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635 SELVA LAKES CIR RFNC21-0082 `;,y Building Permit Application �r Updated 10/9/18 v A City of Atlantic Beach Building Department (,C-1 (J C\ r, **ALL INFORMATION Vilir800 Seminole Road, Atlantic Beach, FL 32233 V ��. .c HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Email: Building-Dept@coab.us tJ`' � � IS REQUIRED. Job Address: 6 �.-(W/4M ( ' ?ó4Permit Number IF� I 1( C) z Legal Description Ti. G C1f zvJ tcciArt C E /d tri4e)RE# Valuation of Work(Replacement Cost)$ /700cam' Heated/Cooled SF Non-Heated/Cooled • • Class of Work: ❑New DAddition ❑Alteration ®Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial ?Residential • If an existing structure,is a fire sprinkler system installed?: ❑Yes .No \— • Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) �INo Describe in detail the type of work to be performed: '880 Ltd, k� re,tiCoe_ . Cec5eit �l r6,4c ic.) Florida Product Approval# for multiple products use product approval form Property Owner Information / ��/Y �� Name L >' //- L..&_1_76/,/,7-67J Address 635" ,rc'( City AYQW-Re_ M State r--?_A Zip 32233 Phone 9©Y �fF1-,-- za5 3 E-Mail r" (.J . `4 `) )4 too k, C C)c-c\ Owner or Agent(If Agent, Power of Attorney or •gency Letter Required)_` Contractor Information _9, .,O � th U 4 r(%0.,c1 -5 0-to-e-'i. /LC Name of Company Oult,`rtrcy p,,h Pnct), cki.. ',l? ,Q., Qualifying Agent ki Address \al 3 29 S (-- / City ,Dog1,6I.Ck State f 2-Zip 3 ( -) Office Phone 6 t -- 3i - 60 t S Job Site Contact Number 1a( -3 3 I - 6/ ' State Certificatidn/Registration# A E-Mail ]o�rn�j LS i. 5-t &g (nCi I . CO I7 • Architect Name&Phone# U ( J Engineer's Name&Phone# .J 41 . Workers Compensation Insurer l4 N. OR Exempt o 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 PRR9-E' '. I YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER O' A► A 'ORN :EFORE RECORDING YOU ' NOTICE OF COMMENCEMENT. 4/ i. /,i e.',.,;„;„ ..-_,__. Alleer or Agent) 4/1-11..."411/41,(Signature of Contractor) ' �`j Ali`-' e /40‘ �worn` .4.ffirmed)before me this 7 day of ed and sw•rn to(or affirmed)before me this 7 day of pa,x2., ?•6<'/ ,by i _ ■■ gli� ,2--11 -i • by (Signature of Notary) (Signature of Notary) :r.a•. rsona y Known : !!"•'!! ;;, MY COMMISSIONCHRIS all K wn OR [�duced Identification ;•: ft :•; #,au1r Id tification :';��r o; EXPIRES.A�r' ,?l?entifi ion: Type of Identification: .`: L Underwriters Building Permit Application ftwaiktOONI tilb.lvis City of Atlantic Reach Building Department .:.4Waltiaanararnina H1"aimartAnta to4 a*.s.* 800 Seminole Road, Atlantic Beach, EL 32233 ,--:.-f.'16101111010ittsi Phone: (904) 247-5826 Email. Building-DeRtioccolvA ,,,!,... .,:ift .z..44‹:„6-_<-4,;„10,v414). . , - __,.....' 700 f.x ...:.._,;i: •,-,,, .- v.000 MX of Wo**;Rtoi,},t..,,,,,,„z,,„,,)5.,,._/ 2r20 4f•ated/Cooted SF Non Heated/Coaled _.,._ • (-44,0f wo,q, , .rv,w : Adrioon „..,Attf..41 :- i ;•., ;,,, • Move : t3emo Poo; Ahndow/Doov • (Apo,existlap-,10,:000sed structu*NS 1.Xorrtrnercta, trke.,,,,tjertasit, , --1:::- • tf an ew., •, - ,i,•• . • - ' separate_ . , _ • i ..., ,.4 ProoLict APPrOi+a)St :. , ,,,.! ;, u'le oroduc' ,• - ProPe.I.Y.P.VICtill ,,../ , il .. _ -- Ar 4;474.7x& ,,,,, ,, , 1 ., i ', .:'1'''.- ,, — 4,,,;:::,-,-; ,„.,„, .4',i'.AK A.,,"m-7;. ,.f,,,„,.?!: r/..e!....: . , .... c,,,,,,:t.ivi,., -. --'0 ,.,..: --,-,7--,,, .-iz-----. 4.i:A r 5,, 4:33____, , ',<, , ... , - - _____ ._ „.,... . ..< . ,.. _. if Ageyirt Power of AttlY,Wy or Arent v icstir. Re(14.14Wi) 1 r contractor Infonnat ion S ‘,.a.et 0 riN Okx-) '-V\.)k,C f 5, L i,, c,...-- ti,vne 04 compar•- . •' ', • ••••- - 444, - ._. Ad.c...,-4Atet "91..14 tr,,. ---- . ... . ' 'r,U.-31a.vial.1.6.4...„ ,.-.' f ...-' .-- --,..1- --r 4;•': et_i_____ _ aff,ce Phone d31„.L.:,,, 31_,..a. 1 -:, ,..,. ,-,,. ,.1:, %,.--,...4” -4'•a i - 7....3 J._ - ps". statt, Certifica dRegistratior z _ . , ,. ' 111011- ----------- ArZnIeCt kagne&Phome J . ._ ... _....................._. Eng}neers Name&Phoni'P 1„.1 4 rkers Cornpensat,e- i •-., , • _.a,fts. ,_..., .._ OR exempt 6 rat;on Date Appikcatior s he,rrtr,made to obtain a germ t to do t,h. wo-k and instaqatons as irtdicated f ter! t ',hat no work or Instal latfan has torn-nented prio,to the issance of a perma and that,,,ti work witt be performed to meet the standards of at the laws regulating construction in thls,uriSd4ChOri, f lart.Cte,l,tand 041 a separ.ite permit trust be secured for t L/C-IRK:At WORK,PLUMBING, SIGNS, WELLS,POOLS FURNACES,801/EPS.I-teAlERS"TANKS,aft d AIR CONDITION/RS,etc NOTICE- In additen to the requirementS Of thts Mem*.tthe inaV b*adddiOrfal rest-trawls arsOitaWe to ti d prObelty that MO be found ici tne pkiti;tt foccitch of trns,coo-city,ad theft may b,e eakkt,,,Gmai permrts required from other governmnentat entittes such as water management Ori.tr,cts,state egenciec. or feoetag agetities 00,01K$.AF-FIDAvcr s,(4-ft,ty ri,at aS tht foregoing rib ?: .' - -,'1_:.er4te ant:'' ,1 ,.,WO,. ,'... tit.(10,74ti'"rf CCIFIVI>drIC,e W1'.' •acIp cit,'*' .,..!,-.. . :-..1rx,•-•,-(,.:, .I?' vt,o, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCENikr •I',, RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER r I. y• ,.11- , ie TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER Or ANATTORNEY' ; : OR . t . , . . i RECO: •ING YOUR NOTICE OF COMMENCEMENT. . 1, ....- , A...) .4 4 4 ,, ,,, ....,. I ), —IW ' -7-- -7-#4, ' 7.--7---- ---,' •t i'' S'Inatate c4.: •• f of...,,ento ------' - t - ir # - -.. , ;,4,91, a , ,,- r ANIP,,,ffirmed)boo,*ff.„. :: , cloy of , ii.ii;ed and .w rte toor Air. ed .,,tote rn4, ' .. a V of L'e.-- ' -24;:-(•--bY.41•11, 1 Li -4-1-7(:, , 4".. ..: t...... ...2-ekv.. bv • -. , s:, II" ....k.efl snatuie of Ncwi1,y1 Kt -^- rN""ereNeN,4,,,,,,Nes„ev,,..„.v -"rronZlv iotiiirr,7ft 1 '''''''''" t . CHFUSTWOOVolit- • , i( to,tt,ON ...-<4>i<ixat ktentificitul ! .4" .4' '• I"C°11"*SSICf4 49411" !-t'IK al' '''".A.' , ':04164 : - ';4 4 ''.''': i--- , • ,,I identifitatson t L p L , , pawls: iota„;,..g.! soo , •. , .,, .-'=""*. Fence Addendum Updated 1/14/2021 I' , ; City of Atlantic Beach Building Department 'Mrs' 800 Seminole Road, Atlantic Beach, FL 32233 9%- PERMIT# Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: Date: Property Type: Lot Type/ Features: \�B \ ` Residential k7 One Street frontage (interior lot) ❑ Commercial 0 More than one street frontage(corner lot,through lot, etc.) 0 Swimming Pool N FenceFMaterial: Fence Height (select all that apply): b[I Wood N 0 Four Foot(4ft) O Chain Link PlJ Six Foot(6ft) O Vinyl ❑ Other ❑ Block/Stone(Plan details required for footings and/or retaining walls) ❑ Other Fence Location: Please submit an accurate and current boundary survey showing all existing improvements(including building footprint, driveway,swimming pool, etc.) and location of fence/wall and any gates. Plan details required for block wall footings and/or retaining walls and any portion or fencing above 6ft in height. Will the fence be built in an easement? ❑ Yes (must submit separate Revocable Encroachment Agreement) No Will tree(s) be removed in association with proposed project? ❑ Yes (must submit separate Tree Removal Permit) \\41 No Conditions of Approval: • Roll off container company must be on City approved list. Roll off container cannot be placed on City right-of-way. • All old fencing and debris must be removed from job site by contractor or homeowner. 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. „- - , ALA SHOG 130 U AP I)AR 17 S 1 r IP v-pv 0 LOT az SIZVA LAA ' uNrr TWO ACCO.RDLVG TO 77L7 PLAT THEREOF AS RECORD-0 IN PLAT Boor 44 PAGFS I1,11A AND 114 OF TET CUR. RE2VT 447.123.11C CO27,747 OF nriVAI COryTry .., ,..o.i. 1 . cr r 11 .1.,N. W.n. • C.:CA.1+4 scAti 9r.:4LE la'•Z). 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