y
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
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING Reviewed by: Date: 74-1V
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑D iE
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by.- Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
r !tit
Application Number . . . . . 14-00001085 Date 7/10/14
Property Address . . . . . . 150 2ND ST
Application type description SIDING PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 2000
Owner Contractor
-
------------------------
-----------------------
WOOLVERTON, DERICK R OWNER
3761 109 AVE NW
PONTE VEDRA BEACH FL 32004
---------------------------------------------------------
Permit . . . . . . SIDING PERMIT
Additional desc .
Permit Fee 60 . 00 Plan Check Fee 30 . 00
Issue Date . . . . 7/09/14 Valuation . . . . 2000
Expiration Date . . 1/05/15
-----------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
----------------------------
Other Fees .
. STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
--------------------------------------------------
Fee summary Charged Paid Credited ----Due---
----------------- ---------- ---------- ------
Permit Fee Total 60 . 00 60 . 00 . 00 . 00
Plan Check Total 30 . 00 30 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING
PERMIT APPLICATION
CITY OF ATLANTIC BEACHJUL 0 7 2014
4, F ! L ECOPY 800 Seminole Road, Atlantic Beach, FL 3223
Office (904) 247-5826 Fax (904) 247-584
By —
Job Address: 150 2"d street Atlantic Beach Florida 32233
p>orm.
Legal Description Lot 6 Block 13 Plat No. 1 Sub"A" Atlantic Beach. Florida Parcel#-1.7-211-0000
Floor Area of Sq.Ft. IFt
Valuation of Work$aLL` Proposed Work heated/cooled 1.490 non-heated/cooled 1.490
Class of Work(circle one): New Addition Alteration epair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed`! (Circle one):des—No N/A
Florida Product Approval# `
For multiple products use product approva orm
Describe in detail the type of work to be performed: � Pl1c-E ��ai+ t"'"�'`"
Property Owner Information:
Name: Derick Woolverton Address: 150 2°d
City Atlantic State Fl Zip 32233 Phone 904 509 6993
E-Mail or Fax#(Optional)
Contractor Inf)rmation:
Qualifying Agent:
Company Name: Cid, State Zip
Address: Fax#
Office Phone Job Site/Contact Number
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address Derick Woolverton
Bonding Company Name and Address
Mortgage Lender Name and Address
months, or z construction or
Application is hCo�b tctiontin�his ju a�dictiontoThis permit becomers null!atnd vo d�if work is nottcommenced within siz(6)ormed to me the standards
laws regulating {{ )
islectncal Work,Plums ng,SignspWells,oPools,(Furnaces,Bo'lers,ZHeatetrs, Tanks and AireConditioners,eetc.nd that separate permits must be secure
E WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TOBTAIN FINANCING, CONSOUI E EN I
TO YOUR PROPERTY. IF YOU INTEND TO
YOUR LENDER OR AN ATTORNEY BEFOCORDING YOUR NOTICE OF
COMMENCEMENT.
ances
I here b certify that 1 have lied with whetheed this
eciaedlhertein or n n and o Theeg granting of a pesame to be true armit does nd cnot prt. All esumeloto givens of mauthows �ry to=nviolate gor cane
type ojYwork will be p
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owne 00, Signature of Contractor
PrintName ......................................................
Print Name ........
.......................................................
P#,cut.............c c'v .e✓........................ .
d subscribed ore me Sworn to and subscribed before me 20
SwQn 20 this Day of
this ay of
Notary Public
N ar u 'oy4.; JENNIFER WALKER Revised 01.26.10
MY COMMISSION Y FF 011480
EXPIRES:
• . Bonded Thru Notary Public April4l
qoUnderwriters
.',+, ff,,•
i,siy;yJ� City of Atlantic Beach APPLICATION NUMBER
rjs r Building Department (To be assigned by a Building Department.)
800 Seminole Road P"MW
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
Jt >% E-mail: building-dept@coab.us Date routed: f
City web-site: hftp://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /�,o 2, 4 Jr Department review required Yes No
Applicant: 7) Planning &Zoning
Tree Administrator
Project: �/ //I 9 Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified s3
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.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: __. Date:
TREE ADMIN. Second Review: []Approved as revised. []Denies;.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denie
Comments:
Reviewed by: Date:
Revised 05/14/09
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
r
Application Number . . . . . 14-00001086 Date 7/10/14
Property Address . . . . . . 150 2ND ST
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 1700
-------------------------------------------------------------
Application desc
window/door
---------------------------------------------------------
Owner Contractor
-
------------------------
-----------------------
WOOLVERTON, DERICK R OWNER
3761 109 AVE NW
PONTE VEDRA BEACH FL 32004
------------------------------------------------------
Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc .
Permit Fee 60 . 00 Plan Check Fee 30 . 00
Issue Date . . . . 7/09/14 Valuation . . . . 1700
Expiration Date . . 1/05/15
----------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
------------------------------
Other Fees .
_ STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
-------------------------------------------------
Fee summary Charged Paid Credited ----Due---
----------------- ---------- ---------- ------
Permit Fee Total 60 . 00 60 . 00 . 00 . 00
Plan Check Total 30 . 00 30 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATIONL Q [�
CITY OF ATLANTIC BEACH JUL 0 7 014
FILE Copy
! 800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 150 2°d street Atlantic Beach Florida 32233
Legal Description Lot 6 Block 13 Plat No. 1 Sub"A" Atlantic Beach. Florida Parcel# 170211-0000
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work O). Proposed Work heated/cooled 1,490 non-heated/cooled 1,490
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercialesidenti
If an existing structure,is a fire sprinkler system installed? (Circle one): es No N /A�
Florida Product Approval
For multiple products use product approval orm
Describe in detail the type of work to be performed: 1
Property Owner Information:
Name: Derick Woolverton Address: 150 2nd
City Atlantic State Fl Zip 32233 Phone 904 509 6993
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: Qualifying Agent:
Address: City State Zip
Office Phone Job Site/Contact Number Fax#
State Certification/Registration# --
Architect Name&Phone# --
Engineer's Name&Phone# —
Fee Simple Title Holder Name and Address Derick Woolverton
Bonding Company Name and Address
j Mortgage Lender Name and Address
! Application is hereby made to obtain a permit to do the work and installations as indicate and that all work will be performed to meet the standards of,
laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or wo
is suspended or abandoned for a period of six (6) months at any time after work is commenced. 1 understand that separate permits must be secured J
Electrical Work,Plumbing,Signs, Wells,Pools,1�urnaces,Boilers,Heaters, Tanks and Air Conditioners,etc.
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 RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 herebfJ certify that 1 have read and examined tt h' a plication and know the same to be true and correct. All provisions of laws and ordinances governing tl
tyr e 07.ns o will be coeperad s th whetheror law filesreght ei construction ograe pegfof ance of ermit does uo presume to give authority to violate or cancel t
p ofany >`
Signature of Owner Signature of Contractor
Print Name Print Name ----
1C. Glc. ... . ........................................................................................ ...............
Sw ed be •
d subscribf e me Sworn to and subscribed before me 20
this17
ay f 20�� this Day of
of Public W*A-- 10 ca��: Notary Publi�-
Revised 01.26.10
,IENNIFERWp�(ER
MY COMMISSION#FF 01 1480
6124,20
EXPIRES: oWic Ueder++ritere
+ ifc Bonded Thru Notary
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City of Atlantic Beach I APPLICATION NUMBER
J� Building Department (To be assigned y the Building Department.)
r 800 Seminole Road / /D
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
µs, , E-mail: building-dept@coab.us Date routed: VIM,
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �n d Sr ment review required Yes No
Building
Applicant: 9 1J) ning &Zoning
Tree Administrator
Project: / /��� �J Q�� Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: roved. ❑Denied.
(Circle one.) Comments:
BUILDI
PLANNING &ZONING Reviewed by: Date.-
TREE
ate:TREE ADMIN. Second Review: ❑Approved as revised. El De ed.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denies
Comments:
Reviewed by: Date:
Revised 05/14/09