55 W 8th ST RESO21-0020 SrSy'''1•4 Building Permit Application Updated 10/9/18
J 31
City of Atlantic Beach Building Department **ALL INFORMATION
J ,ter V 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: S 5 W' S s+ce_ 1V(-) C
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Permit Number: L �j� '
Legal Description Ar\\c \ L \>kCAr\ SQ-C- N 1 L-p-k- L ,J W... Sg RE# 1 -10-1 (y 000C)
Valuation of Work (Replacement Cost)$ O' Heated/Cooled SF Non-Heated/Cooled ‘D.XB
• Class of Work: ❑New , Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): l (Commercial ❑Residential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes gNo
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) KNo
Describe in detail the type of work to be performed:
Florida Product Approval# 'Yor multiple products use product approval form
Property Owner Informations
Name �C��n �CUC' 004-7— Address 1• •„: k-1 eceS+ 00.16-s D;,.
City (vt, nZ �\r, J State Zip 3 � �(oPhone 91D:k --104-Oy S C)
E-Mail 11ecc-A- C Spc citS 'Ara*}�._ 6>c :M
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Owner or Agent(If Agent, Pow&of Attorney Agency Letter Required)
Contractor Information 1
Name of Company (-16f,Ct, �,,.f)- td (�)4l Qualifyinging Agent /V\ ; eke D
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Address 3(a I Q C-flo'1w;C . Or. City �c+ .v.,a C t7 State e..- Zip jci 1
Office Phone cipL{- G-11- (110(A Job Site Ciantact Number
State Certification/Registration# CiS; 1 -ea0V11 E-Mail -k":\0 c A',n11e (--oa54-0.`‘'. u,\do SP c;rvs�r, i CZ,v )
Architect Name & Phone# 1,,;.y c-C7y+1C‘ C1O -\- 1 S3- 4051
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Engineer's Name& Phone# 1 cv\�4 A�Z) c, cj0L{ -) S ' a�'�-1
Workers Compensation Insurer ( OR Exempt);31 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 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 FINANCIN ONSULT WITH YOUR LENDER OR AN A ORNE FOR
RECO j• N�G,YOU O OF COMMENCEMENT. A1,
Ub
(Si of Owner o nt) (Signature of Contractor)
'Sied a d sworn to(or affir •-d) be ore •- th's� day of Si ned a d sw rya or affir ) before m thi d.y of
am , .. . en '�/ i: . c�, . 1 Iia / ' & .
Si:nature of
o.A°"<c►'(Sigt[8lt;f�'.mfidV�7t�8a'�}:FI. ,da Notary
Dan elle Marie Capretti
.y My Commission GG 153245 el"4 Notary Public State of Florida
5•0i 0, Expires 12/06/2021 ' Danielle Marie Capretti
[ ] P rsonally Known OR Personally Known OR o My Commission GG 153245
[Vroduced Identificatio 6'
/ [ ] Produced Identification �or s`� Expires 12/06/2021
Type of Identification: l' / t VAS �` C�IVB Type of Identification:
JARZYNA E ASOOCIATE3 ARCD ITECTS P A
( i 1 4 JUNIPER CT • AMELIA 15LAND. FL 32034
+ TEL: (904) 321-4242 • FAX: (904) 321-2029
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JARZYNA 8 A55OCIATES ARCUITECT6 P A
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4 JUNIPER CT • AMELIA 15LAND. FL 32034
,, TEL: (904) 321-4242 • FAX: (904) 321-2029
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DRAWING
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APPLICATION FOR FENCE PERMIT
Owners name `-.4PiC) _ E_Z phone.22-3
Job address
Lot block and/or unit # subdivision
Contractor if different from owner , LIK.'(:T6 Fe2-,C 67;--- CU
Valuation of fence $ JOZZ) c'. L!e'J'S Corner or interior lot__1ti 7-&'k
Type construction 6000 D /2I Vic/
Show location and height of fence as well as location of street(s) .
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MA[— SHOWING SURVE1r OF
L(7P 7 BLOCK 38, SECTION "t{" ATLAATPIC BEACH AS RECORDED IN PLAT BOOK .18 PAGE 34 OF THE CURRIN]
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
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R.L.S. No. 3195 ��� NO C A P
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50 R/W (PAVED)
NOTES:
I) BEARINGS AS PER PLAT.
2) NO B. R. L , AS PER PLAT.
3) TN/S /S A BOUNDARY SURVEY.
I 1tt:RE3Y k_.rk1'I F Y 't1iN'1' 'I11E PROPERTY SIICWN I{EREX)N LIES IN FLOOD ZONE "C" AS SIICWN ON TUE FLOOE
I{AZARD BOUNDARY MAP FOR ATLANTIC IiEAC iU, FLORIDA.
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