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1323 Linkside Dr FNCE17-0042 Submittal S1,A,vrJCity of Atlantic Beach APPLICATION NUMBER f s� � Building Department .:,t� (To be assigned by the Building Department.) j Atlantic8tla SeminolecRoad F( � t 17-` /�4 a �r Beach, Florida 32233-5445 L —+� Phone(904)247-5826 • Fax(904)247-5845 rji !)%' E-mail: building-dept@coab.us Date routed: ;- City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 3 73 L jti Ks(36. D ,-, Department review required Yes No Building Applicant: 1: FZ MST kC, /0Cl F-E-�;.� CA. Planning &Zonin. free Administrator Project: FC.,- 0 O.-C-- fu Works P` ublic Utiliti Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ❑Denied. ['Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING �,�.,_ Reviewed b . /� Date: 17 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 litILLfrie ,I �� City of Atlantic Beach APPLICATION NUMBER Building Department rECEIv ) ,) (To be assigned by the Building Department.) � .` 800 Seminole Road :- �' jAtlantic Beach, Florida 32233-544 '' r��Phone (904)247-5826 • Fax(904)1.7- 2 201] '�—_�~!J;; E-mail: building-dept@coab.us 0_04 a Date routed: 7/Z(rJ City web-site: http://www.coab.us BY:__ / 7 APPLICATION REVIEW AND TRACKING FORM Property Address: 13 L,,,.-, Ks iii)F D ,Z. Department review required Yes No (Buildin Applicant: 172)- R_MS-Cleo /or, Fe:1.-3 cC, ,Planning & Zonin Tree Administrator Project: rcQac---: ublic Work Public Utilitie Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: r4Approved. Denied. ❑Not applicable (Circle one.) Comments: i4IG 41/4 441 4j 4$ BUILDING PLANNING &ZONING ��f / Reviewed by;J�14/7"/d4%,? Date: e TREE ADMIN. Second Review: A roved as revised. ❑ pp nDenied. nNot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 JZ :_ _ f: -Tx 4 J° to +' 'i MI r • ¢. '+�• .. ._ • • • • • • • • k. b4.11,•;.,°` • . ` 4 ,.yet'�.n°\`i -,�.'1. 3 ° . • :=--- F� 1c 454; 0.1 .. t . rte N\ City of Atlantic Beach APPLICATION NUMBER Building Department :_ ,�, (To r «� be assigned by the Building Department.) - 800 Seminole Road , ee: A '0 Atlantic Beach, Florida 32233-5445 * r(� ( 7 _ 0C-4t/ Phone(904)247-5826 • Fax(904)247- 5 JUL 2 R 2017 / 1 Date routed: 7/Z(rJ 17 �o;t �� E-mail: building-dept@coab.us 11 City web-site: http://www.coab.us BY. APPLICATION REVIEW AND TRACKING FORM Property Address: 1 3 z-3 L 1 ti joe ,Z.. Department review required Yes No (uildin Applicant: R MST 2O 0() FE (Planning &Zonin -'.."11-'be Administrator Project: �,�.� .�- ublic Work Public Utilities Public Safety Fire Services Review fee $ I?' Dept Signature 'y, Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. ['Denied. [Not applicable (Circle one.) Comments: BUILDING ir� PLANNING & ZONING ,/ ;/�` _ Reviewed by: � Date: pc 1 i TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. ❑Not applicable WORK Comments: :LIC UTILITIES PUBLIC SAFETYY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER ys prlo, Building Department (To be assigned by the Building Department.) , , � 800 Seminolec Road �� Atlantic Beach, Florida 32233-5445 F��CZ I Phone(904)247-5826 • Fax(904)247-5845 / / Date routed: �/ Z G' �? E-mail: building-dept@coab.us ` 66 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 3Z3 L, Ks co& ( iZ cps_partment review required Ye No Building.) ley Applicant: H) R eersT iO 0(1 �� (f fanning &Zoninc j ren dministrator Project: FE ubfic Works ublic Utilities Public Safety _ Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: IMApproved. ❑Denied. ['Not applicable (Circle one.) Comments: BUILDING PLANNING & ZONING • Reviewed by: `� Date: TREE ADMIN. Second Review: Approved as revised. ❑Denie Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. ['Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 OFFICE COPY rBuildin Permit Application City of Atlantic Beach 800 Seminole Road,Atlantic Beach, FL 32233 `'�' Phone: (904) 247-5826 Fax: (904) 247-5845 Job Address: l3„q 3 L-", f c d t Permit Number: Kr-.G I�—OCJ-->rZ, Legal Description RE# Valuation of Work(Replacement Cost)$ /6 7 Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one).01b Addition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercialsidential • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: kiN(1� nn 4 ,,f ag"6 e{J rw ' /f-.,4 ,(^thct, LJr 1— y 'w.d KlI u,. G,cft _ �C Florida Product Approval# for multiple products use product approval form Property Owner Information Name: C 1 a.Lk ci\r( ��D l t1(t f Address: /3 City 4-4( c._‘,4,c 737-(C4 State "r/ Zip T 2.1_�Z Phone cY Y- ?14 = 72-?( E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company: f170 h r 71 t-. c< ci O_ Qualifying Agent: 0(,,u Address - 2 Z c!, City J&c)•r opt/./(t State 1--L _ Zi23_ , Office Phone 90,-/ 3)76 - 13)3 Job Site/Contact Number 1- State Certification/Registration# E-Mail C� 1/41/ e )-r,, r.-,-o ti j— Architect Name& Phone# Engineer's Name&Phone# Workers Compensation _ Exempt/Insurer/Lease Employees/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 regulationg 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. 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 IMPROVEMENT e OUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LE ER OR £ N ATTORNEY BEFORE RECORDING YOUR NOTICE 0E_COMMENCEMEN . (S:nature of Oe' r or Agent including Contractor) (Signature of Contractor) igned and sworn to(or affirmed)before me this 2, day of Signed and sworn to(or affirmed)before me this z/ day of 7 )/ ' / ? by (-� .�, TL !kits �� l j ,A0(7 , by hcu 141'(1l"- 1. - ayyee•` 'LL �tt�� ` rt�L 45i:.•.t o �o a feta of Florida ' " g •=M Comm .i�wr aoa% Y Expires Oct 24,2018 fr°.-At`'S Notary Public-State of Florida Fno Cornrc cc,nn a rr 135580 ''+ "' ►'= My Comm.Expires Oct 24,2018 nnn�� Bonded rt. IrJ T., Illi t e: Personally Kno r+-. • 0 a` Assn. [ personally Known R ?t off' Commission dTh Through # FF 136580 NotaryA • Bonded Through National Assn. [ ]Produced Identification [ ]Produced Identific Type of Identification: Type of Identification: It MAP SHOWING BOUNDARY SURVEY OF LOT 73 BLOCK - AS SHOWN ON MAP OF SEL V•9 L/1.k 5/!JE L/iV/T / AS RECORDED IN PLAT BOOK .___44 _ PAGES 42A OF THE CURRENT vUE3(IC 4EC.ORDS OF DUVAL CO FLA FOR• CE,VTEX ,47/(165 Co3 POF7A770M NOTE BEARINGS SHOWN HEREON ARE BASED ON THE ABOVE MENTIONED PLAT ,NOTE:ELEYAT/DAIS Ape sgaicm ri,,,,s:0,-.5z) 4/./0 ReFe.<7 ro ilie,2770A,4L :;=on:;T;: ;r-irz.,'A: DA:[,H C'f,'J09 P4R7 OF -EC17,0A/ /7, TOKGVS,47P ,? Sefie/;/, ,S9i:IA):' .P a 0 - , 4'S7EEL fe,✓rF Il; 1.83'42:/0'- 50.00 ---• — — L`ASEMPO Ev7 P DPAi,vNGc. RECEIVED I _ II' LIT/L/T✓E.5 AND SE-e"�,p5 / irrgCP/ Ca✓cRirE Frti ti --L--.77.5. 7y '' t7�`4re.Z Cita l999 .wooD BETA/N/,/i WALL , mi. :�S Cara ` "� _.__._.. _. y of yn,� E BuNdtng Atl c Beach s`'„,o a>ic�IDntng • c Lti \ �, �Oe..: .:.,::. ... I. • pP, pt, to` ,rc t : `9/ ( •?9' F CO p 230' ° `� v 9.0', . =J It l.. 1.11 !Li � tp -sroRy s7�cco L. ti: f,c,2. h.‘•ti ed-.4.r,a rDWELLIM6 . o��-�33.;:\ ti TQ7..:\i'4 L. a.9' N \IWIL >\ DT- • . �• A Q Q N .74 ri 4.1 _ _ 3 9 w h14,4 4 L 5' .a .� 5 � ,I t. 4a-,zv ° q It 2 P of°17215°- 4a.,,,,, C c,0 NO‘C' ''':S( ( ii 1, kt i 11 if /A.//r' A ,/�s/,04,-- 0 -322 j -4.¢L is, 'ie�� ‘...77:::, .9 Si E, f of p ,` at/,90. . r� do '',. Misr 7 7 F/ 4 -yak Vey- 9-/3.95 wort sir. ''r'.cuT_i)T.r, , .<f.:,..,...-:_..9... .:,,.f,.', ---- - I HEREBY CERTIFY THAT THIS SURVEY PERFORMED UNDER Mr HESI-„ NSIRLt r>RR1t '—..NrJ�✓ TECHNICAL STANDARDS FOR LAND SURVEYORS IN ACCORDANCE WITH.'IIAP' H,, "JH •,M. '” 'ri % .:.JIM LEGEND (PURSUANT TO SECTION 472.027.FLORIDA STATUTES,.AND FUN(MEN:;ERIK•I,IA,I, IAA '' SI♦•Rn ,t•,.,I?( MENTS UPON THE SUBJECT PROPERTY EXCEPT ASHFHF ANF N, „SID(t t nut,,A:-H • CONCRETE1UNIRON 1.1 FLOOD SHOWN ON THIS SIIRVf.Y • r,7 FOUND,ROM _`OOD CERTIFICATE: THE LOT SHOWN HEREON IS IN FLU'JI 0 I.7 !ET IRON L! I7w ZONE -X. AS SHOWN ON THE FLOOD INSURANCE NPI, CLARSON •r.t,ASSOCIATES, INC. !•` CENTRAL MOLE l,oN LOU MAP. COMMUNITY PANEL No 120075. OOO/0 CENTRAL ANDRE DATED f./7 e1 IONS NALDD AVE JACRlONV1LLE FIA J770, 'V AADIU6 • •AC DISTANCE SURVEYED HA Y /2 19 95 C1. CNOAD DUTANCE SCALEn //, O GO, _- .. •/_-ieel •t POr1.r O,rANOEMCr . :\'f NI1. , 1..1.•;. �4. IAC //VV// ,..k.se 4 I.�/ •011.1 OF RE COMPOUND CLAVE G,.. /L L •C C •011.1 Or COMPOUND CURVE PM A •nn✓ «.. __ -