1785 Beach Ave RES21-0049 3 DoorsOWNER:ADDRESS:CITY:STATE:ZIP:
DANA and SHELLEY
LEONARD 1785 BEACH AVE ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
Meta Construction 5616 Baxter Lake Drive Jacksonville Fl 32258
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169677 0000 NORTH ATLANTIC BCH
UNIT 1
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1785 BEACH AVE RESIDENTIAL
WINDOWS/DOORS 3 DOORS $950.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $55.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $27.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 2/23/2021
PERMIT NUMBER
RES21-0049
ISSUED: 2/23/2021
EXPIRES: 8/22/2021
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
TOTAL: $86.50
2 of 2Issued Date: 2/23/2021
PERMIT NUMBER
RES21-0049
ISSUED: 2/23/2021
EXPIRES: 8/22/2021
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
42'
1-/:
Updated 10/9/18BuildingPermitApplication
City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
t9~
IS REQUIRED.Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: f7 3 o c'ie• Permit Number: F G-J Z ' o 1 1
Legal Description 16-lel CR-25-290.25510 14444 &Q 3 OM;# Alin /d 38 RE# OM"6161
Valuation of Work(Replacement Cost)$ 993.00 Heated/Cooled SF Non-Heated/Cooled
Class of Work: ONew Addition Alteration Repair Move Demo OPool t Window/Door
Use of existing/proposed structure(s): Commercial Residential
If an existing structure,is a fire sprinkler system installed?: Yes LtK0
Will tree(s)be removed in association with proposed proiect? Yes(must submit separate Tree Removal Permit) B31(o
Describe in detail the type of work to be performed: ]Pep/ace 3 mare ex;s1-iit er•1er+or dear 1,3* 3 aew i Mpad.
z pered
P64 I kw- E oars.
Florida Product Approval# fL 15213.1. for multiple products use product approval form
Property Owner Information
Name 19A4& tI) Lte r//d Address MC &ad' de-
City hilisPc. 8ez A State fL Zip 32233 Phone 0Q00 66-7304
E-Mail L.,$/Jle 0 ke#sex* NA'
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company M •6•54,144‘ T"c'
Qualifying Agent I+/bel #66-
Address G6AddressEtit &Ax,ior ( ke A . City SurksottvdlL State Ft Zip 5ZZ4 _
Office Phone 000 31 -7053 Job Site Contact Number Moil) 231-7653
State Certification/Registration# C6C /26 3o/9 E-Mail Wei&cow+r+c-05akeo co»,
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation Insurer OR Exempt/Expiration Date Dy- 07- ZO2/
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
TOBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
RECO DING YO R NO - OF COMMENCEMENT.RECO
14/
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14 1di --'-r
Signature Owner or Agent) Signature of Contractor)
Si and sworn to(or affirmed)before m- his 0 day of Signed and sworn to(or affirmed)before me this day of
le n,
p, ' o'' • . -ic,'ICI'CAC. 4 a 't Ll \ by 1\k‘\- r.i. r
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gnatu •o :ot. ''
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Signature of'Notary)
I
MICHAEL LANGLEY
I
Personally Know R;,;nYp TONI GINDLESPERGER personally Known OR
Produced Identif :;fin, .: MY COMMISSION fE GG 353178
Produced Identification c MY COMMISSION
r
GG 292845
Type of Identificatio ••• ' ' Type of Identification: 'V( I ;;i'"5 t PIKES:January 21,2023EXPIRES:October 6,2023Sri;,^, P
oF F,°' Bonded Thru Notary Public Underwriters
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