2359 Seminole Rd RES21-0145 ShuttersOWNER:ADDRESS:CITY:STATE:ZIP:
JACOBSON SAMUEL S 2359 SEMINOLE RD ATLANTIC BEACH FL 32233-5971
COMPANY:ADDRESS:CITY:STATE:ZIP:
CUSTOM STORM
SHUTTERS DIRECT 826 HULL RD ORMOND BEACH FL 32174
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
168349 0000 SECTION LAND
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
2359 SEMINOLE ROAD RESIDENTIAL ALTERATION
RESIDENTIAL SHUTTERS $14878.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $125.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $62.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.81
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $192.31
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: 4/30/2021
PERMIT NUMBER
RES21-0145
ISSUED: 4/30/2021
EXPIRES: 10/27/2021
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 4/30/2021
PERMIT NUMBER
RES21-0145
ISSUED: 4/30/2021
EXPIRES: 10/27/2021
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $192.31
RES21-0145 Address: 2359 SEMINOLE ROAD APN: 168349 0000 $192.31
BUILDING $125.00
BUILDING PERMIT 455-0000-322-1000 0 $125.00
BUILDING PLAN REVIEW $62.50
BUILDING PLAN CHECK 455-0000-322-1001 0 $62.50
STATE SURCHARGES $4.81
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.81
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R15677 $192.31
Printed: Friday, April 30, 2021 3:09 PM
Date Paid: Friday, April 30, 2021
Paid By: CUSTOM STORM SHUTTERS DIRECT
Pay Method: CREDIT CARD 450308319
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R15677
asacanis5@gmail.com
RES21-0145
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