2247 Beachcomber Tr RES21-0163 New Window, Water Damage Repairs ii.,r RESIDENTIAL PERMIT PERMIT NUMBER
JSr ! ,J'�
CITY OF ATLANTIC BEACH
RES21-0163
800 SEMINOLE ROAD
ISSUED: 5/25/2021
' 0:li>r ATLANTIC BEACH. FL 32233 EXPIRES: 11/21/2021
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:
2247 BEACHCOMBER TR RESIDENTIAL NEW WINDOW AND WATER $2000.00
WINDOWS/DOORS DAMAGE REPAIRS
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169463 0164 OCEANWALK UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
JONATHAN DAVID SMITH 66 WEST 14TH STREET ATLANTIC BEACH FL 32233
INC.
OWNER: ADDRESS: CITY: ! STATE: ZIP:
BURGIN CHRISTOPHER C 1857 BEACH AVE ATLANTIC BEACH FL 32233
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.
1 BUILDING IN-PROGRESS INSPECTION REQUIRED INFORMATIONAL
Notes:
IN-PROGRESS INSPECTIONS ARE REQUIRED FOR EXTERIOR SIDING,WINDOW,AND DOOR INSPECTIONS,AND SHOULD BE SCHEDULED FOR THE FIRST DAY
OF WORK,
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 565.00
Issued Date:5/25/2021 1 of 2
r '-'1")r RESIDENTIAL PERMIT PERMIT NUMBER
'1CITY OF ATLANTIC BEACH RES21-0163
x' ISSUED: 5/25/2021
Ji3„',' 800 SEMINOLE ROAD EXPIRES: 11/21/2021
ATLANTIC BEACH, FL 32233
BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$101.50
Issued Date:5/25/2021 2 of 2
:e „, Building Permit Applicati -on COP'
li
_ __ City of Atlantic Beach Building Department gi7''
REVIEWED
800 Seminole Road, Atlantic Beach, FL 3223 By Mike Jones at 4:51 pm, May 24, 2021
Phone: (904) 247-5826 Email:
Job Address: j.1.-il i- 6C"11tgeolktit t: -0:41L- ACI-141.4" 6414, fL 3L3)93ermit Number:
,�(3 e 5z/( "C% i ' 3
V Legal Descript'onLi f e4---21';',29e--- c 1� 3?: RE#/� !/ 3` 6/4'9
.C°('•1� 1)4-, c
valuation o`f r(k7-06--r-
ement Cost)$ 4.-- 6)476.) Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration DRepair ❑Move LIDemo ❑Pool Window/Door
• Use of existing/proposed structure(s): ❑Commercial XResidential REVIEWED FOR CODE COMPLIANCE
5.24.2021
• If an existing structure, is a fire sprinkler system installed?: Lilies ho
• Will tree(s)be removed in association with proposed project? LlYes(must submit separat ifree Rem val Permit) o
Describe in detail the type of work to be performed: ;,r etce 4-&,... c., pQ,,,, �,}'� LU',, ow
evb bt.h.%ic.itk.)
Florida Product Apprval# // /y 0 / 7-,P / /for multiple products use product approval form
Property Owner Information
Name GI ei-ktbM - C - &aid Address 244n b 4le1Myi/21411, fluviiL kiteri1 f1. 32233
City {}'114.11- - 6‘.1-4i _State (L. Zip 321-3'> Phone d2D1- 1-fir I'd/a)
E-Mail CebtA-41-4tt4 I Ca KG • 0'1
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) _
Contractor Information _ _ I /
Name of Company ca.c. r., ., o, V. J n( Qualifyin , :.�Ag
T, . �Ct ,rel•T_
Address &-t .•., IA-) /-/_ City /4,,,� c 11 State I( ?Ip .32.23
Office Phone Ye,/-76_2-7= Job Site Contact Number fo' -2I 2 .5
State Certification/Registration If (27 //G 2. C'"( E-Mail `S.-". --i (r )0.,, .(,L.,, A., 1,,,, kr, '.,-i
Architect Name&Phone#
J
Engineer's Name&Phone# t�Workers Compensation Insurer 5 T �--� /?) plc- J� 1n5. ��, OR Exempt❑ Expiration Date / /j22-
A lication is herebymade to obtain apermit dot work and installat•1bns as indicated. I certify thatnor or ih
pp � e ty wo K o starvation nay
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 FINANCING, CONSULT WITH YOUR LENDER OR . • ir • 'EY ELi
RECORDING O NOfICEUF COMMENCEMENT. 1 ,
(Si ature of Owe or ent) (Signature of Contractor)
Sued an swornttoq(or affirr�tcsi�hefor• a this y of j -• and sworn to7(or aft rm•dh1 j bet. day 91
- 6 • ' rwig
(Signature of Notary _t - j ' ignIli'•
I 46' JQMATMAM 0 Paw
1 , war-,ovelic•stet.d nre+ ) +:. TONI GINDLESPER�..
[ I Personally Known OR i '4 ^ tom.nue..6G UN.N i I Personally Known I • : "': •:
*,c.mm 14"."1"3'Sou MY COMMISSION#GG 333178
t I Produced Identification II [ I Produced Identifica •"it:,� :�` PiRES:October62023
Type of Identification: Type of Identification: "•Eo • - .,,